Beyond the Breakouts: Exploring the Pathophysiology and Integrating the Clinical Insights, Phytotherapeutics, Therapeutic Advances and Future Directions for Acne Management

Acne vulgaris is a common chronic inflammatory skin disease, characterized by increased sebum production, follicular hyperkeratinization, dysbiosis of Cutibacterium acnes and inflammation. Common therapies such as topical retinoids, benzoyl peroxide, antibiotics and hormonal therapies are widely used, but adverse effects, antibiotic resistance and recurrence remain major challenges. This review highlights the therapeutic potential of medicinal plants as adjunctive modalities in acne management such as Glycyrrhiza glabra (licorice), Camellia sinensis (green tea) etc. These ingredients contain bioactive phytoconstituents that have potential anti-inflammatory and antioxidant activity. Green tea may also help to regulate sebum, and licorice may help to reduce skin pigmentation associated with inflammation. Other medicinal plants such as Azadirachta indica, Aloe vera, Curcuma longa and Melaleuca alternifolia have also been discussed for their possible antimicrobial, soothing and anti-inflammatory effects. In addition, the review describes new methods for drug delivery such as liposomes, nano emulsions, solid lipid nanoparticles and nanostructured lipid carriers that can revolutionize drug stability, follicular delivery, skin retention and controlled release. Available clinical evidence suggests potential benefits of some herbal and conventional therapies, although strong clinical evidence of licorice and green tea use in the acne treatment is still missing. Future research should be directed toward standardization of extracts, optimization of formulations, safety evaluation, and controlled clinical trials to determine therapeutic efficacy and long-term benefits. To summarize, evidence-based herbal research along with modern drug delivery technologies may provide promising complementary approaches for improved management of acne.