Description Of The Condition
Acne is a multifactorial inflammatory skin disease affecting 70% to 90% of individuals from the age of 12 to 24 years . Although acne is classically a selflimiting disease of adolescence, evidence suggests it is occurring at earlier stages of puberty and is also lasting longer . It is currently considered a chronic disease . Persistent acne beyond teenage years is more common in women than men and may be associated with hormonal imbalances .
Acne is centred around the pilosebaceous unit . Therefore, acne is predominantly located in areas rich in sebaceous follicles, such as the face, back, and chest . It is a polymorphic disease that can present with open and closed comedones , inflammatory lesions , and subsequent atrophic or hypertrophic scars .
Clinical forms of acne, classified by the predominant type of lesions, include comedonal acne, papulopustular acne, and nodular or conglobate acne. For research purposes, lesions may be further categorised into inflamed and noninflamed , and the number of lesions per patient is counted and documented . Many clinical trials also capture global assessments including patient perspectives .
What If Standard Acne Treatments Dont Work
For severe acne that doesnt respond to standard treatment, there are other options:
- Isotretinoin. This oral retinoid can shrink the size of oil glands.
- Hormone therapy. Some women have acne due to excess androgen . They may also have irregular periods and thinning hair. Low-dose estrogen and progesterone may help.
- Low-glycemic diet. Some studies have found a link between acne and sugar intake. Cutting back on sugar can help with other inflammatory skin diseases, too, says Dr. Kassouf. Start by avoiding sugary drinks.
Topical Antibiotics For Acne
Since they are applied directly to the skin, topical antibiotics work by accumulating in follicles to target and destroy bacteria, and provide anti-inflammatory effects.
Numerous topical antibiotics are available including creams, gels, lotions, solution, medicated wipes and foams. They are typically recommended for mild acne, but can also be effective for treating severe acne when combined with other acne treatments.
Clindamycin and erythromycin are the most commonly used topical acne antibiotics. Other options include dapsone and sulfacetamide.
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Healing Ingredients In Neosporin
The active ingredients in Neosporin are bacitracin, neomycin and polymixin-B, as well as zinc. These ingredients are antibiotics designed to kill bacteria on the skin. Neosporin is specifically mixed to prevent infection in minor scrapes, cuts and burns. It can also speed up the healing process and prevent scarring. As such, people with acne have used Neosporin on pimples.
A dab of Neosporin gently rubbed into the zit may help improve its appearance. However, you may not experience any results, or the acne may become worse. There is no consensus about the sort of skin, or type of acne, that responds well to this treatment.
Salicylic Acid Pimple Creams
There are far too many salicylic acid based acne creams in the market. But that doesnt justify their effectiveness. Clearasil Ultra Rapid Action Pimple Clearing Cream and Garnier Pure Active Pimple Relief Roll On are two popular acne creams with 2% salicylic acid.
Salicylic acid based pimple creams can bring cystic acne to a head, creating pus and eventually a pit hole in the skin from that. Too much salicylic acid can darken the skin around the pimple and these dark marks can stay on for months.
Salicylic acid works well for blackheads and teenage pimples, but when it comes to cystic acne it may not be enough on its own. Using it in combination with glycolic acid based products works well.
An effective 1% salicylic acid gel is Sebonac gel which has received good reviews for acne prone skin. Read more about using Sebonac gel as part of an acne regimen here.
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Triple Antibiotic Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
A rare but serious side effect of neomycin is hearing loss, which has occurred in people using other forms of neomycin. It is unlikely that you would absorb enough of this medicine through your skin to cause this effect. Call your doctor at once if you notice any changes in your hearing.
Common side effects may include:
mild itching or rash or
minor skin irritation after using the medicine.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Four Ways To Reduce How Long You Take An Antibiotic
You can shorten the amount of time that you need an antibiotic in your treatment plan by doing the following:
Use all of medicine in your treatment plan.When taken alone, an antibiotic can quickly lose its ability to fight acne. When this happens, the bacteria continue to grow and you can develop a condition known as antibiotic resistance. Antibiotic resistance is a global health problem. Thats why your dermatologist prescribes other acne medicine along with an antibiotic. You may need to use benzoyl peroxide or adapalene gel along with an antibiotic.
Reduce acne flares with gentle skin care.To get rid of acne, you may be tempted to scrub your skin clean. Scrubbing can irritate your skin and worsen acne. You can reduce flare-ups by following the skin care tips at, Acne: Tips for Managing.
Keep all follow-up appointments with your dermatologist.This will allow your dermatologist to see whether the treatment is working. Some patients need a different antibiotic. Others need a different type of treatment.
