It’s tempting to try out acne remedies that you can grab in your medicine cabinet. The idea that you could have something here, right now, that would be the miracle cure to that zit popping up just seems ideal. Unfortunately, there are plenty of at-home remedies that don’t work. I remember the first time I heard about Neosporin for acne. I stood in the mirror staring at a big, red pimple that had just popped up. One of the girls in the bathroom imparted the kind of woman-to-woman knowledge that happens at the restroom sink: “Put Neosporin on that.” Neosporin is part of a group of infection-preventing creams and gels containing Polymyxin B Sulfate, Bacitracin Zinc, and Neomycin, which are known as Triple Antibiotic Ointments (TAOs). And while these topical ointments work well to prevent infection in wounds, they shouldn’t be used to treat acne. In fact, while they're very effective for wounds, TAOs can do more harm than good for acne.
It seems somehow logical that TAOs would work. After all, acne that’s caused by bacteria should be taken care of by a cream intended to kill bacteria, right? Unfortunately, that’s not entirely flawless logic, and not just because Neosporin is intended for wound care and not acne clearing. Because of the nature of these ointments, intended for temporary wound healing and not regular acne use, applying them too regularly can cause the bacteria they're intended to kill that exists on your skin to become resistant, which is a big problem. Right down to ingredients, it’s evident that TAOs aren’t really acne friendly. Neosporin contains: Polymyxin B Sulfate, Bacitracin Zinc, Neomycin, Cocoa Butter, Cottonseed Oil, Olive Oil, Sodium Pyruvate, Tocopheryl Acetate (Vitamin E), White Petrolatum; with the first three being the active ingredients. First and foremost, you might notice that certain ingredients like olive oil can clog pores and actually worsen acne.
Here are the bacteria that the three active ingredients are used to kill: Staphylococcus aureus, streptococci including Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa (Daily Med). While it’s possible for many types of bacteria to cause acne, Propionibacterium acnes are the type most commonly responsible for acne vulgaris (European Bioinformatics Institute). This means that from the get-go, we know that Neosporin’s active ingredients aren’t intended to fight the main kind of bacteria that causes acne.
[Read More: How to Get the Maximum Benefit from Skin Oils]
Polymyxin B Sulfate is an antibiotic that’s intended for gram-negative bacteria. These bacteria are commonly what cause infections in wounds and after surgery (CDC). These are often resistant to drugs and, more concerning, are able to adapt to become resistant to antibiotics, which is why you don’t want to use antiobiotics for a prolonged period of time or too commonly. So this ingredient can be ruled out quickly, not only because it can be unsafe to used for a prolonged period but also because Propionibacterium acnes is a gram-positive bacteria.
Bacitracin does work against gram-postitive bacteria, but it really only works against S aureus and streptococci. It also works as a superficial bacterial infection, meaning that it won’t penetrate the skin enough to really reach the cause of acne (MedScape). And if you perked up at the mention of zinc because you’ve heard it in acne forums, think again. Zinc is sometimes discussed in terms of acne because studies have shown that those with acne tend to have lower levels of zinc in their bodies. And while taking zinc has been shown to help to some extent with acne when taken orally, it’s still not as effective as oral antibiotics (NYU Medical). Studies done on topically applied zinc have found that it’s no better than the placebo (International Journal of Dermatology).
Neomycin works by getting in the way of protein synthesis and can be used on gram-positive and gram-negative bacteria. But that doesn’t mean it works against P acnes either. It’s primarily intended for gram-positive S aureus, as well as E coli. And aside from that, it’s been shown to cause allergic contact dermatitis, as well as nonallergic irritant reactions, in some individuals (Pediatric Consultant Live, JAMA Network). Irritation and contact dermatitis on top of acne is, inevitably, a terrible thing, which makes this a poor choice for acne fighting.
There’s a delicate balance with acne and moisturizing and that could explain why triple antibiotic ointments, such as Neosporin, can make your acne seem like it’s getting better with usage. Neosporin’s ingredients are intended for wound-healing aid, which means while they won’t kill acne bacteria, they will help skin heal. Moisturizing helps heal the appearance of scars, and works even better under something occlusive, like petrolatum (International Journal of Cosmetic Science). It can help the skin that’s been damaged by acne regain proper barrier function, which makes the acne seem better, but is really the skin around it healing. A much better option would be to use a moisturizer intended for acne-prone skin, such as Proativ Solution Green Tea Moisture ($6, amazon.com).
When it comes to acne, it’s best to stick with products that have been proven scientifically and are recommended by dermatologists. Triple Antibiotic Ointments, such as Neosporin, not only contain pore-clogging ingredients that can worsen acne, but they can also cause the bacteria they’re intended to kill to become resistant with regular use. While these products are great for preventing infection and wound healing, they shouldn’t be used to treat acne. It’s better to use ingredients like benzoyl peroxide on acne, which has been shown to kill P acnes and can be found in products such as ZapZyt ($4.25, amazon.com). Even when home remedies work, it can be more effective to find products that contain them as ingredients. This is because products formulated for your face and for acne are made to minimize irritation and be as effective as possible, whereas complications may arise with the homemade version.
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