A 20-year-old gentleman had acne for a few years and was being treated with herbal medicine. In the past month he has complained that his acne was gradually getting worse, with the formation of “boils”. He was prescribed oral doxycycline and topical clindamycin but no improvement was seen after 3 weeks. There were no systemic symptoms, such as fever or arthralgia. Aside from the acne, he enjoyed good health. On examination, there were multiple papules, pustules, inflammatory nodules and abscesses on his face. There were necrotic and scabbed lesions over his mandible. Comedones were also seen in focal areas.