: Skin illnesses, such as acne vulgaris, have psychological effects for those who suffer from them, causing sense of guilt, shame, and social withdrawal. The onset of acne vulgaris throughout puberty renders this condition a main point of concerns for many people since teenagers are psychologically extremely disturbed. The current study aims to measure the effects of acne on female secondary school students in Al-Najaf City. An observational case-control design has been conducted in secondary schools at Al-Najaf city starting from 1st of November 2021 to 3rd of July 2022. The sample was acquired using a non-probability purposive sample of 200 female students with acne and 200 female students without acne, which was developed by the researcher using a self-administrative questionnaire to meet the study's aims. The questionnaire's validity and reliability were assessed by experts and cronbach's alpha, respectively, while the respondents employed the questionnaire as a self-report technique. According to the findings of the study, female students with acne have a significantly lower level of self-esteem than female students without acne. The study has concluded that the case group have low self-esteem level as compare control group because they are girls in this age group and are attending college focusing on self-centered and force of personality, it is normal for them to have sentiments of low self because they have been withdrawn, get less connections with others, and have a lowered body self-image, even if they have poor self..