Comprehensive review on current pharmacotherapy strategies for acne vulgaris: Evidence-based insights and emerging treatments

Acne vulgaris is a commonest chronological inflammatory disease of the pilosebaceous unit, which is predominant among teenagers and young adults all over the world. This will be a thorough review of the existing pharmacotherapy treatments of acnes vulgaris with highlight to its evidence-based understanding and new modalities of treatment. Traditional treatment, incorporating topical retinoids, benzoyl peroxide, antibiotics, hormonal agents and systemic retinoids, such as isotretinoin, continue to be the mainstay of treatment. Nevertheless, problems related to antibiotic resistance, side effects and drug compliance have led to the creation of new therapeutics. The latest developments are a focus on the use of topical and systemic agents that address individual pathogenic processes, including: sebum production, colonization of Cutibacterium acnes, inflammation, and follicular hyper keratinization. New formulations like fixed-dose combinations, retinoid analogs (trifarotene), selective androgen receptor modulators, probiotics and photodynamic therapies have demonstrated good outcomes. Moreover, biologic agents which inhibit inflammatory pathways such as interleukin and toll-like receptor modulators are a possible paradigm shift in management of refractory acne. The combination of personalized medicine and pharmacogenomics is likely to maximize the effectiveness of the therapeutic process and reduce the number of adverse effects. The review brings together the existing clinical evidence to help dermatologists make evidence-based decisions and points to the new therapies that are transforming the treatment of acne. Further studies and extensive randomization and controlled trials are needed to determine long-term safety and effectiveness of these new interventions, thus improving patient-centered dermatology.