Information is limited on the management of truncal acne vulgaris. Survey results suggest that most dermatologists commonly prescribe oral antibiotic therapy when treating acne involving the chest and back. This article reports therapeutic outcomes based on an investigator-blinded, randomized, 10-week observational trial completed in patients presenting with moderate or severe truncal acne vulgaris. One group received treatment with benzoyl peroxide (BP) 9% cleanser daily, clindamycin 1% foam daily, and doxycycline 100 mg twice daily. The other group received BP cleanser 9% daily and doxycycline 100 mg twice daily without clindamycin 1% foam. Baseline, week 6, and week 10 evaluations were completed. Efficacy parameters included inflammatory and total lesion count reduction, and investigator global assessment. Global evaluations of treatment response were recorded and skin tolerability was also evaluated. This trial was designed to capture observational experience reflective of treatment of patients with truncal acne in a private practice dermatology setting.