Topical Antibiotics
Topical antibiotics work by killing the Propionibacterium acnes bacteria. This not only helps reduce the small infections in the pores but also indirectly keeps the pores open. Topical antibiotics have been around for a while without many changes to the formulations; here’s a brief summary of each. All topical antibiotics must be prescribed by a healthcare provider.
Clindamycin
Clindamycin is the most frequently used topical antibiotic for acne, and it’s available as a solution, lotion, or gel at 1% strength. It’s applied twice a day to all acne prone areas. Clindamycin is generally well tolerated but may cause some irritation. It should not be used by people with regional enteritis, ulcerative colitis, or a history of antibiotic-induced colitis
Erythromycin
Erythromycin is the second most commonly used topical antibiotic used for acne, available as a solution, gel, and ointment at 2% strength. It’s applied twice a day to all acne prone areas. Like clindamycin, it’s generally well tolerated but may cause some irritation. Erythromycin is safe for use by pregnant women.
Tetracycline
Tetracycline is not used very often as a topical treatment, but it is available as an ointment and solution at different strengths. Tetracycline contains sodium bisulfite, a sulfa derivative that can cause allergic reactions. It may also cause yellowing of the skin.
Metronidazole
Metronidazole is used frequently for acne caused by rosacea and is available as a gel at 0.75%. It’s applied one or twice per day and is generally well tolerated but can cause irritation.
