Antibiotics for Your Skin
When you need them—and when you don’t
Skin problems can sometimes look like infections, especially if they’re red, swollen, or tender. So it might seem like treating them with antibiotics is a good idea. But some skin problems don’t stem from infections at all. So treating them with antibiotics can do more harm than good. Learn about situations when you don’t need antibiotics for your skin. Also learn how to talk to your doctor about when antibiotics may be needed.
Antibiotics don’t help if your skin is not infected
Eczema causes red, itchy, and scaly skin. People with eczema often have high amounts of bacteria on their skin. But that doesn’t mean that the germs are causing infection. Even so, some doctors treat eczema with antibiotics that you take by mouth (in pill or liquid form) to kill the germs.
Antibiotics also don’t help your itching or redness. And they don’t make your eczema less severe. Plus, your skin bacteria usually come back in a month or two, if not sooner.
You can control eczema better with lotions and other steps (see “Advice from Consumer Reports”). To ease itching and swelling, ask your doctor about other treatments, such as creams and ointments that contain medicine. You can get them with or without a prescription.
Inflamed cysts usually don’t require antibiotics
Swollen, red, and tender lumps under the skin are usually either inflamed cysts or small boils. You usually don’t need antibiotics for either of these problems.
Inflamed cysts sometimes get better on their own. If they keep getting inflamed, or if they are large or painful, the doctor can open and drain the cyst by making a small incision. Some cysts can be removed surgically. Both are simple procedures that can be done in a doctor’s office. After that, your cyst will likely heal on its own without antibiotics.
Most surgical wounds don’t need antibiotics
Some doctors prescribe antibiotic creams or ointments to keep wounds from getting infected after surgery.
Although infections still happen at hospitals and ambulatory surgery centers, the risk of an infection is fairly low. And topical antibiotics for your skin don’t lower your risk of infection. Other measures, such as good handwashing by staff, work better to prevent infection. Petroleum jelly (Vaseline and generic) can help wounds heal by keeping them moist. Plus, it’s cheaper and less likely to make the wound sore.
Dangers of superbugs
Each year, at least 2 million Americans get sick from superbugs.
Some 23,000 of them die as a result.
About 14,000 Americans die from Clostridium difficile
(C. diff) bacteria every year. This infection is triggered by antibiotics.
It causes bad diarrhea and often high fever.
Swelling and redness in your lower legs may not require treatment with antibiotics
If one or both of your lower legs are swollen and red, visit your doctor to find out why. In most cases, if both of your lower legs are swollen and red at the same time, it’s not because of an infection. That means you don’t need antibiotics.
There are many other reasons why your lower legs could be swollen and red. For instance, you could have varicose veins or a blood clot in your leg. You could have an allergy to something you touched, such as a detergent or soap. Leg swelling could even be a sign of heart disease.
Before prescribing an antibiotic, your doctor should talk to you and do any tests needed to rule out these problems. Even then, you should take antibiotics only if there’s a clear sign of an infection like cellulitis. That’s a common skin infection that causes redness and swelling.
Who needs antibiotics for skin problems?
You need antibiotics only if you have signs of a skin infection. These may include:
- Bumps filled with pus
- Cracks and sores that ooze pus
- Wound that oozes pus or has yellow crusts
- Feeling very hot or cold
- High white blood cell count
- Crusts the color of honey
- Very red or warm skin with other signs of infection
- Wound that is red, painful, swollen, or warm
Antibiotics can be harmful
If you have an infection, antibiotics can save your life. But antibiotics can also be harmful if you take them when you don’t need them. The more antibiotics you use, the less likely they are to work when you need them.
Antibiotics can cause side effects. Antibiotics that you take by mouth can cause upset stomach, vomiting, diarrhea, and vaginal yeast infections. They can also cause allergic reactions. These include rashes, swelling, itching, and trouble breathing. Side effects from antibiotics cause nearly 1 in 5 trips to the emergency department.
Antibiotic creams and ointments can slow the healing of wounds. And they can cause redness, swelling, blistering, draining, and itching.
Antibiotics can breed superbugs More than half of all antibiotics used in the U.S. are not needed. That’s according to the Centers for Disease Control and Prevention. Taking antibiotics when you don’t need them can breed “superbugs.” These are bacteria that are hard to kill. They can make it harder to get well and cause health problems. You can spread superbugs to other people.
Antibiotics can be a waste of money Antibiotics that you take by mouth can cost from $8 to more than $200. Antibiotic creams and ointments can cost from $5 to more than $150. Plus, you may need to spend more on healthcare and treatments due to side effects and superbugs from antibiotics.
Advice from Consumer Reports
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
© 2016 Consumer Reports. Developed in cooperation with the American Academy of Dermatology. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/.