Erythromycin (Topical)

Overview

Acne vulgaris typically emerges during puberty, when oil glands receive stimulation from male hormones (in both males and females) that are produced by the body's adrenal glands. The oil collides with dead skin cells to create unsightly blemishes on the skin, often called zits or pimples. Older individuals may develop acne as well, but this is not common. Acne typically subsides in a patient in their early 20s.

Acne is painless and other than the blemishes it creates, causes no other symptoms. It is not particularly harmful to health, but may make the afflicted individual feel self-conscious about their appearance. In some cases, the sufferer may be so distressed by their acne that they develop mental health conditions such as anxiety and depression. Leaving acne untreated can also lead to permanent scarring. Several treatments exist, including the avoidance of substances (foods, cosmetics etc) that aggravate the condition.

Medications (both prescription and over-the-counter) exist in a variety of forms, one of which is erythromycin, which is prescribed for this purpose in a topical gel form. Erythromycin belongs to a class of medications known as macrolide antibiotics, which kill certain bacterias that cause the development of acne. Erythromycin is highly effective in the treatment of acne, and usually quickly rectifies the effects of the condition. However, due to its strength, there is the possibility for hypersensitivity, so care should be taken before beginning topical Erythromycin treatment.

Type of Drug

  • Antibiotic

Conditions Treated

Skin Conditions, Particularly Acne

Side Effects

Erythromycin, like most medications, can cause side effects. If an allergic reaction featuring symptoms such as swelling of the face, lips, throat or tongue, hives, and trouble breathing occurs, medical attention should be sought immediately. Additionally, the following side effects warrant immediate medical attention, these include:

  • Bloody or Watery Diarrhea
  • Burning, Stinging, or Redness (Severe)
  • Signs of Skin Infection Such as Oozing
  • Worsening Infection

There are some side effects that are not as serious and do not warrant immediate treatment. They may subside as the patient's body adjusts to Erythromycin. Additionally, the caregiver may be able to instruct the patient on how to avoid these reactions. These include:

  • Dry or Oily Skin
  • Itching
  • Mild Eye Irritation
  • Mild Irritation of Skin
  • Peeling
  • If reactions that are not listed here occur, the patient should notify their caregiver.

Dosage

Before applying the Erythromycin solution, the patient should wash their face and pat it dry. The patient should wash their hands The patient should then apply a thin layer of the solution to the affected areas. The solution should be lightly spread, as opposed to "rubbed in". The applications should take place once or twice per day. The erythromycin should begin working soon after the patient begins treatment. If six to eight weeks pass without improvement of the condition, or the condition worsens at any time, the patient should stop erythromycin treatment immediately.

The acne may significantly improvement within 12 weeks, but noticeable improvement should occur sooner.

Topical Erythromycin solution is typically distributed in 30g or 60g tubes.

Drug Interactions

Erythromycin has the potential to interact with a number of other medications. The patient should inform their doctor of any medications they are taking, as well as any allergies they may have before beginning Erythromycin treatment. Some of the medications that Erythromycin treatment interacts with include:

  • Other Medications to Treat Acne
  • Clindamycin (common in many skin products)
  • Disulfiram

Sold under the brand names:

  • Cleocin HC
  • Cleocin Pediatric
  • Cleocin Phosphate
  • Cleocin Phosphate
  • ADD-Vantage

Medications for Acne Include:

