Topical Antimicrobials

For the treatment of mild to moderate inflammatory acne, topical antimicrobials (substances that eliminate or reduce microorganisms) are prescription medications that inhibit the growth of P. acnes, the bacteria responsible for acne.

Creams, Lotions, Gels and Foam

Topical antimicrobial acne medicines come as creams, lotions, gels, and foam. Your dermatologist will determine which form would be the most effective and comfortable for you based on your skin type and environment.

For instance, creams and lotions provide moisture and may be better for people with sensitive or dry skin. On the other hand, gels and solutions are mostly alcohol based and because of their drying power and may be better for people with oily skin or for those who live in hot, humid climates. A foam acne product can provide increased spreadability which is convenient for application to larger body areas.

Types of Topical Antimicrobials

Azelaic Acid

This prescription medication is used to treat mild to moderate inflammatory and non-inflammatory acne.
Azelaic acid is believed to clear acne by minimizing P. acnes, regulating abnormal skin cell shedding and reducing inflammation.
This acne medication has also been shown effective in treating the dark spots that develop in some acne patients with skin of color.
Easily tolerated by most people, azelaic acid can be safely used. Side effects can include skin dryness and lightening of the skin where applied.

Benzoyl Peroxide

Although benzoyl peroxide (BPO) does not reduce inflammation, it is included in the ingredients of several over-the-counter and prescription acne preparations because of its ability to kill P. acnes.
BPO is available over-the-counter but only in a mild formula. The prescription forms of benzoyl peroxide are available in a wide range of strengths. It is also available in several forms such as gels, lotions, cleansers, creams and washes.
Side effects include skin irritation and the possibility of bleaching your hair or fabrics that may come in contact with it. Some people may also have an allergic reaction to the medicine.

Clindamycin

With a long history of successful acne treatment, this semi-synthetic antibiotic works by reducing P. acnes and decreasing inflammation.
The topical form has proven safe and well tolerated. Possible side effects are skin dryness and irritation.
As with all antibiotics, it is important to use only as directed by your doctor to minimize the risk of developing bacterial resistance.
Learn about a clindamycin acne product.

Erythromycin

In the topical form, erythromycin is both an antimicrobial and an anti-inflammatory. It is effective against a broad spectrum of bacteria, including P. acnes.
The combination of the two antimicrobial agents, erythromycin and benzoyl peroxide, provides a powerful and proven anti-acne treatment.
Possible side effects are dry and or irritated skin. Remember to use only as directed by your doctor in order to avoid the potential development of bacterial resistance to the antibiotic.

Sodium Sulfacetamide

Effective in treating inflammatory acne, this topical antibiotic inhibits P. acnes and opens clogged pores.
Many of the medications containing sodium sulfacetamide include sulfur in their formulas. The smell and grittiness of the sulfur can be unpleasant. Newer products that contain sulfur have eliminated these drawbacks.

Temporary Side Effects

Sometimes, after the initial application of a topical antimicrobial medication, your skin can look worse before it gets better. It is not uncommon to experience stinging, burning, redness, peeling, scaling or skin discoloration. These side effects usually decrease or go away after the medicine is used for a period of time. Ask your dermatologist what to expect. If you suffer severe side effects you should contact your doctor immediately and together review the course of treatment.

Follow Directions

It is always important to follow your doctor's advice on how to apply the medicine and how often to use it. Overuse can lead to skin irritation and in some instances other side effects. In the case of antibiotics, improper use could lead to the development of bacterial resistance to the drug.

Acne Tip