Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle which is characterized by blackheads, papules, cysts, and pustules. Acne vulgaris predilection especially on the face, shoulders, upper arms, chest, and back. Acne vulgaris is a skin disease that is often found in adolescents, 85% of adolescents are affected with a certain severity, and most often appears at the age of 15-18 years old, both in men and women. This study was conducted to investigate the association between family history, stress, sleep quality, consumption of dairy products, and zinc levels on the severity of acne vulgaris. The analytical observational study using cross sectional design. The sample in this study were students of class XI IPS 1 SMA Methodist 1 Medan who suffered acne vulgaris as many as 31 people who met the inclusion criteria. The instruments used were family history questionnaire, PSS, PSQI, food consumption questionnaire, and laboratory examination of serum zinc levels. The results of the test using Kruskal wallis from this study, there is an association of family history with the severity of acne vulgaris (p = 0.006), while the factors of sleep quality and consumption of dairy products cannot affect the severity of acne vulgaris (p = 0.932), (p = 0.082) ). Similarly, stress did not have an association to the severity of acne vulgaris (p = 0.412), so also with zinc levels did not have an association (p = 0.788). There is a family history relationship on the severity of acne vulgaris, and there is no association between stress, sleep quality, and consumption of dairy products and zinc levels on the severity of acne vulgaris.