Follow your maintenance plan.Once your skin clears, youll need different acne treatment to prevent new breakouts.Most people can keep their skin clear by using medicine they apply to their skin. Continuing to use the acne treatment in your maintenance plan will help you keep your skin clear and reduce the need for stronger acne medicine like an antibiotic.
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What Side Effects Are Possible With This Medication
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- irritation of the area where the ointment is applied
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a severe allergic reaction such as severe rash or hives difficulty breathing or swelling of the mouth, lips, tongue, or throat
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Role Of Benzoyl Peroxide
It is used in acne treatment since 1934. It is often prescribed with different classes of topical antibiotics.
It potentiates the efficacy of oral and topical antibiotics against acne.
You need to check the concentrations of Benzoyl peroxide if its 5% then you are good to go! Higher concentrations are also available but they are associated with allergic reactions.
It is safe for the use in lactating mothers and soon-to-be moms. However, its use should be reserved for the situations where it is greatly needed and when no suitable alternative is available.
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Inflamed Cysts Usually Dont Require Antibiotics
Swollen, red, and tender lumps under the skin are usually either inflamed cysts or small boils. You usually dont need antibiotics for either of these problems.
Inflamed cysts sometimes get better on their own. If they keep getting inflamed, or if they are large or painful, the doctor can open and drain the cyst by making a small incision. Some cysts can be removed surgically. Both are simple procedures that can be done in a doctors office. After that, your cyst will likely heal on its own without antibiotics.
What Is Acne Anyway
Acne is a chronic inflammatory skin condition, characterized by blackheads and whiteheads , pimples, and deeper lumps . They are caused when hair follicles are clogged with oil, bacteria and dead skins cells, and can occur on the face, neck, chest, back, shoulders and upper arms.
While once thought to be a direct result of overactive sebaceous oil glands, now we know that inflammation is the driving force behind acne. In fact, this inflammation can be seen in the skin even before a pimple pops up. And clogged follicles can also stimulate more inflammation.
The bacterium that lends its name to the condition Propionibacterium acnes, is just one of the factors that stimulates this acne-causing inflammation.
Hereditary and genetic factors, hormones, emotional stress and even diet can also bring on the zits. For instance, foods with a high glycemic load such as white grains and sweets have been linked to acne, as they can increase oil production and skin cell turnover. This ultimately causes a backup in the pores and follicles on our skin creating a nice environment for the inflammation-inducing P. acnes to flourish.
When that happens, these enzymes contribute to the formation of the big, angry, red, cystic acne lesion, and they can also contribute to the creation of pitted scars.
This is why antibiotics are used to treat acne, but also rosacea, razor bumps and scarring hair loss, to name a few other dermatological conditions.
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Antibiotic Resistance: A Big Concern
Treatment with oral or topical antibiotics, especially over longer periods of time, can also lead to a phenomenon called antibiotic resistance. Antibiotic resistance means that bacteria become immune to the effects of antibiotics over time, and eventually the antibiotics can no longer kill the bacteria. Antibiotic resistance is a serious global problem, because:
- When bacteria become resistant to an antibiotic, that antibiotic becomes less effective and less able to treat the condition for which it was prescribed as well as for other bacterial conditions. This applies to both the person taking the antibiotic as well as the population at large.
- Bacteria can share their genes with each other and transfer antibiotic resistance from one strain of bacteria to another.
- Ultimately, antibiotic resistance could result in many types of bacteria becoming resistant to all antibiotic medications. This means that doctors may eventually be unable to treat bacterial infections, and people may die from even common bacterial diseases such as strep throat, as people did before antibiotics were developed.
Expand to read details of study
How To Use Triple Antibiotic Ointment
Clean and dry the affected skin area. If you are using the ointment, wash your hands first. Then apply a small amount of medication in a thin layer on the skin and rub in gently, usually 1 to 3 times a day. Wash your hands after applying the ointment. If you are using the spray, shake the container well before using, then spray a small amount on the affected area as directed, usually 1 to 3 times a day. You may cover small treatment areas with a sterile bandage.
Do not use large amounts of this medication or apply this more often or for a longer period than directed. Your condition will not clear faster, but the risk of side effects may be increased. Do not use this product for longer than 1 week unless directed by your doctor. Do not use this medication on irritated skin in a child’s diaper area unless directed by the doctor. After applying the medication to the diaper area, do not use tight-fitting diapers or plastic pants.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.
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So Can I Use Neosporin At All
Neosporin should only be used on wounds. And, yes, unfortunately, pimples sometimes do become wounds because we personally massacre them. But you wont be doing that right?
