Drug development continues to focus on the challenge of treating acne effectively and safely. Inflammation is a backdrop to the commonly cited elements of the pathophysiology of acne: Propionibacterium acnes proliferation, increased sebum production with an increase in circulating androgens, and faulty keratinization. As such, there is increased emphasis on targeting inflammation and its effects. Vehicle innovations are optimizing existing active drugs and creating opportunities to deliver new compounds to the skin. Recently approved sarecycline is the first new chemical entity approved for acne in several years. It might be followed in coming years by other new actives, including clascoterone and cannabidiol (CBD).