Using topical antibiotics for acne is a widely accepted and safe protocol for treatment of moderate to severe acne that is localized or not too widespread. They work by killing the p. acnes bacteria thus reducing inflammation. They show little effect on non-inflammatory acne-- e.g., those whiteheads and blackheads that are not infected.
The current medical consensus is to use them together with other anti-acne agents as they induce bacterial resistance and tend to act slowly. Their side effects are usually minor and negligible.
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Clindamycin
- Clindamycin is a semi-synthetic antibiotic with a long history of being used successfully against acne
- It works by preventing bacteria from producing proteins essential to their growth
- In topical form, it has proved to be generally safe and well-tolerated
- Available as a gel, solution, or lotion at 1% concentration
- Marketed as Cleocin T®, Clinda-Derm®, Evoclin®, and Dalacin T®
- Combined with benzoyl peroxide in BenzaClin® and Clindoxyl®
Erythromycin
- Erythromycin is comparable to clindamycin in treating inflammatory acne
- Available as a gel, solution, gel, or ointment at 2% concentration
- Generally well-tolerated but may cause skin irritation, burning, redness, or itching
- Marketed as Emgel®, Erygel®
- Combined with benzoyl peroxide in Benzamycin®
Tetracycline
- Tetracycline is less effective than topical clindamycin or erythromycin
- Available as an ointment and solution at different strengths
- Marketed as Achromycin®, Topicycline®
- Generally well-tolerated but may cause yellowing of the skin, which can be easily removed with soap and water
When the infected acne lesions are too numerous and widespread, topical antibiotics would not be sufficient to control the infection and oral antibiotics for severe acne would be required instead.