But if you do, you can suddenly be faced with a mini wound. And, right then and there is the best time to apply a little Neosporin. A tiny dab of Neosporin on a freshly picked pimplemay potentially speed up the healing process and prevent scarring. But everyones skin is different.
You can think of Neosporin as a first-responder who rushes in but then makes way for other experts to come in and treat the patient.
Studies have found that wounds seem to heal fastest when theyre kept moist and covered because the blood vessels regenerate faster. But that doesnt mean that an antibiotic ointment is your go-to. Though they can keep your wound soft, weve already seen the issues they can create.3
The problem is that its hard to keep a plaster on your face. So, experts recommend just a dab of plain petroleum jelly twice a day max on that newly healing wound. The jelly prevents the wound from drying out too much and therefore forming a scab. Wounds with scabs are believed to take longer to heal.4
But, as long as the wound is cleaned daily, it is not necessary to use anti-bacterial ointments. And, overuse of petroleum jelly can clog your pores and cause more pimples.
It Can Make Your Acne Worse
Antibacterial ointment has a petroleum jelly base, which means that it isnt breathable. Petroleum products may be great on top of your moisturizer if youre walking through the arctic tundra because they can form a barrier over your face and protect it from the harsh winds.
But, if youre not in the Arctic, youll want to avoid using petroleum products on your face too often, unless youll be using it sparingly on a wound. Because, just like the Arctic, you may need the protective barrier that petroleum provides.
The trouble with petroleum though, is that in order to give this barrier protection, it also prevents your skin from breathing. It robs your skin of its ability to create its own moisture or to get much-needed fresh air. Using petroleum products on your skin too often can lead to more clogged pores, meaning that its far more likely to hurt your acne than help it.
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How Do Antibiotic Acne Creams Work
Antibiotic creams work by controlling and killing the skin bacteria that is associated with acne. This common bacteria feeds on the sebum produced by the skin, creating waste products and fatty acids that contribute to the condition and worsen acne symptoms. This can cause the skin to become more inflamed and infected.
The anti-inflammatory action of topical antibiotics can reduce the swelling, redness, and discomfort of acne spots.
Antibiotic creams also help to keep your pores more open, reducing the effects of acne.
Your doctor or pharmacist will prescribe an antibiotic cream that is suitable for your type of acne, as well as instructions on how and when to apply it.
We Need To Change How We Use Antibiotics
Thanks to using higher-than-needed doses of antibiotics and keeping patients on them for longer than recommended, the P. acne and other skin bacteria, like Staphlyococcus aureus have developed resistance to multiple topical and oral antibiotics used to treat this disease chronically. For instance, 20 or 30 years ago, the antibiotic erythromycin was used frequently to treat acne, but now both bacteria are uniformly resistant.
So far we have not seen too much resistance to the tetracycline class of antibiotics used today, but they too will be on their way out if we do not change our prescribing patterns.
This is frustrating because antibiotics dont need to kill bacteria to treat acne. Clearing P. acnes from the area can be helpful, but the bacteria is just one stimulus of inflammation, so removing it is an assist, not a win. And research has shown that the desired anti-inflammatory effects can be achieved at sub-antibacterial dosing. This means that the needed dose is so low that it cant kill good bacteria or challenge pathogenic bacteria to become resistant.
And antibiotics should never be prescribed on their own to treat acne. In fact, treatment guidelines always recommend that antibiotics be combined with a nonantibiotic topical treatment.
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How The Intervention Might Work
Topical antibiotics reduce the population of P. acnes within the follicles and are thought to possess an antiinflammatory and mild comedolytic effect their bacteriostatic activity is based on interaction with ribosomal subunits and the inhibition of protein synthesis . They also inhibit the synthesis of lipase, the enzyme used by P. acnes for hydrolysing serum triglycerides to proinflammatory free fatty acids and glycerol, which is a substrate important for bacterial growth . The antiinflammatory property of antibiotics is related to the inhibition of complement pathways and subsequently the impairment of neutrophil chemotaxis . Increasing bacterial resistance has led to recommendations against the use of topical antibiotics as monotherapy, but they still play an important role when combined with other topical agents in mild to moderate acne .
Benzoyl peroxide, the most frequently used agent for combination therapy with topical antibiotics, is a bactericidal agent that kills P. acnes and has mild antiinflammatory and comedolytic activities . Due to its lipophilic properties, it accumulates inside the pilosebaceous unit, producing benzoic acid and reactive oxygen species, which oxidise bacterial proteins. This leads to the inhibition of protein and nucleotide synthesis, metabolic pathways, and mitochondrial activity of P. acnes .