  • Sprintec (28) oral
  • Clindamycin HCl oral
  • YAZ (28) oral
  • Tri-Sprintec (28) oral
  • Doxycycline hyclate oral
  • TriNessa (28) oral
  • Lo Loestrin Fe oral
  • Generess Fe oral
  • Mononessa (28) oral
  • Seasonique oral
  • Azurette (28) oral
  • Minastrin 24 Fe oral
  • Junel FE 1/20 (28) oral
  • Beyaz oral
  • Ocella oral
  • Solodyn oral
  • Ortho Tri-Cyclen Lo (28) oral
  • Lutera (28) oral 243
  • Microgestin FE 1/20 (28) oral
  • Gildess FE 1.5/30 (28) oral
  • Loryna (28) oral
  • Necon 1/35 (28) oral
  • Sronyx oral
  • Doxycycline oral
  • Minocycline oral
  • Tri-Previfem (28) oral
  • Cryselle (28) oral 1
  • Yasmin (28) oral
  • Aviane oral
  • Natazia oral
  • Viorele (28) oral
  • Femcon Fe oral
  • Reclipsen (28) oral
  • Epiduo topical
  • Ortho Tri-Cyclen (28) oral
  • Apri oral
  • Jolessa oral
  • Amethia oral
  • Kariva (28) oral
  • Ortho-Cyclen (28) oral
  • Quasense oral
  • Junel FE 1.5/30 (28) oral
  • Doryx oral
  • Claravis oral
  • Gianvi (28) oral
  • Low-Ogestrel (28) oral
  • Microgestin Fe 1.5/30 (28) oral
  • Trivora (28) oral
  • Enpresse oral
  • Cleocin oral
  • Tri-Estarylla oral
  • LoSeasonique oral
  • Balziva (28) oral
  • Levora-28 oral
  • Vestura (28) oral
  • Nortrel 1/35 (28) oral
  • Camrese oral
  • Aubra oral
  • Tazorac topical
  • Erythromycin oral
  • Clindamycin phosphate topical
  • Portia oral
  • Orsythia oral
  • Aczone topical
  • Levora 0.15/30 (28) oral
  • Chateal oral
  • Previfem oral
  • Microgestin 1/20 (21) oral
  • Nortrel 1/35 (21) oral
  • Tri-Lo-Sprintec oral
  • Differin topical
  • Ziana topical
  • Junel 1/20 (21) oral
  • ZenChent (28) oral
  • Loestrin Fe 1/20 (28-Day) oral
  • Isotretinoin oral
  • Tetracycline oral
  • Mono-Linyah oral
  • Falmina (28) oral
  • Tarina Fe 1/20 (28) oral
  • Lomedia 24 Fe oral
  • Desogen oral
  • Benzoyl peroxide topical
  • Tilia Fe oral
  • Introvale oral
  • Emoquette oral
  • Tretinoin topical
  • Tri-Linyah oral
  • Retin-A Micro topical
  • Lessina oral
  • Alyacen 1/35 (28) oral
  • Benzaclin topical
  • Quartette oral
  • Norgestimate-ethinyl estradiol oral
  • Necon 7/7/7 (28) oral
  • Doxycycline monohydrate oral
  • Syeda oral
  • Acanya topical
  • Retin-A topical
  • Vibramycin oral
  • Altavera (28) oral
  • Junel 1.5/30 (21) oral
  • Atralin topical
  • Acticlate oral
  • Mircette (28) oral
  • Duac topical
  • Caziant (28) oral
  • Safyral oral
  • Amethyst oral
  • Veltin topical
  • Nortrel 7/7/7 (28) oral
  • Zarah oral 2
  • Tri-Legest Fe oral
  • Minocin oral
  • Estrostep Fe-28 oral
  • Nikki (28) oral
  • Onexton topical
  • Amethia Lo oral
  • Adapalene topical
  • Ery-Tab oral
  • Ortho-Novum 7/7/7 (28) oral
  • Ortho-Novum 1/35 (28) oral
  • Daysee oral
  • Microgestin 1.5/30 (21) oral
  • Enskyce oral
  • Loestrin 1/20 (21) oral
  • Monodox oral
  • Ovcon-35 (28) oral
  • Camrese Lo oral
  • Norinyl 1+35 (28) oral
  • Cyclafem 1/35 (28) oral
  • Myzilra oral
  • Vienva oral
  • Benzaclin Pump topical
  • Necon 0.5/35 (28) oral
  • Sumaxin topical
  • Kurvelo oral
  • Zenatane oral
  • Velivet Triphasic Regimen (28) oral
  • Cyclessa (28) oral
  • Levonorgestrel-ethinyl estradiol oral
  • Sulfacetamide sodium-sulfur topical
  • Erythrocin (as stearate) oral
  • Loestrin Fe 1.5/30 (28-Day) oral
  • Avar-E topical
  • Retin-A Micro Pump topical
