Last Updated on August 8th, 2020
By Dr. Jaggi Rao, MD, FRCPC, Double board-certified dermatologist
Neosporin for acne is a popular home remedy for acne treatment, but does it actually work? Home remedies are a vital part of the skin care industry because they offer inexpensive easy-to-use solutions to everyday problems like acne. While many home remedies are very effective, it’s important to do your research and make sure the science backs the claims you’ve read online. When it comes to Neosporin for acne, the truth is, it is unlikely to help. It utilizes three major antibiotics, but these antibiotics aren’t effective against acne-causing bacteria specifically. They are growing increasingly ineffective in general with the rise of bacterial resistance. Instead, we recommend using other, scientifically-supported home remedies, or a gentle over-the-counter system, like Exposed Skin Care.
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We totally understand why people want to try using Neosporin for acne. It’s well-known for fighting bacteria, and acne is often related to bacteria, so theoretically, it should be the perfect treatment. Sadly, it isn’t quite that simple. Bacteria are a complex group of organisms, and each antibiotic is only capable of killing certain strains. Unfortunately, bacitracin, neomycin, and polymyxin-b, the antibiotics used in Neosporin, are designed to kill staph bacteria and strep bacteria, not acne bacteria.
All antibiotics have a different mechanism of action, or a method they use to kill bacteria.
Bacitracin’s mechanism of action is using peptides (long chains of amino acids) to prevent the proper construction of the bacteria’s cell walls. Without this cell wall, the bacteria fall apart before they even fully form. Studies have shown that bacitracin is particularly effective against Staphylococcus aureus (staph) and Streptococcus pyogenes (strep), but not against acne-causing bacteria, Propionibacterium acnes (p. acnes).
Neomycin, another antibiotic present in Neosporin, has a slightly different mechanism of action. Instead of using peptides to prevent proper cell wall construction, neomycin attaches to the bacteria’s DNA and messes up the genetic coding so that proteins can’t form properly. Proteins are the building blocks of living organisms, and without them, the bacteria die. 🧱 Specifically, neomycin is effective in killing most strains of staph bacteria, but is generally not very effective against strep or p. acnes bacteria.
Polymyxin-b, the last antibiotic in Neosporin, kills bacteria by interfering with their cell membrane to make it more permeable. This allows for an influx of fluid into the cell, which often causes it to burst. This is most effective against gram-negative bacteria that don’t have a strong cell wall to protect the cell membrane, which is one reason it is not effective against p. acnes.
To best understand why Neosporin for acne doesn’t work, and to find the right products that do work, it’s important to know the role of p. acnes bacteria in acne formation. For instance, did you know that it’s impossible to get rid of p. acnes bacteria completely because they are a natural part of our skin’s bacterial flora? Or that not all types of acne involve p. acnes bacteria?
All acne, from blackheads to pimples to cysts, starts with inflammation. The skin gets irritated and in response, it swells slightly to try and protect itself. This constricts the pores, trapping oil, dead skin cells, and sometimes p. acnes bacteria inside. If only a few bacteria get trapped in the pore, then a blackhead or whitehead form, and the best way to treat them is with exfoliation that will help remove the oil and dead skin cells clogging the pore. If a sizable number of p. acnes bacteria get trapped in the pore, then a minor infection breaks out, and that’s when a pimple or cyst can form.
A pimple forms when p. acnes create an infection that the body quickly fights off through extra inflammation. 🤺 This is why pimples get so red and swollen, but they also disappear within a few days. Cysts are also often red and swollen, but instead of coming to a relatively small white head, they tend to form a large, soft, blister-like head. It is widely accepted that cysts form when a person’s immune system overreacts to a p. acnes infection, but as for what causes this overreaction, researchers aren’t sure, though they believe there may be a genetic component.
Even if Neosporin contained antibiotics that effectively killed p. acnes bacteria, we might not recommend it. Why? Because of bacterial resistance. Bacterial resistance is a phenomenon in which bacteria become resistant to the antibiotics designed to kill them. This typically starts when the bacteria are exposed to the antibiotic and a few bacteria randomly mutate in a way that allows them to survive the antibiotic.
On their own, these p. acnes bacteria aren’t a problem, but once they start reproducing, they create even more bacteria that are resistant to the antibiotic, until you have a whole colony that is difficult to control. Even worse, it’s easy to spread these bacteria from one person to another. For many young, healthy people, resistant bacteria aren’t so terrible because your immune system can successfully hold them at bay. However, for the especially young, old, or immune-compromised, these bacteria could generate a serious infection that is incredibly difficult to treat.
