Acne vulgaris is an extremely common dermatologic condition. Individuals with acne present not only to dermatologists, but also to internists, family medicine physicians, pediatricians, estheticians, and beauty counters alike in search of a treatment. The diagnosis of acne is relatively straightforward, leading many to believe that acne is a simple condition. However, the pathophysiology of acne is anything but simple. Decades of research has ultimately revealed a complex interaction of pathogenic factors that lead to acne. This includes sebum production, C. acnes colonization, inflammation, and follicular hyperkeratinization. Understanding each of these features has been fundamental to the development of anti-acne medications. Topical agents are often used as an initial therapy given their safety and efficacy. While some topical therapies have been used for decades, new creams, gels, and lotions continue to be added to the list of approved acne treatments. Given the number of topical acne products on the market, we present an updated review of the current landscape of topical acne treatments and how each choice functions mechanistically to fight against acne. J Drugs Dermatol. 2024;23:10(Suppl 1):s4-11.
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