Antimicrobial treatment

Propionibacterium acnes (P. acnes) is a bacteria that grows deep inside of pores, where it feeds on the sebum that is produced by the sebaceous glands that surround the base of the hair shaft. Most individuals with acne symptoms have an overgrowth of P. acnes bacteria in their skin.

The P. acnes bacteria itself does not directly cause significant damage to the skin. Instead, most of the damage caused by acne is due to the inflammation brought about by the immune response to the presence of the P. acnes bacteria.

Antimicrobials come in the form of prescription creams, gels and foams, and are used to kill or inhibit the growth of microorganisms such as mould, fungi, protozoans (single cell organisms) and bacteria, including P. Acnes.

As antimicrobials are a mild form of treatment, if you suffer with severe acne this type of medication is unlikely to make a significant difference.

All preparations work differently and it is advisable to apply a topical antimicrobial to all of the affected area and not just to each individual spot.

Sometimes for severe acne a combination of a topical preparation and an antibiotic topical preparation may be advised or indeed a topical preparation as well as an antibiotic tablet. These combinations may work better together than either one by themselves. However, a single topical preparation may be sufficient for mild acne.

Treatment

There are various topical antimicrobials which will assist in the treatment of acne. You should seek advice from your Doctor/Dermatologist before starting on a treatment regime.

Cleansing wipes

Cleansing wipes are one type of product that is available as both an antibacterial product and an antimicrobial product. Antibacterial hand wipes kill bacteria, while antimicrobial wipes kill bacteria plus other micro-organisms that can cause human illness. Both antibacterial and antimicrobial wipes can be a component of effective hand hygiene.

Oral rinses

An oral rinse (mouth rinse or mouthwash) is used to reduce bacterial count and inhibit the bacterial activity that can cause gum disease. They may be purchased over-the-counter (OTC) or via prescription, and can be categorized as cosmetic, therapeutic or a combination of the two.

An oral rinse may also be prescribed following oral surgery or periodontal treatments in order to promote healing, reduce microbial load (number and types of micro-organisms) and help with discomfort. Many therapeutic oral rinses are strongly recommended for people who cannot brush due to physical impairments or medical conditions.

If you or your child experiences any adverse reactions to an oral rinse, stop using it immediately and consult your Dentist, who may be able to recommend alternative treatments based on your particular dental needs

Benzoyl peroxide
Benzoyl peroxide gets rid of bacteria, reduces inflammation and helps to unblock clogged pores which in turn help to clear blackheads as well as whiteheads. Benzoyl peroxide can be sourced over-the-counter at a pharmacy without a prescription.

Azelaic acid
Azelaic mainly helps to unblock clogged pores as an alternative to Benzoyl peroxide. Azelaic acid can be sourced over-the-counter at pharmacists without a prescription.

Retinoids
Retinoids are prescription medications such as adapalene, tretinoin and isotretinoin these help unblock clogged pores and reduce inflammation

Topical antibiotics
There are many topical antibiotic medications available on prescription. They do not unblock clogged pores but assist in reducing inflammation.

Timescales

If you suffer with mild to moderate acne you may notice a difference within a couple of months after applying a topical antimicrobial, however it can take a lot longer for the skin to be generally free of spots.

When using this type of medication, it is important to persevere: don’t give up with the treatment too quickly, if there is not a significant improvement after say six weeks it may be necessary to add another type of treatment or change to a stronger one.

After the spots have cleared it is advisable to continue with a treatment regime such as Benzoyl peroxide or a topical retinoid: these two antimicrobials can be used long term. However, your doctor will advise you on the best course of treatment.

You should seek advice from your Doctor/Dermatologist before embarking on a treatment regime.

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.

Information written by the talkhealth team

Last revised: 1 May 2018

Next review: 1 May 2021