Ultrasound-assisted wearable patches for transdermal drug delivery

Wearable ultrasound patches represent a new class of transdermal drug delivery systems, offering a minimally invasive, programmable, and user-friendly platform for personalized therapy and precision medicine. Here, we review recent advances in ultrasound-assisted transdermal drug delivery (UATDD) with an emphasis on acoustic mechanisms and device engineering. We describe the recent evolution of UATDD from early high-energy sonophoresis to sophisticated, skin-conformal platforms that exploit advanced acoustic modalities for precise, on-demand delivery. Key innovations include bulk-wave, surface acoustic wave, and acoustic vortex-based devices, alongside the synergistic integration of ultrasound with microneedles, which transforms the patch into a localized, in situ therapeutic platform. Looking forward, UATDD systems are poised to evolve toward fully autonomous, closed-loop wearable theranostic platforms that integrate real-time biosensing with artificial intelligence (AI)-driven adaptive control, but challenges remain, including long-term biocompatibility, efficient wireless power management, and clear regulatory pathways. We believe UATDD patches hold significant potential to redefine disease management, shifting the paradigm from intermittent treatment to continuous, adaptive, and autonomous care.