  • Estarylla oral
  • Erythromycin ethylsuccinate oral
  • Marlissa oral
  • Ashlyna oral
  • Salicylic acid topical
  • Azelex topical
  • Evoclin topical
  • Absorica oral
  • Norgestrel-ethinyl estradiol oral
  • Pimtrea (28) oral
  • Acnomel topical
  • Cleocin T topical
  • TRETIN-X topical
  • Gildess 1.5/30 (21) oral
  • Clindamycin palmitate HCl oral
  • Leena 28 oral
  • Bensal HP topical
  • Clindagel topical
  • Erythromycin-benzoyl peroxide topical
  • Myorisan oral
  • Desogestrel-ethinyl estradiol oral
  • Avar-E LS topical
  • Dasetta 1/35 (28) oral
  • Blisovi Fe 1/20 (28) oral
  • Ogestrel (28) oral
  • Nortrel 0.5/35 (28) oral
  • Zenchent Fe oral
  • Loestrin 1.5/30 (21) oral
  • Benzamycin topical
  • Azelaic acid topical
  • NuOx topical
  • BenzEFoam topical
  • Larin Fe 1.5/30 (28) oral
  • Epiduo Forte topical
  • Tri-Norinyl (28) oral
  • Avar topical
  • Dasetta 7/7/7 (28) oral
  • Tazarotene topical
  • Erythromycin stearate oral
  • Necon 10/11 (28) oral
  • Modicon (28) oral
  • Plexion topical 4
  • Aranelle (28) oral
  • Avar-E Green topical
  • Cyclafem 7/7/7 (28) oral
  • Norethindrone acetate-ethinyl estradiol-iron oral
  • Avage topical
  • Blisovi 24 Fe oral
  • EryPed 200 oral
  • Brevicon (28) oral
  • Sumadan topical
  • Wymzya Fe oral
  • Vyfemla (28) oral
  • Liquimat topical
  • Klaron topical
  • Acne-Clear topical
  • Norethindrone acetate-ethinyl estradiol oral
  • Clindamycin-benzoyl peroxide topical
  • BenzEFoam Ultra topical
  • Norethindrone-ethinyl estradiol oral
  • E.E.S. 400 oral
  • L.norgest-eth.estradiol triphasic oral
  • Rosula topical
  • Briellyn oral
  • SulfaCleanse 8-4 topical
  • Philith oral
  • Elinest oral
  • Alyacen 7/7/7 (28) oral
  • Pirmella oral
  • Cyred oral
  • Setlakin oral
  • Bekyree (28) oral
  • Panoxyl topical
  • Coal tar-salicylic acid topical
  • BenzamycinPak topical
  • Ery Pads topical
  • Pacnex topical
  • PanOxyl-4 topical
  • Effaclar DUO topical
  • Blisovi Fe 1.5/30 (28) oral
  • Doryx MPC oral
  • EryPed 400 oral
  • E.E.S. 200 oral
  • E.E.S. Granules oral
  • Drospirenone-ethinyl estradiol oral
  • Rosanil topical
  • Plexion Cleansing Cloths topical
  • Levonorgestrel/ethinyl estradiol and ethinyl estradiol oral
  • BP 10-1 topical
  • Sumaxin TS topical
  • Sulfacetamide-sulfur-skin cleanser no.23 topical
  • Wera (28) oral
  • Levonest (28) oral
  • Clindamycin Pediatric oral
  • Gildagia oral
  • SSS 10-5 topical
  • Desogestrel-ethinyl estradiol/ethiny estradiol oral
  • Layolis Fe oral
  • Juleber oral
  • TriNessa Lo oral
  • Tri-Lo-Estarylla oral
  • Tri-Lo-Marzia oral
  • Kaitlib Fe oral
  • Tretinoin microspheres topical
  • Sulfacetamide sodium (acne) topical
  • Persa-Gel topical
  • Avita topical
  • Salicylic acid-sulfur topical
  • Acne Treatment (benzoyl peroxide) topical
  • Sulfo-Lo topical
  • Neutrogena Oil-Free Acne Wash topical
  • Minocycline intravenous
  • Minocin intravenous
  • Vanoxide-HC topical
  • X-Seb T Pearl topical
  • Acne Pads topical
  • Scalp Relief topical
  • Tretinoin-emollient cmb9-skin cleanser 1 topical
  • Benzoyl peroxide microspheres topical
  • Inova 8-2 topical
  • Salkera topical
  • Dapsone topical
  • Adapalene-benzoyl peroxide topical
  • Benzoyl peroxide-vitamin E mixed topical
  • Pacnex MX topical
  • Clindacin P topical

