Procedural Treatments as Adjuncts in the Management of Acne Vulgaris: A Narrative Review

BACKGROUND: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit and one of the most prevalent dermatological conditions globally. Its multifactorial pathogenesis and variable clinical presentation necessitate a multimodal therapeutic approach. While pharmacological interventions remain first-line therapy, cosmetic and dermatologic procedures are increasingly utilized as adjunctive strategies to enhance clinical outcomes. This narrative review synthesizes current evidence on four commonly employed cosmetic modalities in acne management: chemical peels, mechanical peels, light-based therapies, and radiofrequency-assisted microneedling. AIM: The aim of this study is to evaluate the role of procedural treatments as adjunctive options in the management of acne vulgaris. METHODS: A literature search was performed in PubMed, Web of Science, and Scopus with no time restrictions, focusing on patients with acne vulgaris and adjunct cosmetic/procedural interventions. RESULTS: Given the narrative scope, this was a non-comprehensive, non-exhaustive evidence synthesis, with treatment options organized thematically. Overall, these cosmetic procedures can provide meaningful adjunctive benefits when integrated into individualized acne treatment plans. However, variability in study designs, procedural parameters, and outcome measures limits direct comparison across modalities. Further high-quality randomized controlled trials are necessary to establish standardized protocols and to determine long-term safety and efficacy. CONCLUSIONS: Procedural treatments can serve as valuable adjuncts in the management of acne vulgaris by enhancing therapeutic outcomes and addressing treatment-resistant cases. However, individualized treatment selection and further high-quality studies are needed to optimize their use and long-term benefits.