As a result of increasing bacterial resistance, many doctors and researchers are trying to spread awareness of what they’re calling rational use of antibiotics. Studies show that antibiotics are often inappropriately prescribed, and researchers believe that by putting in place national policies on rational antibiotic use, we may be able to decrease the global effect of bacterial resistance. One area that often comes under fire when discussing bacterial resistance and inappropriate antibiotic usage is acne treatment. Many dermatologists prescribe antibiotics much longer than recommended because for many patients, once the antibiotic is discontinued, acne returns. 👩🏻⚕️👨🏽⚕️👨🏼⚕️👩🏾⚕️ However, this causes an increase in resistant bacteria, which is why many dermatologists are looking for new, better treatments that can get their patients clear skin without adding to a global health risk.
If you’ve tried Neosporin for acne in the past and it cleared up your breakout in just a day or two, that may not have been genuine acne. It may have been the early signs of a minor staph infection. Like p. acnes, staph bacteria (S. aureus) always live on the surface of our skin. They generally don’t cause issues unless they find their way into the skin through a cut or minor wound. Once this happens, the infection often starts with a series of reddish bumps that are often mistaken for acne.
To best treat your symptoms and get clear skin, it’s important to be able to tell the difference between a staph infection and acne.
First, try to remember if you’ve had any minor wounds in the area of the “breakout” recently. These can be as small as a slight nick with your razor or a scratch with a ragged fingernail. If so, then the staph bacteria had a chance to get into the skin and could be causing the bumps. Second, look for similar bumps in your armpits or groin area. Acne typically sticks to the face, trunk, and arms, while a staph infection does not. Finally, look at the bumps closely to determine if they have a white head. Pimples may start without a head, but they quickly develop one. Bumps from a staph infection, on the other hand, rarely form a white head.
If Neosporin has worked for your acne before, 🔎 you may want to check for these signs of staph infection the next time you experience a breakout.
Because any kind of bacterial infection, not just p. acnes, can cause increased inflammation, some might argue that even though Neosporin can’t kill acne-specific bacteria, it is still a good idea for a home remedy. After all, reducing inflammation is one of the best ways to prevent acne from forming in the first place. However, Neosporin is more than just a collection of antibiotics. It also contains inactive ingredients, and not all of them are ideal for acne-prone skin.
One of the first things to you want to do when buying a new product for acne treatment is check the ingredient label for comedogenic (AKA, pore-clogging) ingredients.
All ingredients can be ranked on the comedogenicity scale from 0 to 5, with 0 being least likely to clog pores and 5 being most likely. It’s important to avoid pore-clogging ingredients because clogged pores lead to all kinds of acne.
Neosporin doesn’t provide their ingredient labels on their website, but it can be found on DailyMed, a US government website. According to DailyMed, Neosporin contains cocoa butter, cottonseed oil, olive oil, sodium pyruvate, vitamin E, and white petrolatum. Most of these ingredients are perfectly safe for acne-prone skin, but the reason we advise staying away from Neosporin for acne is because cocoa butter and cottonseed oil are highly comedogenic. Cocoa butter ranks at a 4 and cottonseed oil ranks at a 3, meaning there is a very good chance Neosporin will clog your pores, and increased acne could be the result.
Even though Neosporin isn’t the most effective acne treatment, there are other options out there. The best way to treat acne is with gentle, consistent treatment that cleanses, treats, and moisturizes your skin. These steps help get rid of acne you currently have while preventing the emergence of new acne, so you can have truly clear skin.
One of the best ways to accomplish all of these important steps without accidentally buying products that don’t work well together is to buy an acne treatment kit, like the Expanded Kit available with Exposed Skin Care. 🌱 They’re one of the very few skin care companies out there that seem to understand that higher concentrations of active ingredients are not necessarily better. Their products use just the right amount of each acne-fighting ingredient to clear away your acne without irritating your skin.
If you prefer home remedies, try tea tree oil or Manuka honey. Research shows that 5% tea tree oil is just as effective as 5% benzoyl peroxide, plus it’s typically less drying. Tea tree oil kills p. acnes bacteria, reduces inflammation, and can even help reduce oil production. 🌿🐝 Manuka honey is another great natural antibiotic, and research proves it is effective in killing p. acnes bacteria specifically. It’s so reliable and effective, many hospitals now use Manuka honey in wound dressings to speed the wound healing process.
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