Atypical sensory processing occurs commonly in individuals with Autism Spectrum Disorder (ASD) and may impact the care these patients receive for skin conditions like acne vulgaris. This is a retrospective cohort study of acne-specific medication and outpatient utilization and costs from MarketScanª database (2015)(2016)(2017) for continuously enrolled 11 to 18-year-old patients. People with acne were identified based on at least one instance of ICD-9/ICD-10 code (706.1/L70.0), then assigned to a cohort with ASD based on at least one instance of ICD-9/ICD-10 code (299, F84) or the cohort without ASD based on random selection of age and sex at a 10:1 ratio. Medication claims were based on NDC codes recorded at acne-specific visits and were controlled for age and sex. Outpatient utilization excluded ED and urgent care claims. Overall, 4,269 patients with acne and ASD and 42,690 patients with acne alone were identified.ASD patients received topical antimicrobials more often (25.06% vs 21.89%, p<0.0001) and had a higher mean 3-year cost per patient ($588.48 vs. $460.39, p<0.0001). ASD patients were prescribed topical retinoids less frequently (32.68% vs. 34.53%, p¼0.02) with a greater mean 3-year cost per person ($888.68 vs. $814.74, p<0.0001). Oral antibiotics were used less frequently for ASD patients (18.74% vs. 20.35%, p¼0.02) with a higher mean cost ($257.41 vs. $176.29, p<0.0001). Both spironolactone (0.51% vs. 1.58%, p<0.0001) and isotretinoin (8.27% vs. 11.27%, p<0.0001) were prescribed less often to ASD patients. For ASD patients, the odds of claims for topical retinoids (OR¼ 1.088, p¼0.0139), spironolactone (OR¼2.659, p<0.0001), and isotretinoin (OR¼1.351, p<0.001) were higher when age was controlled. Likewise, the odds of claims for topical retinoids (OR¼1.089, p¼0.0143), oral antibiotics (OR¼1.116, p¼0.0089), and isotretinoin (OR¼1.697, p<0.0001) were higher when adjusted for age and sex. Analysis of outpatient claims is underway and will investigate utilization differences. This study demonstrates important differences in utilization and costs for acne patients with ASD.