Background: Acne formation can be controlled effectively but it heals slowly and has numerous interactions with neuropeptides. Once gone another one pops up. Sometimes it can be filled with pus. Its size varies and can cause anxiety, depression, stress and social withdrawal. The mechanism is hyper secretion of sebaceous glands. Introduction: Acne vulgaris is a condition when hair follicles are accumulated with oil, dead cells and bacteria from skin. It can lead to formation of blackhead, whitehead, oily skin, pimples and scarring eventually. Patients have raised sebum level and thus skin is more prone to acne formation; triggered by propionibacterium, genetics, environment and food. Most commonly occurring on the face, upper limb and trunk between teen to middle age. Sebum contains wax esters, cholesterol, and triglyceride. Objectives: · To extensively explain the etiology of acne vulgaris, hormonal, bacterial causes and UV light. · To write comprehensive review on treatment of AV conventional, topical, retinoid and antibiotics based treatment. · Write a comprehensive review on its complications and its management. Methodology: In this research article we have explained systematic review, as well as we have described the systematic literature review of Acne Vulgaris, We did a literature search using electronic bibliographic databases and Journals : such as ELSEVIER ,British Medical Journals ,MEDLINE (Ovid SP and PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CENTRAL), as well as annual meetings abstracts from inception till Oct 2024. The literature search has focused mainly on randomized clinical trials, Meta-analysis, phase II/III, and retrospective studies. Results and Conclusion: The review included 45 studies with a total of 12000 participants. Acne vulgaris affects 9% of the population worldwide, 85% are between 12-24 years. Characters such as age and sex may vary among different studies. Many papers demonstrate the effect of demographic factors. Reaching late teenage can decrease its prevalence, and eruption is higher in females compared to male. Topical retinoid and benzoyl per oxide were effective in reducing inflammatory and non-inflammatory lesions. For mild to moderate acne pharmacological treatment, chemical, antibiotic and photodynamic therapy are among most effective. Oral antibiotics while effective, have raised concerned about resistance. For moderate to severe, the most effective one is oral Isotretinoin and photodynamic treatment. Most of us already know too much about this topic. Its 8th commonest disease known globally. It has many treatments. It’s the cause of social withdrawal and depression. In this case it is important to know about the causes that shift non inflammatory to inflammatory ones. Dermatologists are trying their best in combination of multiple therapies to treat it successfully. Personalized treatment plans considering patient-specific factors, such as acne severity, patient preference and risk of adverse effects, are essential for optimal management.