Acne vulgaris is a common dermatological condition affecting individuals across all ages, particularly adolescents and young adults. The pathogenesis of acne is complex, involving genetic, hormonal, microbial, and inflammatory factors. This review comprehensively addresses current and emerging management strategies for acne, emphasizing both topical and systemic treatments, procedural therapies, and dietary modifications. **Topical Treatments:** - **Retinoids:** Retinoids, such as tretinoin, adapalene, and tazarotene, are effective in reducing acne lesions through comedolytic and anti-inflammatory effects. They bind to retinoic acid receptors, influencing gene transcription and reducing sebum production. - **Benzoyl Peroxide:** A widely used antimicrobial treatment, benzoyl peroxide disrupts the cell walls of *Cutibacterium acnes* bacteria and exhibits mild comedolytic and anti-inflammatory properties. - **Antibiotics:** Topical antibiotics, including clindamycin, erythromycin, and minocycline, offer both anti-inflammatory and antibacterial effects, particularly for inflammatory lesions. - **Azelaic Acid:** Effective for mild to moderate inflammatory and non-inflammatory acne, azelaic acid functions as a comedolytic, antimicrobial, anti-inflammatory, and antioxidant agent. - **Salicylic Acid:** A beta-hydroxy compound that acts as a comedolytic, keratolytic, and mild anti-inflammatory agent, suitable for mild acne. - **Dapsone:** A sulfone medication with antimicrobial, anti-inflammatory, and immunomodulatory actions, useful for specific patient groups. - **Sulfur and Sodium Sulfacetamide:** Combined use offers complementary antibacterial and keratolytic properties, effective for mild to moderate acne. - **Clascoterone:** The first topical antiandrogen, clascoterone competitively inhibits dihydrotestosterone binding to androgen receptors, reducing sebum production and inflammation. **Systemic Treatments:** - **Oral Antibiotics:** Tetracyclines, doxycycline, and minocycline are effective for moderate to severe inflammatory acne, reducing bacteria and inflammation. - **Hormonal Therapies:** Combined oral contraceptives (COCs) and antiandrogens like spironolactone are used for women, targeting androgen production and activity. - **Oral Retinoids:** Isotretinoin and acitretin are highly effective for severe cases, preventing keratin formation and reducing inflammation. **Procedural Therapies:** - **Laser Devices:** Laser technologies, including photodynamic therapy (PDT), LED, and IPL, offer viable options for reducing acne symptoms and scarring. - **Chemical Peels:** Chemical peels can improve skin texture and reduce acne lesions. - **Intralesional Injections:** Intralesional steroid injections can helpAcne vulgaris is a common dermatological condition affecting individuals across all ages, particularly adolescents and young adults. The pathogenesis of acne is complex, involving genetic, hormonal, microbial, and inflammatory factors. This review comprehensively addresses current and emerging management strategies for acne, emphasizing both topical and systemic treatments, procedural therapies, and dietary modifications. **Topical Treatments:** - **Retinoids:** Retinoids, such as tretinoin, adapalene, and tazarotene, are effective in reducing acne lesions through comedolytic and anti-inflammatory effects. They bind to retinoic acid receptors, influencing gene transcription and reducing sebum production. - **Benzoyl Peroxide:** A widely used antimicrobial treatment, benzoyl peroxide disrupts the cell walls of *Cutibacterium acnes* bacteria and exhibits mild comedolytic and anti-inflammatory properties. - **Antibiotics:** Topical antibiotics, including clindamycin, erythromycin, and minocycline, offer both anti-inflammatory and antibacterial effects, particularly for inflammatory lesions. - **Azelaic Acid:** Effective for mild to moderate inflammatory and non-inflammatory acne, azelaic acid functions as a comedolytic, antimicrobial, anti-inflammatory, and antioxidant agent. - **Salicylic Acid:** A beta-hydroxy compound that acts as a comedolytic, keratolytic, and mild anti-inflammatory agent, suitable for mild acne. - **Dapsone:** A sulfone medication with antimicrobial, anti-inflammatory, and immunomodulatory actions, useful for specific patient groups. - **Sulfur and Sodium Sulfacetamide:** Combined use offers complementary antibacterial and keratolytic properties, effective for mild to moderate acne. - **Clascoterone:** The first topical antiandrogen, clascoterone competitively inhibits dihydrotestosterone binding to androgen receptors, reducing sebum production and inflammation. **Systemic Treatments:** - **Oral Antibiotics:** Tetracyclines, doxycycline, and minocycline are effective for moderate to severe inflammatory acne, reducing bacteria and inflammation. - **Hormonal Therapies:** Combined oral contraceptives (COCs) and antiandrogens like spironolactone are used for women, targeting androgen production and activity. - **Oral Retinoids:** Isotretinoin and acitretin are highly effective for severe cases, preventing keratin formation and reducing inflammation. **Procedural Therapies:** - **Laser Devices:** Laser technologies, including photodynamic therapy (PDT), LED, and IPL, offer viable options for reducing acne symptoms and scarring. - **Chemical Peels:** Chemical peels can improve skin texture and reduce acne lesions. - **Intralesional Injections:** Intralesional steroid injections can help