Background: Acne vulgaris is a skin condition that often occurs in adolescents and is influenced by both internal and external factors, including digital behavior. TikTok is a popular social media platform with the potential to influence acne severity by engaging in various contents and causing psychosocial stress. Aim: To determine the association of TikTok use duration and patterns with the severity of acne vulgaris in adolescents. Method: This cross-sectional, observational analytical study involved 20 adolescents aged 13-19 who actively use TikTok. Data were collected through a questionnaire to gather information on frequency of use, daily duration of use, predominant time of use, type of content consumed, and interest in self-medication. Acne severity was classified using Lehmann system. Data were analyzed using the Chi-Square and Fisher's Exact tests. Result: Significant association was observed between daily duration of use (p = 0.007), predominant time of use (p = 0.001), type of content (p = 0.01), and interest in self-medication (p = 0.017) with the severity of acne vulgaris. No significant association was found between frequency of access and acne severity (p = 0.496). Conclusion: TikTok usage patterns, particularly prolonged use, nighttime scrolling, and passive content consumption are associated with increased acne severity. Promoting responsible social media use is essential to prevent its negative impact on adolescent’s skin health.