When you're dealing with acne and you've exhausted all of the at-home treatments—the glycolic acid serums, the salicylic acid toners, the mandelic acid peels, the soothing cica balms—and your acne is still not clearing up, it might be time to move on to the big guns.
And by big guns, we mean the prescriptions. Sometimes, your acne needs an intervention from a dermatologist, so today, we'd like to introduce you to a popular, prescription-only acne treatment: clindamycin. Ahead, our experts Dr. Amir Karam and Dr. Marisa Garshick break down all the details about this acne-fighting prescription, below.
Meet the Expert
Type of Ingredient: Antibacterial treatment
Main Benefits: Decreases acne-causing bacteria
Who Should Use It: "It can be used on all skin types and is available in different formulations, with gels being best for those with oily skin and lotions preferred for those with dry skin," says Garshick. "Anyone with a history of clostridium difficile colitis or inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, should speak with their gastroenterologist prior to using any form of clindamycin. Additionally, those with an allergy to clindamycin should avoid it."
How often can you use it: Once or twice daily
Works well with: "It is also often combined with Retin-A as well as benzoyl peroxide," explains Karam.
Don’t use with: You should not use clindamycin with erythromycin, another medication used to treat bacterial infections.
What Is Clindamycin?
Clindamycin, according to both Garshick and Karam, is an oral and topical antibiotic treatment that's designed to treat acne. "Clindamycin is an antibiotic," says Karam. "It's most commonly used in an oral form to treat various types of infections that can affect the body. It's also very specifically used for skin infections because of its coverage of the typical bacteria that cover and affect the skin. However, in the way of acne treatments, it's used as a topical treatment, not as an oral form."
Karam goes on to say that it's often used as a trial treatment because it's difficult to gauge how the acne it's being used on will respond to it. "Not every type of acne will respond to this. Sometimes acne can be hormonal, which means it won't respond well to clindamycin," he says. "Also, it's not clear why some people are responders and others are not, and why some people with the P. Acnes colonization on the skin never form acne while others do."
Garshick adds, "While it can be used for all types of acne, it is most commonly prescribed in the setting of mild to moderate inflammatory acne and can be used in conjunction with oral medications in the setting of severe acne." She explains that inflammatory acne often refers to breakouts that are red bumps and pustules.
Benefits of Clindamycin for Acne
- Reduces acne-causing bacteria: One of the biggest benefits of clindamycin for acne is that it decreases acne-causing bacteria. "As an antibiotic, it helps to reduce acne-causing bacteria and can be particularly helpful for inflammatory acne," explains Garshick.
- Pregnancy-safe option for acne: If you're pregnant, your options for safe, acne treatments are limited, since it's not safe to use treatments like retinol or salicylic acid. "[Clindamycin] is considered pregnancy-safe so it is a good option for those who are pregnant and looking to treat their acne," says Garshick.
- Minimal side effects: According to Karam, clindamycin has minimal side effects topically. "Most of it would be related to the ingredients of alcohol, which can create some burning sensation to the skin and dryness."
- Decrease inflammation in pores: "You can decrease the potential for infection and inflammation of the pores, which leads to acne from occurring," adds Karam.
Side Effects of Clindamycin
Overall, clindamycin is incredibly safe for most, if not all skin types. However, that doesn't mean that it doesn't come with a few caveats. "As with any topical ingredient, it can lead to irritation or dryness," says Garshick. "In some cases, prolonged use of antibiotics can trigger a different type of breakout known as pityrosporum folliculitis which should be evaluated by a dermatologist."
If you notice that your skin is getting significantly worse, that's the time to contact your doctor so they can assess what steps to take next. "There's no real skin type or group of people that would have to avoid using clindamycin," Karam adds. "It's a pretty safe, broad class of antibiotics that can be used as a primary treatment for acne. It is also often combined with Retin-A as well as benzoyl peroxide. The three of those typically become a standard first-line treatment for most acne cases."
Oh, and yes, clindamycin does make your skin more sensitive to the sun, so be sure to stock up on the sunscreens and apply them daily.
How to Use It
Clindamycin can be used once or twice daily during your AM and PM routine. According to Garshick, it's typically prescribed in a topical form that can be a gel, lotion, solution, foam, or wipe, depending on your skin type and what area you need it for. Wipes are great for large areas like the back and chest, while gels work great for people with oily skin types.
"Importantly, to minimize the chance of antibiotic resistance, it is best to use in conjunction with benzoyl peroxide which works to reduce the potential for antibiotic resistance," says Garshick. "The location being treated can guide the optimal formulation to use, with the solution being helpful in hair-bearing areas and the gel being good for oily areas."
You'll need to use it for about three months to potentially see results, adds Karam.
How long does clindamycin take to work for acne?
A typical course of clindamycin is three months. You should see a reduction of acne during that time, but if not, it might be time to reevaluate things with your physician.
Can clindamycin make acne worse?
Clindamycin, like retinol, can cause irritation, dryness, and yes, an increase in acne during its initial use. However, you can expect that your acne will decrease during the duration of your treatment.
Can I put moisturizer on over clindamycin?
Clindamycin should be applied topically to the skin after washing it as directed by your dermatologist. After that, yes, you can (and should) apply a gentle moisturizer over it. This will help decrease irritation and dryness as well.