Background The psychological factors associated with the impairment of the quality of life (QoL) in acne vulgaris have not been fully elucidated, yet. The aim of the present study was to evaluate the performance of the difficulties in emotion regulation (DER) in predicting the QoL of patients with acne vulgaris and to examine the relationship between acne vulgaris and common psychopathologies, such as anxiety and depression. Methods A total of 141 patients were administered the difficulties in emotion regulation scale (DERS-Brief Form) (DERS-16), Hospital Anxiety and Depression Scale (HADS), and Acne Quality of Life (AQOL) Scale, while the control group including 102 participants was administered all scales other than the AQOL. Results The patients with acne vulgaris had significantly higher DERS scores than the control group. DER were found to predict quality of life more than acne severity. A strong positive correlation was found between the DERS and anxiety and depressive symptoms. There was no significant correlation between the acne severity and HADS and DERS scores, although only a weak correlation was found with the AQOL scores. The duration of acne showed no correlation with any of the variables. Conclusions Our study results showed the relationship between the DER and acne vulgaris. The ignorance of this relationship while evaluating patients with acne may result in anxiety and depression symptoms and impairment in the QoL in the future. Hence, psychopathologies should be considered in acne treatment and patients should gain the ability of regulating their emotions through appropriate therapeutic approaches.