Recent advances in dermatological therapeutics highlight pivotal progress in gene therapy and vaccine development. The gene therapy beremagene geperpavec (B-VEC) has demonstrated substantial efficacy in epidermolysis bullosa, marking a first for topical gene-replacement therapies in rare skin conditions. Concurrently, immunotherapeutic strategies targeting acne-causing bacteria via vaccines are entering early clinical phases, reflecting a shift towards immune-regulatory approaches in managing inflammatory skin diseases. These innovations underline the expanded horizons of precision dermatology through genetic and immunological modalities.