Background: Increased sebum levels are triggering factors of acne vulgaris. No studies on sebum levels exist among acne patients in Africa. Aims/Methods: Cross-sectional study to determine facial sebum levels, acne lesions and red fluorescence among adolescents (n = 80) with acne vulgaris in Nigeria, who were interviewed and clinically examined. Results: Facial sebum levels were higher among adolescents with acne than among those without. There was a positive correlation between sebum levels and acne lesions in the U zone but not in the T zone. There was also a positive correlation between the size of red fluorescence and acne lesions and mean sebum levels. Both correlations were highly significant in the U zone but not in the T zone. Conclusion: Facial sebum levels are higher among black African acne patients. Sebum is responsible for facial red fluorescence. The U zone may serve as a more reliable site than the T zone for measurements of sebum levels in black African acne patients.