A Comprehensive Review of Acne: Pathogenesis, Etiology, Treatment Approaches, and Recent Developments

Introduction: Acne vulgaris is a prevalent chronic inflammatory condition of the pi-losebaceous units, primarily affecting adolescents. It arises from a multifactorial interplay of ge-netic, hormonal, microbial, and environmental factors. Besides physical manifestations, acne sig-nificantly impacts mental health, contributing to anxiety, depression, and low self-esteem. Con-ventional therapies are often limited by poor skin penetration, drug resistance, and undesirable side effects, highlighting the need for more effective treatment approaches. Methods: A systematic literature review was conducted according to PRISMA guidelines. Arti-cles published between 2013 and 2023 were retrieved from PubMed, Scopus, and Web of Science using keywords such as “acne pathogenesis,” “acne treatment,” “nanocarriers,” and “drug deliv-ery systems.” After duplicate removal and screening of titles and abstracts, relevant full-text ar-ticles were analyzed. Additionally, ongoing clinical trials and patents were reviewed to under-stand current and emerging therapeutic strategies. Results: Acne development involves four core factors: increased sebum production, follicular hyperkeratinization, Cutibacterium acnes colonization, and inflammation. Nanocarrier-based sys-tems–liposomes, niosomes, ethosomes, SLNs, NLCs, transfersomes, and nanoemulsions have demonstrated improved drug delivery in acne treatment. These systems enhance dermal penetra-tion, control drug release, improve bioavailability, and reduce side effects. Discussion: Nanocarrier systems address critical limitations of conventional acne therapies, of-fering improved efficacy and patient adherence. However, issues like high production costs, for-mulation complexity, and limited long-term safety data remain. Continued preclinical and clinical research is essential. Conclusion: Nanomedicine offers a promising future for acne management by enhancing drug delivery and minimizing side effects. With further innovation and validation, these systems may revolutionize dermatological treatment practices.