Walk through the aisles of your local pharmacy, and you’ll notice an array of over-the-counter antibiotics in the form of creams, salves, and ointments (think bacitracin and polysporin).
However, just because you can freely purchase these products and apply themad libitumdoesn’t mean that they work well. Furthermore, the improper use of topical antibiotics can pose a public health hazard in the form of increased antibiotic resistance. Overall, topical antibiotics have very few appropriate (evidence-based) uses.
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Acne
When used to treat acne, topical antibiotics shouldn’t be used as sole treatment (monotherapy) for more than 3 months.
Mild to moderate acne can be treated withtopical antibioticslike clindamycin, erythromycin, and mincycline in addition to benzoyl peroxide. When used in combination. benzoyl peroxide and topical antibiotics reduce the risk that resistant strains ofPropionibacterium acnes(P. acnes)will emerge.Of note, P. acnes is a slow-growing, gram-positive bacteria that contribute to the development of acne.
Clindamycin is probably more effective than erythromycin when treating acne long-term. Furthermore, clindamycin has been linked to decreases in the number of blackheads (comedones and microcomedones) typical of acne. In addition to being combined with benzoyl peroxide, clindamycin can also be combined with tretinoin for the treatment of acne.
Some topical antibiotics not only fight bacterial infection but also reduce swelling.
Wounds
The decision whether to use topical antibiotics for wound care should best be left to your physician. Ultimately, topical antibiotics probably help only a small subset of patients with wounds like those who are immunocompromised or have diabetes. Moreover, with most minor surgical wounds — wounds created during an aseptic procedure like skin biopsy — topical antibiotics are probably unneeded.
Impetigo
In conclusion, topical antibiotics have very limited medical uses. At best, when you purchase topical antibiotics for self-treatment, you’re likely wasting your money. At worst, you’re contributing to antibiotic resistance andskin allergy.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Goossens A, Gonçalo M.Contact allergy to topical drugs.Contact Dermatitis. 2021:1019-1055. doi:10.1007/978-3-030-36335-2_38
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