Topical Antibiotics for Acne

Topical antibiotics are sometimes used to treat acne. You're probably familiar with antibiotics; odds are that you've used them at some point in your life. They're used to treat bacterial infections.

Since acne is, in part, caused by bacteria, topical antibiotics (meaning, you apply them to the skin) are one way to get acne under control. Oral antibiotics are used to treat acne, too.

There are many different types of antibiotics. The ones used most often to treat acne topically are clindamycin and erythromycin. Topical tetracycline is sometimes used too, but less often because it has the tendency to turn the skin yellow.

Topical antibiotics are used to treat mild to moderately severe inflammatory acne. They come in a variety of forms, including lotions, gels, pads (pledgets) and toner-like solutions.

Just like oral antibiotics, topical antibiotics inhibit the growth of bacteria. A chief cause of acne is the proliferation of the acne-causing bacteria Propionibacteria acnes, or P. acnes.

This bacterium is an ordinary resident of the skin, but in those with acne the P. acnes population grows out of control. These bacteria irritate the skin's follicles, creating inflamed papules and pustules.

Applying a topical antibiotic reduces the amount of P. acnes, which in turn helps control acne. Topical antibiotics also reduce inflammation, so they work best for inflamed breakouts rather than non-inflamed blemishes or blackheads.

Topical antibiotics are not used on their own to treat acne, or at least they generally shouldn't be.

Antibiotic-resistant bacteria are becoming more of a problem. Using topical antibiotics alone to treat acne can contribute to this problem, creating acne that just won't respond to that type of antibiotic anymore. 

Some doctors believe that topical erythromycin isn't as effective in treating acne as it used to be precisely because of this reason. Luckily, using another acne treatment along with your topical antibiotic can help prevent this problem from happening.

Besides, topical antibiotics alone simply aren't the best way to treat acne. They work really slowly when compared to other topical acne treatments available. Who really wants to wait longer than they have to before seeing results?

Typically, your doctor will prescribe an additional acne treatment to be used along with topical antibiotics.

While antibiotics reduce bacteria and inflammation, they do nothing to reduce pore blockages and the formation of microcomedones (the tiny beginnings of a pimple under the skin). Pairing topical antibiotics with another acne medication ensures you're treating all causes of acne, not just bacteria, so your treatment regimen will be much more effective.

Benzoyl peroxide is a likely choice. It works well with topical antibiotics, and can help reduce the likelihood of developing antibiotic-resistant bacteria.

Topical retinoids are another option that work well with topical antibiotics. These rapidly exfoliate your skin, reducing the formation of comedones (blocked pores). 

Spironolactone or birth control pills aren't as commonly used, but they can be helpful in certain cases where hormonal fluctuations are contributing to acne breakouts. These can only be used by teen girls or adult women.

Your dermatologist will know which medications are the best fit for you.

There are some acne treatments available that combine topical antibiotics with another acne treatment in one medication. These combination acne medications aren't necessarily any more effective than using the medications separately. The benefit is they streamline your acne treatment routine. A drawback, though, is that they can be pricey compared to some other acne medications.

Some of available combination medications are:

• Benzamycin (erythromycin and benzoyl peroxide)
• Acanya, BenzaClin, Duac, and Onexton (clindamycin and benzoyl peroxide)
• Ziana (clindamycin and tretinoin)

Depending on your skin, one of these might be a good fit for you. Again, your dermatologist will help create the best treatment plan.

The possible side effects depend on the type of medication you're using, but most people can use topical antibiotics without difficulty. Side effects, when they do happen, aren't usually too bothersome. 

You might get some dryness, flakiness, or minor peeling of the skin. Your medication may burn or sting slightly when it's applied. Some topical antibiotic medications may cause some mild skin irritation.

Serious side effects from topical antibiotics are very rare.

If you have inflammatory acne, topical antibiotics may be a good addition to your acne treatment regimen. Remember, topical antibiotics work best when they're paired with another acne medication, like benzoyl peroxide or topical retinoids.

And even if topical antibiotics aren't the right choice for you, your dermatologist has plenty of treatment options to help clear your skin. So don't wait to make that appointment.

_Sources:

_{Andriessen A, Lynde CW.  "Antibiotic Resistance: Shifting the Paradigm in Topical Acne Treatment."  Journal of Drugs in Dermatology. 2014 Nov; 13(11):1358-64.}

_{"Clindamycin Topical." Medline Plus. 01 Aug 2010. U.S. Library of Medicine & National Institutes of Health.}

_{Hoover WD, Davis SA, Fleischer AB, Feldman SR.  "Topical Antibiotic Monotherapy Prescribing Practices in Acne Vulgaris." The Journal of Dermatological Treatment. 2014 Apr; 25(2):97-9.}