The patient should also advise their physician of any over the counter skin products they are taking. If interaction with any medication not listed here occurs, the patient should inform their physician.

Warnings

A major risk of antibacterial agents is pseudomembranous colitis. This condition causes inflammation of the colon caused by an overgrowth of bacteria resultant from antibiotic use. If the patient reports diarrhea at any time, the caregiver should consider this diagnosis to ensure that this condition is adequately treated. In milder cases, discontinuation of Erythromycin is sufficient to treat the pseudomembranous colitis. In more moderate to severe cases, management of the condition with electrolytes and fluids, and supplementation with protein are used in conjunction with an antibacterial drug to successfully treat pseudomembranous colitis.

Erythromycin must only be used topically, never in an ophthalmic manner. Other topical acne therapies should be used with caution due to the potential for cumulative irritancy. This risk is especially present when Erythromycin is used in conjunction with agents for abrasion, desquamating, or peeling. In general, it may be best to avoid mixing erythrmycin with other topical products unless necessary. The use of antibacterial agents can cause the growth of organisms that resist bacteria. The occurrence of this growth should prompt immediate discontinuation of Erythromycin.

Studies on rats to determine Erythromycin's potential for carcinogenesis, mutagenesis and fertility impairment found no evidence of tumorigenicity or effect on fertility. However, studies on human females have not been performed. Caution should be exercised when pregnant women use erythromycin. Though some erythromycin crosses the fetal plasma barrier. In general, caregivers should carefully consider the risks involved when prescribing any medication to pregnant women.

Women who are nursing should use caution when taking erythromycin, due to the possibility of secretion in breast milk. Though there is no evidence that secretion will harm the baby, it may be a possibility.

Proper hand washing should occur both before and after erythromycin treatment. The solution should never be ingested or inhaled, as it is toxic.

Erythromycin is contraindicated in patients who show hypersensitivity to the drug or its ingredients.

Storage

Erythromycin is flammable. Tubes should be kept away from heat and flame. It should be stored at a temperature between 59-77 degree Fahrenheit.

Summary

Topical Erythromycin can be an effective treatment for the bothersome condition known as acne. Patients report seeing results within days of starting. It is a powerful antibiotic that can effectively cleanse pores by killing the bacteria that causes acne. Effective treatment of acne, coupled with healthy practices that curtail the condition such as avoidance of certain foods and drinks can be helpful in keeping skin healthy and avoiding permanent acne scarring. Erythromycin can be a great treatment for other skin conditions when the caregiver deems in necessary.

Erythromycin is one of several great drugs available for the condition. However, it can come with side effects. Antibacterial medications such as erythromycin can enable growth of bacteria in the colon, which may serious conditions such as pseudomembranous colitis. If a patient has diarrhea at any point during their treatment with erythromycin, the doctor should stop erythromycin treatment immediately and provide any necessary therapy for the pseudomembranous colitis.

Additionally, irritation of the skin may occur, especially if the topical erythromycin is used in conjunction with other medications for skin. Caregivers should discourage their patients from using any other topical skin treatment during erythromycin treatment. Patients may have an allergy to the drug, and if an allergic reaction occurs erythromycin should be immediately discontinued. Before beginning treatment with any drug, a patient's caregiver should determine if the risk is worth the benefit.