Skin Health Acne Treatment Topical Erythromycin for Acne Erythromycin, an antibiotic, reduces acne-causing bacteria when applied to skin By Angela Palmer Updated on February 21, 2023 Medically reviewed by Leah Ansell, MD Print Table of Contents View All Table of Contents Effect on Acne When It's Used How to Use Dosage Side Effects Frequently Asked Questions Erythromycin, in its topical form (applied to skin), is used to treat inflammatory acne. It cannot cure acne, but it can help you keep it under control. Erythromycin is typically used in combination with other medications. You can only get topical erythromycin for acne with a prescription. Oral erythromycin is also sometimes used to treat acne. This article discusses topical erythromycin as an acne treatment. It also goes over dosage and side effects. Jamie Grill Collection / The Image Bank / Getty Images How Erythromycin Helps Acne A proliferation of acne-causing bacteria within the pore is a factor in acne development. Propionibacterium acnes is the chief culprit. Antibiotics like erythromycin reduce the amount of acne-causing bacteria. Topical erythromycin specifically can also help decrease redness and inflammation. Topical Antibiotics for Acne When Topical Erythromycin Is Used for Acne Topical erythromycin isn't the first treatment choice for acne. First-line treatment typically includes topical benzoyl peroxide or a topical retinoid. Topical erythromycin isn't as effective as some of the other treatment options. This is because it only targets one acne-causing factor: bacteria. There are other factors that are responsible for acne breakouts, like the abnormal shedding of skin cells and the development of pore blockages, that topical erythromycin just doesn't address. More importantly, antibiotic resistance is a big issue with topical antibiotics and erythromycin for acne, in particular. The bacterium that causes acne has become used to the medication, rendering it ineffective as time goes on. Erythromycin may be recommended in certain situations, such as when first-line treatments aren't effective or when acne is severe and there's a risk of scarring. Topical formulas containing erythromycin are available by prescription only. As a second-line treatment, erythromycin is usually prescribed as part of a combination topical formula that also contains benzoyl peroxide or a retinoid. Combining the antibiotic with another medicine has been shown to be more effective and help reduce antibiotic resistance. Benzamycin is an example of an acne treatment medication that combines topical erythromycin with benzoyl peroxide. Erythromycin is sometimes recommended for treating acne in pregnant and breastfeeding moms, but usually in combination with other therapies. It is also prescribed to treat newborn baby acne and infantile acne if need be. Coping and Living With Acne How to Use Topical Erythromycin Before using topical erythromycin, wash your face with warm water and a gentle cleanser. Rinse thoroughly and pat dry. It's a good idea to wait 30 minutes after washing before applying the solution. If you use moisturizer, wait until the solution has completely dried before applying it. To help prevent clogged pores, make sure to choose an oil-free moisturizer. You will only use topical erythromycin for a short time. This is to help prevent antibacterial resistance. Once inflammation is improved, you can stop using this medication. Keep using your second acne medication, though, to continue to reduce breakouts and keep your acne under control. Can I Use Erythromycin With Other Products? Usually, there isn't a risk of interactions when using erythromycin along with other topical treatments. However, if you're being treated with Retin-A (tretinoin), you should not use erythromycin because it can cause severe skin irritation. Let your healthcare provider know about other medications and over-the-counter topical products you may be using before getting a prescription for erythromycin. Dosage This topical antibiotic is usually prescribed as an ointment, gel, topical solution, or medicated pad with a strength of 2% erythromycin. Your healthcare provider will likely direct you to spread it on the affected area twice a day (morning and night), but individual recommendations may vary. Oral Acne Medication Options Possible Side Effects Most people can use topical erythromycin without any problems at all. When using erythromycin for acne, side effects, though, may occur. These are similar to other acne treatments: Mild irritationBurningStingingRednessDry skinSun sensitivity If side effects are bothering you, or if you develop a rash, let your dermatologist know. Likewise, tell your healthcare provider know if the medication is not working or if acne comes back after clearing up. Summary Topical erythromycin is a second-line treatment for acne. It is usually prescribed in combination with another medicine such as benzoyl peroxide. Because of the risk of antibiotic resistance, medicines containing erythromycin are intended for short term use. You can discontinue this medication once your acne has improved, but you should continue to use other medicines as prescribed by your dermatologist. Erythromycin can cause side effects like dry skin, redness, and sun sensitivity. Frequently Asked Questions How long does it take for erythromycin to clear up acne? You should expect to use erythromycin or a similar antibiotic treatment for three to four months. You may see improvements in your acne before then, but continue applying the medication as directed. In cases of severe acne, you may need to use the antibiotic for more than four months. How often should I use erythromycin for acne? Apply erythromycin topical treatments twice a day for 12 weeks or as long as your doctor recommends. Learn More How Acne Is Diagnosed 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. McLaughlin J, Watterson S, Layton AM, Bjourson AJ, Barnard E, McDowell A. Propionibacterium acnes and acne vulgaris: new insights from the integration of population genetic, multi-omic, biochemical and host-microbe studies. Microorganisms. 2019;7(5):128. doi:10.3390%2Fmicroorganisms7050128 Santer M, Francis NA, Platt D, Eady EA, Layton AM. Stemming the tide of antimicrobial resistance: implications for management of acne vulgaris. Br J Gen Pract. 2018;68(667):64-65. doi:10.3399/bjgp18X694457 Dréno B. Bacteriological resistance in acne: A call to action. Eur J Dermatol. 2016;26(2):127-32. doi:10.1684/ejd.2015.2685 Dreno B, Thiboutot D, Gollnick H, et al. Antibiotic stewardship in dermatology: limiting antibiotic use in acne. Eur J Dermatol. 2014;24:330-4. doi:10.1684/ejd.2014.2309 Zaenglein AL. Acne vulgaris. N Engl J Med. 2018;379(14):1343-1352. doi:10.1056/NEJMcp1702493 Chien AL, Qi J, Rainer B, Sachs DL, Helfrich YR. Treatment of acne in pregnancy. J Am Board Fam Med. 2016;29(2):254-62. doi:10.3122/jabfm.2016.02.150165 St. Luke's. Benzoyl peroxide and erythromycin topical. American Academy of Dermatology Association. How long can I take an antibiotic to treat acne? Additional Reading Bartlett KB, Davis SA, Feldman SR. Topical antimicrobial acne treatment tolerability: a meaningful factor in treatment adherence? J Am Acad Dermatol. 2014;71(3):581-582. doi:10.1016/j.jaad.2014.01.883 Hoover WD, Davis SA, Fleischer AB, Feldman SR. Topical antibiotic monotherapy prescribing practices in acne vulgaris. J Dermatolog Treat. 2014;25(2):97-9. doi:10.3109/09546634.2013.852297 Serna-Tamayo C, Janniger CK, Micali G, Schwartz RA. Neonatal and infantile acne vulgaris: an update. Cutis. 2014;94(1):13-6. By Angela Palmer Angela Palmer is a licensed esthetician specializing in acne treatment. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit