Topical Erythromycin for Acne

Erythromycin, an antibiotic, reduces acne-causing bacteria when applied to skin

Erythromycin, in its topical form (applied to skin), is used to treat inflammatory acne. It cannot cure acne, but can help you keep it under control.

If you need to use topical erythromycin, you can choose between erythromycin lotions, gels, ointments, toner-like solutions, and pledgets (small pads soaked in the medicated solution, similar to a Stridex pad). It is typically used in combination with other medications.

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

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How Erythromycin Helps Acne

A proliferation of acne-causing bacteria within the pore is a factor in acne development. Propionibacterium acnes is the chief culprit.

Antibiotics like erythromycin reduce the amount of acne-causing bacteria. Topical erythromycin specifically can also help decrease redness and inflammation.

When Topical Erythromycin Is Used for Acne

Topical erythromycin isn't the first treatment choice for acne. It actually 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, antibiotic resistance is a big issue with topical antibiotics and erythromycin for acne, in particular. The bacterium that causes acne has become used to the medication, rendering it ineffective as time goes on.

In some cases, though, erythromycin is the best treatment choice. This may be the case 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 certain topical retinoids.

Can I Use Erythromycin With Other Products?

Usually, there isn't a risk of interactions when using erythromycin along with other topical treatments. However, if you're being treated with Retin-A (tretinoin), you should not use erythromycin because it can cause severe skin irritation.


Let your healthcare provider know about other medications and over-the-counter topical products you may be using before getting a prescription for erythromycin.

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 erythromycin. Keep using your second acne medication, though, to continue improving breakouts and keep your acne under control.

Dosage

This topical antibiotic is usually prescribed as an ointment, gel, topical solution, or medicated pad with a strength of 2% erythromycin. Your healthcare provider will likely direct you to spread it on the affected area twice a day (morning and night), but individual recommendations may vary.

Possible Side Effects

Most people can use topical erythromycin without any problems at all. When using erythromycin for acne, side effects, though, may occur.

These are similar to other acne treatments:

  • Mild irritation
  • Burning
  • Stinging
  • Redness
  • Dry skin

If side effects are bothering you, or if you develop a rash, let your dermatologist know.

Likewise, tell your healthcare provider know if the medication is not working or if acne comes back after clearing up.

Frequently Asked Questions

  • How long does it take for erythromycin to clear up acne?

    You should expect to use erythromycin or a similar antibiotic treatment for three to four months. You may see improvements in your acne before then, but continue applying the medication as directed. In cases of severe acne, you may need to use the antibiotic for more than four months.

  • How often should I use erythromycin for acne?

    Apply erythromycin topical treatments twice a day for 12 weeks or as long as your doctor recommends.

6 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. McLaughlin J, Watterson S, Layton AM, Bjourson AJ, Barnard E, McDowell A. Propionibacterium acnes and acne vulgaris: new insights from the integration of population genetic, multi-omic, biochemical and host-microbe studies. Microorganisms. 2019;7(5):128. doi:10.3390%2Fmicroorganisms7050128

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

  3. 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

  4. St. Luke's. Benzoyl peroxide and erythromycin topical.

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

  6. American Academy of Dermatology Association. How Long Can I Take an Antibiotic to Treat Acne?

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.

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