Topical Antibiotics for Acne

Pros, Cons, and When They're Considered

Since acne is, in part, caused by bacteria, topical antibiotics (meaning, those that get applied to the skin) are one way to treat acne. Topical antibiotics are typically used mild to moderately severe inflammatory acne.

Medications like clindamycin and erythromycin are most commonly used for this purpose. Topical tetracycline is another option, but it's prescribed less often because it has the tendency to turn the skin yellow. These come in a variety of forms, including lotions, gels, pads (pledgets), and toner-like solutions.

A woman putting cream on her face
 kate_sept2004 / Getty Images

How Topical Antibiotics Work to Treat Acne

Antibiotics—oral and topical—inhibit the growth of bacteria. Propionibacteria acnes, or P. acnes, is a chief cause of acne.

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 the bacteria, 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 Aren't Used as the Sole Acne Treatment

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 healthcare providers 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.

Using an Additional Acne Treatment Helps Topical Antibiotics Work Better

Typically, your healthcare provider 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 works 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.

Combination Acne Medications Give You a Two-In-One Treatment

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:

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

Possible Side Effects

Most people can use topical antibiotics without difficulty, but some people may experience side effects. These aren't usually too bothersome.

Possible side effects depend on the type of medication you're using. Sometimes, the medication can burn or sting slightly when it's applied. Other side effects may include:

  • Dryness
  • Flakiness
  • Minor skin peeling
  • Mild skin irritation

Serious side effects from topical antibiotics are very rare.

A Word From Verywell

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.

Frequently Asked Questions

  • Can topical antibiotics make acne worse?

    Antibiotic use has been linked to an overgrowth of yeast; a fungal infection on the skin could make it appear that your acne has gotten worse. It's also possible that you may not see any improvement in your acne if it is caused by a

    drug-resistant strain of P. acnes.

  • How long does it take for topical clindamycin to work for acne?

    It takes anywhere from four to six weeks of clindamycin use to see a noticeable improvement in your acne.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kraft J, Freiman A. Management of acneCMAJ. 2011;183(7):E430–E435. doi:10.1503/cmaj.090374

  2. Eady AE, Cove JH, Layton AM. Is Antibiotic Resistance in Cutaneous Propionibacteria Clinically Relevant? American Journal of Clinical Dermatology. 2003;4(12):813-831. doi:10.2165/00128071-200304120-00002

  3. Lazic Mosler E, Leitner C, Gouda MA, Carter B, Layton AM, KhalafAllah MT. Topical antibiotics for acne. Cochrane Database Syst Rev. 2018;2018(1):CD012263. Published 2018 Jan 23. doi:10.1002/14651858.CD012263.pub2

  4. Kaur J, Sehgal VK, Gupta AK, Singh SP. A comparative study to evaluate the efficacy and safety of combination topical preparations in acne vulgaris. Int J Appl Basic Med Res. 2015;5(2):106-110. doi:10.4103/2229-516X.157155

Additional Reading

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.