An overview of etiology and pathogenesis of acne vulgaris is presented and the issues of topical therapy with lincosamide antibiotics (in particular, clindamycin) are discussed. The authors present the data evaluating the efficacy and tolerability of topical clindamycin solution (Zerkalin) as monotherapy and in combination treatment of acne of different severity degrees. The study included 45 patients (29 women and 16 men) aged 16 to 33 years diagnosed with acne vulgaris of mild to moderate severity. The absolute hyperandrogenism was found in three of 29 women; they were prescribed proper therapy. A group of 12 patients was analyzed separately; they were prescribed clindamycin solution (Zerkalin) as monotherapy for 1.5 months followed by subsequent systemic therapy with retinoids, as well as combination therapy with aknekutan capsules during the first 1.5 months. Results demonstrated the high clinical efficacy of topical treatment of acne with Zerkalin, which has a pronounced anti-inflammatory effect and helps to prevent new lesions. The drug is recommended for use as monotherapy or in combination with anti-androgens in patients with mild to moderate severity of acne.