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Topical Antibiotics Treatments for Acne
This article was Medically reviewed by
Several topical antibiotics are used as a common treatment for cystic acne. Topical antibiotics prevent the growth of acne bacteria like P. acne
s and decrease inflammatory response.The most commonly prescribed topical antibiotics are erythromycin and clindamycin. However, most topical antibiotics are prescribed in combination with benzoyl peroxide or topical retinoids due to the potential for the development of bacterial resistance in long-term use.
Common topical antibiotics like erythromycin and clindamycin are one of the
chosen options for the treatment and management of acne. These topical antibiotics are available in several kinds of delivery vehicles and many sorts of packaging. Clindamycin and erythromycin have both shown effectiveness in cases of inflammatory cystic acne when used as a topical application of a combination of 1% to 4% concentrations with or without being combined with zinc. .
Topical clarithromycin, azithromycin, and nadifloxacin formulations continue to be available, but there are no validated clinical trials or research studies that clearly show their efficiency or safety.
How Do Topical Antibiotics Work?
Topical antibiotics used in the treatment of cystic acne act within the affected follicle through an anti-inflammatory and antibacterial activity. These drugs work best when they are utilized together with benzoyl peroxide (either wash-off or leave-on versions) that heightens their efficiency and reduces the potential development of resistant strains of acne bacteria. Only using topical antibiotics for the treatment and management of cystic acne is mostly not recommended due to the possibility of developing antibiotic resistance.
Topical antibiotics used in the treatment of cystic acne act within the affected follicle through an anti-inflammatory and antibacterial activity. These drugs work best when they are utilized together with benzoyl peroxide (either wash-off or leave-on versions) that heightens their efficiency and reduces the potential development of resistant strains of acne bacteria. Only using topical antibiotics for the treatment and management of cystic acne is mostly not recommended due to the possibility of developing antibiotic resistance.
Combination formulations are known to improve the compliance of the patient in using the prescribed treatment protocols. There have been a few rare incidents of side effects with diarrhea or Clostridium difficile associated colitis following the use of topical clindamycin for the treatment of severe acne in some patients, but since these cases are quite rare, the potential risk of this side effect with the use of such topical combination formulations is quite low. In general, most people show a good degree of tolerance towards these combination antibiotic treatments for acne.
Topical antibiotics seem to be more suited to the treatment and management of mild and moderate acne. Even though their effectiveness continues to be average, they have been used for many years now. The efficiency of topical antibiotics used for treating acne has been examined in many research studies and clinical trials. Both antibiotics erythromycin and clindamycin have been shown to be moderately effective with patients showing a good degree of tolerance. However, there is a trend for decreasing sensitivity of the acne-causing bacteria P. acnes to these two antibiotics, which may limit the use of these antibiotics in the future.
Side Effects of Topical Antibiotics
Erythromycin and clindamycin continue to be commonly prescribed in the last decades. Nowadays, they continued to be frequently prescribed mainly because the side effects which they produce are almost nonexistent or minor. The most significant side effects experienced when using topical antibiotics for the long-term treatment and management of severe acne include the following:
- Erythema, peeling of the skin, itchiness, drying and a burning sensation.
- The incidence of pseudomembranous colitis. This is rare side effect, however, some people using topical clindamycin experience it.
- Development of bacterial resistance as well as cross-resistance. This may be a result of long-term use of topical antibiotics. This is why it is recommended that topical acne antibiotics are used in combination with other treatments.
Estimated costs for commonly available products containing topical antibiotics:
- Approximate cost of 1 tube of erythromycin gel: $10 to $125 (GoodRx_Erythromycin).
- Approximate cost of 1 tube of clindamycin gel: $20 to $110 (GoodRx_Clindamycin).
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