Introduction: The balance between intestinal microbiota and skin is essential for health, including acne prevention and understanding these interactions is role for developing targeted acne therapies. Objective: This literature review aims to elucidate the interconnection between the intestinal microbiome and health, focusing on the etiology and intensity of acne, and examining modifications in intestinal microbiota and their effect on acne pathogenesis. Results and discussion: Intestinal dysbiosis, Western diet, Cutibacterium acnes, and microbiota-host interactions are key elements in acne pathogenesis, affecting sebum production and triggering inflammatory responses. The diet, especially the Western one, influences both intestinal microbiota and acne, highlighting the relationship between gastrointestinal and skin health. C. acnes plays a essential role in acne by stimulating sebum production and triggering inflammatory responses in the skin. Conclusion: Intestinal microbiome, skin microbiota, diet, dysbiosis, and C. acnes are key research areas for understanding and treating acne, emphasizing the importance of diet in skin health. Dietary interventions may benefit acne patients, leading to more effective and personalized therapeutic approaches.