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Acne Treatment With Topical Antibiotics

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Updated July 03, 2014

Acne is caused by the effects of hormones on the pilosebaceous unit, consisting of a hair follicle, sebaceous gland, and a hair. The follicle becomes obstructed and an overgrowth of a normal skin bacteria, Propionibacterium acnes, causes destruction of the lining of the follicle. This process allows follicular material to enter the dermis, causing an inflammatory response. For a more detailed description of this process, see What Causes Acne?

Acne Treatment With 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, so I'm giving only a brief summary of each. All topical antibiotics must be prescribed by a health care provider.

Acne Treatment With Clindamycin

  • The most frequently used topical antibiotic for acne
  • Available as a solution, lotion, or gel at 1% strength
  • Applied twice a day to all acne prone areas
  • Generally well tolerated but may cause some irritation
  • Should not be used by people with regional enteritis, ulcerative colitis, or a history of antibiotic-induced colitis

Acne Treatment With Erythromycin

  • Second most commonly used topical antibiotic used for acne
  • Available as a solution, gel, and ointment at 2% strength.
  • Applied twice a day to all acne prone areas
  • Generally well tolerated but may cause some irritation
  • Safe for use by pregnant women

Acne Treatment With Tetracycline

  • Not used very often as a topical treatment
  • Available as an ointment and solution at different strengths
  • Contains sodium bisulfite, a sulfa derivative, and can cause allergic reactions
  • May also cause yellowing of the skin

Acne Treatment With Metronidazole

  • Used frequently for acne caused by rosacea
  • Available as a gel at 0.75% strength
  • Applied once or twice a day
  • Generally well tolerated but can cause irritation
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