Acne vulgaris (AV) is the most common and multifactorial skin disease in adolescents affecting the pilosebaceous unit that involves hormonal imbalance, increased sebum production, and bacterial colonization, which causes both physical and psychological disorders. Cutibacterium acnes is considered one of the key contributing factors even though many Cutibacterium acnes colonies are on healthy skin. Cutibacterium acnes induces lipogenesis and production of sebum. Through its production of porphyrins, it may act as a catalytic agent in squalene oxidation that is comedogenic, thus aggravating comedogenesis. We review the dual role of Cutibacterium acnes to provide an understanding of the pathophysiology of acne vulgaris.