Background: Acne vulgaris is a multifactorial disease with significant clinical and psychosocial impacts. Methods: The purpose of this study was to evaluate the efficacy of a combination therapy including oral isotretinoin and a non-ablative 675 nm red-light laser compared with laser monotherapy. Thirteen young patients with active facial acne of varying severity were enrolled and divided into two groups: Seven subjects received laser monotherapy treatment (RT group), while six underwent combined laser and isotretinoin therapy (RTI group). The laser protocol consisted of six weekly sessions, with a 5-point pain scale used to monitor tolerability. Standardized photographs were obtained at baseline and at a 3-month follow-up after the last treatment. Each patient completed the Acne Radar Questionnaire, and lesion severity was assessed using the Global Evaluation Acne (GEA) scale. Results: All patients completed the study without adverse events. Scores from the Acne Radar Questionnaire improved in both groups, while the GEA scale demonstrated a significant reduction in lesion severity, confirmed by photographic comparison. Pain was reported as mild in most cases, and no discontinuations occurred. Conclusions: These findings indicate that the 675 nm laser is a safe and effective therapeutic option for acne vulgaris, with isotretinoin addition resulting in more rapid and pronounced clinical improvement.