Acne Vulgaris: An Evidence-Based Review of Current and Emerging Therapies

Abstract

Acne Vulgaris offers an in-depth analysis of acne vulgaris, addressing its underlying pathophysiology, clinical presentation, and available treatment modalities, with particular emphasis on both conventional pharmacologic therapies and emerging natural alternatives. Acne vulgaris is a widespread, chronic inflammatory disorder of the pilosebaceous units, predominantly affecting adolescents and young adults. Its complex etiology involves excess sebum production, follicular hyperkeratinization, proliferation of Cutibacterium acnes, and subsequent immune-driven inflammation. Additionally, genetic, hormonal, dietary, and environmental factors play significant roles in disease progression and persistence. The review examines standard therapeutic options—including topical retinoids, benzoyl peroxide, antibiotics, hormonal treatments, and systemic isotretinoin—detailing their mechanisms, efficacy, and associated limitations. It also explores the growing interest in natural remedies such as turmeric, aloe vera, tea tree oil, honey, calendula, neem, witch hazel, and spearmint. These plant-derived agents exhibit antimicrobial, anti-inflammatory, and antioxidant effects that may support acne management. Although conventional treatments remain the cornerstone for moderate to severe forms of acne, natural therapies present promising adjuncts or alternatives, especially for mild cases. Adopting a personalized, evidence-based treatment strategy that integrates both pharmacologic and natural approaches may enhance clinical outcomes, minimize adverse effects, and improve long-term skin health and patient adherence.