Objective The aim of this study was to find lipid profile and hormone levels in patients with severe acne vulgaris and to correlate lipid profile with hormone levels. Design and methods Prospective study was performed in the 60 patients of severe acne vulgaris. Lipid profile and serum testosterone, estrogen, and progesterone levels were measured in three consecutive menstrual cycles during luteal phase (19th to 21st day). Their results were compared with a group of 60 age-matched healthy controls. Results Total cholesterol (TC), LDL-C, testosterone, and progesterone levels were higher in patients. Estrogen and HDL-C levels were decreased in patients. Positive correlation was found between testosterone and TC and LDL-C. Estrogen levels were positively correlated with VLDL-C, triglyceride levels, and HDL-C and negatively correlated with TC and LDL-C. Conclusions These abnormalities must be considered in the pathogenesis of the disease and must be taken into account for the treatment of patients of acne.