Acne vulgaris is a prevalent inflammatory disorder of the pilosebaceous unit involving follicular hyperkeratinization, altered sebum production, Cutibacterium acnes proliferation, microbiome imbalance, and immune activation. Although antibiotics, retinoids, benzoyl peroxide, and keratolytic agents remain central to clinical management, their long-term use may be limited by irritation, recurrence, adherence issues, and increasing antimicrobial resistance. This narrative review critically evaluates the dermatological relevance of Melaleuca alternifolia tea tree essential oil (TTEO), Mentha piperita peppermint essential oil (PPEO), and polyhydroxy acids (PHAs), as well as their incorporation into biopolymeric delivery systems for acne-oriented topical applications. Following SANRA principles, evidence from clinical, preclinical, ex vivo, and in vitro studies was synthesized, with emphasis on antimicrobial activity, inflammatory modulation, keratolytic and barrier-supportive effects, formulation stability, and release behavior. TTEO shows the strongest clinical support among the reviewed natural bioactives, including reductions in lesion counts and acne severity when applied as conventional or nanoemulsion-based formulations. PPEO is mainly supported by experimental evidence, particularly antimicrobial activity against acne-associated microorganisms, anti-inflammatory potential, and menthol-related neurocutaneous effects, whereas acne-specific clinical validation remains limited. PHAs, particularly gluconolactone, are better supported for barrier improvement, hydration, tolerability, and seboregulation than for direct acne lesion reduction. Hydrogels, electrospun nanofibers, polymeric films, nanoencapsulation systems, and controlled-release platforms may improve local retention, protect volatile or irritation-prone compounds, and modulate active release at the skin surface. However, most biopolymeric platforms still rely on early-stage or indirect dermatological evidence. Overall, biopolymeric delivery systems offer a rational formulation strategy to improve the stability, tolerability, and localized action of selected acne-relevant bioactives, but their clinical translation requires standardized composition, reproducible fabrication, skin-relevant release assays, safety assessment, and controlled human studies.
Suárez-Pérez et al. (Wed,) studied this question.