A Comprehensive Review of Acne Treatments: Unpacking the Chemical Structures and Effective Bioactive Compounds

Acne vulgaris is a frequent skin disorder, affecting a large part of the population worldwide, and strongly influencing not only the physical but also the mental aspects of health. The choice of therapy for acne vulgaris is a very difficult one because the multifactorial causality of the disease and interindividual variability in response to treatment should be considered. This article aims to provide a comprehensive review of the drugs used in the treatment of acn\e vulgaris, along with their chemical structure.

A comprehensive search of relevant databases (PubMed, Google Scholar, Web of Science, and Scopus) was conducted using keywords such as "acne vulgaris", "chemical structure", "mode of action", and "structure-activity relationship". We reviewed articles published up to 2025. The authors reviewed articles that discussed the chemical structure and structure-activity relationships of drugs used in the treatment of acne vulgaris. In addition, articles on acne vulgaris pharmacotherapy were also reviewed.

In this review, all the current modalities for the management of acne vulgaris are presented and grouped according to their chemical nature, including topical applications and systemic administration. In this light, we go further into the mechanism of action of each treatment, its efficacy and safety, and possible side effects. New therapeutic agents targeting the skin microbiome, inflammation, and hormonal imbalance are also a focus. We finally propose one step for choosing an optimum therapy based on the subject's constitution, the severity of post-acne scarring, and associated comorbidities.

The present review would benefit general physicians in adapting their management to treat zits and pimples for the improvement of their patients, with particular importance given to the knowledge of the chemical structures of various drugs.