Latest advances have enabled possible novel methods to acne management owing to better understanding of the pathophysiology and immunological aspects. Biological antibodies targeting IL-1β, IL-17, IL-23, and TNFα could deliver novel tactics for treating severe acne and connected disorders.

Investigation into the microbiome may also provide understandings into possible future therapeutic options for acne. Biological antibodies targeting TGFβ, IL-6, MMP, IGF-1, and B cells may be a potential strategy for the prevention and treatment of this type of scar in the future.

To date, acne pathogenesis has implicated four major factors: androgen-dependent sebogenesis, hyperkeratinization of the infundibulum, Cutibacterium acnes (C. acnes) colonization, and inflammation. Successful targeted therapy for acne currently includes topical retinoids that normalize abnormal hyperkeratinization in the infundibulum and novel topical retinoids with anti-inflammatory properties. Topical benzoyl peroxide (BPO) is highly effective in reducing both sensitive and resistant strains of C. acnes and has some impact on hyperkeratinization in the infundibulum. Anti-androgens can regulate androgen metabolism, resulting in suppression of sebum excretion. 

There is robust evidence in acne guidelines to support the use of medications such as adapalene, BPO, antimicrobials, and isotretinoin.

Other optional treatments that have the potential to offer effective treatment in the future include TNFα, IL-17, IL-23, IL-1β, IL-1α, anti-androgen, IGF-1, and vitamin D analogues, Vitamin C, hydroquinone, azelaic acid, tranexamic acid, and chemical peeling. 

Future treatment for acne should hold approaches that target the main etiological factors of acne.