Background Acne vulgaris is the most common skin disease and can pose a substantial therapeutic challenge. Recently, several phototherapeutic modalities, most notably pulsed-dye laser (PDL) treatment, have been introduced, but the published results -albeit promising -are controversial. Objectives To assess the efficacy of an adjuvant PDL treatment when combined with a proven topical treatment [fixed-combination clindamycin 1%-benzoyl peroxide 5% hydrating gel (C โBPO)]. Methods Eighty patients (38 males and 42 females, mean ยฑ SD age 19AE7 ยฑ 5AE9 years) were randomized in a 1 : 2 ratio to receive C โBPO alone or in combination with PDL treatment (wavelength 585 nm, energy fluence 3 J cm )2 , pulse duration 0AE35 ms, spot size 7 mm). Patients were evaluated at baseline and at 2 and 4 weeks after initial treatment. The primary end points were the Investigator's Static Global Assessment (ISGA) score and lesion count; the secondary end point was the Dermatology Life Quality Index (DLQI). Results Both groups showed a significant improvement during observation [ISGA 27AE1% (C โBPO) and 24AE6% (C โBPO + laser), total lesion count 9AE2% and 9AE0%, inflammatory lesion count 36AE3% and 36AE9%, DLQI 54AE5% and 42AE5%], but there was no significant or otherwise appreciable difference between treatment modalities as far as the extent of improvement was concerned. Patients with more severe findings at baseline had a greater benefit from either therapy regimen. Conclusions Our findings do not support the concept of a substantial benefit of PDL treatment in acne vulgaris.