Acne vulgaris is a chronic inflammatory disease with a multifactorial pathogenesis, primarily affecting adolescents and an increasing number of adult patients. Recent research highlights the significant role of skin microbiota disturbances, especially dysbiosis characterized by the predominance of pathogenic Cutibacterium acnes phylotypes, in initiating and perpetuating the disease process. Traditional treatment methods, including prolonged antibiotic therapy, carry the risk of developing bacterial resistance and adverse alterations in the microbiome composition, which limit their efficacy and therapeutic safety. In response to these challenges, innovative therapeutic strategies based on microbiota modulation are being developed, particularly targeting quorum sensing interference and reducing biofilm formation by C. acnes. One promising therapy, with clinically confirmed effectiveness, is a biotechnological complex containing lysates of Camellia sinensis and Morinda citrifolia. The presented data emphasize the importance of a holistic approach to acne treatment that combines conventional therapies with modern microbiota modulation methods, which may represent the future of effective and safe management of this common skin disease.