How Do Topical Antimicrobials Work?

Topical antimicrobials are medications used to treat skin infections caused by bacteria and reduce the redness, swelling, itching, and discomfort of various skin conditions. They play a crucial role in the prevention and treatment of primary and secondary superficial bacterial infections. They are often used as a first aid in minor skin abrasions and wounds.

Topical antimicrobials work in the following ways:

• They inhibit the growth of micro-organisms (fungi, viruses, bacteria), exerting a fast and prolonged antibacterial effect.
• They easily diffuse through cells with minimal toxicity and have a sparse activity against normal skin flora. 
• In addition, topical antimicrobials possess bactericidal activity; they eventually kill the invading bacteria.

Topical antimicrobials are available in the form of creams, ointments, scrubs, lotions, and swabs.

Follow these instructions for proper use:

• Clean the affected area with water
• Apply a thin layer of cream/ointment/lotion on the skin
• Usually, one to three times daily or as directed by your doctor
• Rub it gently on the affected site
• If you are using the powder, apply a light dusting of the powder on the area
• Wash your hands after use

Topical antimicrobials are used as a cleanser and antiseptic by health care workers and doctors and in hospitals as a surgical hand scrub, wound cleanser, and preoperative skin cleanser.

They are also used in conditions such as:

• Mild folliculitis (a skin disorder caused by inflammation and infection in the hair follicles)
• Herpes labialis (an infection of the mouth area that causes small, painful blisters to develop on the lips, gums, or throat)
• Steroid responsive dermatoses with infection (skin conditions that can be successfully treated with corticosteroid medications)
• Antiseptic wound cauterization (using heat to burn a part of the body to stop bleeding or remove tissue)
• To prevent infection from:
  • minor abrasions
  • wounds
  • scratches
  • scrapes
  • cuts
  • burns

Avoid applying them in your eyes or inside the mouth. If this occurs, wipe off the medication and rinse thoroughly with water. 

Common side effects include:

• Drying/flaking of skin
• Burning and/or tingling at the application site
• Erythema (a type of skin rash caused by injured or inflamed blood capillaries)
• Itching
• Hypopigmentation (patches of skin that are lighter than your overall skin tone)
• Skin irritation
• Striae (stretch marks)

Other rare side effects include:

• Hypertrichosis (a condition that causes excessive hair growth all over the body)
• Perioral dermatitis (inflammation of the skin around the mouth in the form of a scaly or bumpy rash)
• Skin atrophy (thinning of the skin)
• Acneiform eruptions (a group of disorders characterized by papules and pustules)
• Nasal congestion (stuffy nose as a result of too much mucus in the nasal passage)
• Dyspnea (difficulty in breathing)
• Balance/hearing problems
• Allergic reaction
  • Hives
  • Rash
  • Itching/swelling

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Drug names include:                              

• Acyclovir/hydrocortisone
• Bacitracin/hydrocortisone/neomycin/polymyxin topical
• Betadine
• Betasept
• Bioscrub
• Chlorhexidine topical
• Cortisporin ointment
• Dyna-Hex
• Exidine
• Hibiclens
• Hibistat
• Povidone iodine
• Silver nitrate
• Xerese