Topical Antibiotics for Acne

Treating Acne with Topical Antibiotics

Topical Antibiotic Cream
Photo: Christine Glade / Getty Images

You're probably familiar with antibiotics; odds are that you've used them at some point in your life.  They're used to treat any type of bacterial infection. 

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.

Here's How They Work

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 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.

Much more attention is paid to the fact of antibiotic resistance.  Using topical antibiotics alone to treat acne can contribute to this problem.

  Then you'll wind up with acne that just won't respond to that type of antibiotic anymore. 

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

Plus, topical antibiotics alone just 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?  

And while they 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).

Other Acne Treatments Help Topical Antibiotics Work Better

Typically, your doctor will also prescribe another acne treatment to be used along with topical antibiotics.  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). 

For adult women with hormonal acne, topical antibiotics might also be combined with oral medications like spironolactone or birth control pills.

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

Prescription Medications That Contain Topical Antibiotics

There are some acne treatments available that combine both topical antibiotics with another treatment medication.  Some of these combination medications are:

Benzamycin (erythromycin and benzoyl peroxide)

Acanya, BenzaClin, and Duac (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. 

Possible Side Effects of Topical Antibiotics

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.

Even if topical antibiotics aren't the right choice for you, your dermatologist has plenty of treatment options to help get your acne under control.  So, don't wait any longer.  Make that appointment today!

Next Steps:

More Topical Acne Medication Options

Do You Need a Prescription Acne Treatment?


Andriessen A, Lynde CW.  "Antibiotic Resistance: Shifting the Paradigm in Topical Acne Treatment."  J Drugs Dermatol.  2014 Nov; 13(11):1358-64.

"Clindamycin Topical."  Medline Plus.  01 Aug 2010. U.S. Library of Medicine & National Institutes of Health. 28 Dec 2015.

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.

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