Acne is an inflammatory disease of the pilo-sebaceous unit, which mainly affects young adolescents. The pathogenesis is multifactorial, as a combination of genetic predisposition, hormonal production, hyper-seborrhea, inflammation and overgrowth of C. acnes. Moreover, diet-induced hyperinsulinemia can lead to sebocyte stimulation, androgen production, and thus acne lesions. Pharmacological therapeutic approaches are varied and include topical and systemic antibiotics and, in severe cases, systemic retinoids, with several side-effects. However, increasing evidence has shown that adequate vitamin supplementation, use of probiotics, and proper nutrition with low carbohydrates and fats intake, can significantly contribute to the patient's clinical improvement. In this review, we describe the role of probiotics, vitamins, alimentation, antioxidants, UV exposure, and plants in acne disease.