Treating Acne With Topical Erythromycin

Erythromycin is a topical antibiotic that is used to treat inflammatory acne. It comes in many different forms, from lotions, gels, and ointments, to toner-like solutions and pledgets (small pads soaked in the medicated solution, similar to a Stridex pad).

You can only get topical erythromycin with a prescription. Oral erythromycin is also used to treat acne.

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How It Works

One factor of acne development is a proliferation of acne-causing bacteria within the pore. The Propionibacterium acnes is the chief culprit here. Antibiotics like erythromycin reduce the amount of acne-causing bacteria and infection. Topical erythromycin can also help decrease redness and inflammation.

Topical Erythromycin Isn't the First Treatment Choice

Topical erythromycin itself isn't the first treatment choice for acne. It isn't incredibly effective against acne, and there are plenty of other options that simply work better.

Topical erythromycin only targets one acne-causing factor: bacteria. There are other factors that are responsible for acne breakouts, like the abnormal shedding of skin cells and the development of pore blockages, that topical erythromycin just doesn't address.

More importantly, a big issue with topical antibiotics and erythromycin, in particular, is antibiotic resistance. The bacterium that causes acne has become used to the medication, so it no longer works against it.

In some cases, though, erythromycin is the best treatment choice. For pregnant and breastfeeding moms, for example. It is also prescribed to treat newborn baby acne and infantile acne if need be.

Getting the Best Results

If your dermatologist decides that topical erythromycin is needed to treat your acne, there are some steps that can be taken to help get the best possible results.

First, don't use erythromycin as the sole acne treatment. It works much better if it's paired with a second acne medication, like benzoyl peroxide or a topical retinoid.

Benzamycin is an acne treatment medication that combines topical erythromycin with benzoyl peroxide. This helps streamline your treatment routine, giving you the benefit of two acne-fighting ingredients in one.

Secondly, to help combat bacterial resistance you ideally will only use topical erythromycin for a short time. Once inflammation is improved, you can stop using the erythromycin. Keep using your second acne medication, though, to continue improving breakouts and keep your acne under control.

One drawback of topical erythromycin treatment is that it can stop working over time. For this, you can blame bacterial resistance. Let your dermatologist know if it isn’t working for you, or if acne comes back after clearing up.

Possible Side Effects

Most people can use topical erythromycin without any problems at all. If you do develop side effects, they're similar to other acne treatments: mild irritation, burning or stinging, redness, and dry skin. If side effects are bothering you, or if you develop a rash, let your dermatologist know.

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3 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. Dréno B. Bacteriological resistance in acne: A call to action. Eur J Dermatol. 2016;26(2):127-32. doi:10.1684/ejd.2015.2685

  2. Chien AL, Qi J, Rainer B, Sachs DL, Helfrich YR. Treatment of Acne in Pregnancy. J Am Board Fam Med. 2016;29(2):254-62. doi:10.3122/jabfm.2016.02.150165

  3. Zaenglein AL. Acne Vulgaris. N Engl J Med. 2018;379(14):1343-1352. doi:10.1056/NEJMcp1702493

Additional Reading
  • Bartlett KB, Davis SA, Feldman SR.  "Topical antimicrobial acne treatment tolerability: a meaningful factor in treatment adherence?"  2014 Sep;71(3):581-582.
  • Hoover WD, Davis SA, Fleischer AB, Feldman SR.  "Topical antibiotic monotherapy prescribing practices in acne vulgaris."  J Dermatolog Treat.  2014 Apr;25(2):97-9.
  • Kong YL, Tey HL.  "Treatment of acne vulgaris during pregnancy and lactation."  Drugs. 2013 Jun;73(8):779-87.
  • Serna-Tamayo C, Janniger CK, Micali G, Schwartz RA.  "Neonatal and infantile acne vulgaris: an update."  Cutis. 2014; 94(1):13-6.