Topical clindamycin is a medication used to treat acne by targeting the bacteria that cause it. It belongs to the class of medications known as lincomycin antibiotics. Clindamycin is available in various forms, including a solution (liquid), a lotion, and a pledget (swab) for topical application to the skin.
Understanding Topical Clindamycin
Clindamycin phosphate, in a 1% solution, is an antibiotic prescribed to combat the bacteria responsible for acne. It functions by inhibiting the growth of Cutibacterium acnes, a bacterium commonly found in clogged pores. When used for acne treatment, clindamycin is often effective when combined with other treatments such as benzoyl peroxide or retinoids like adapalene. Beyond its antibacterial properties, clindamycin phosphate also offers anti-inflammatory benefits, contributing to radiant and refreshed skin.
This medication is available by prescription only and comes in several dosage forms:
- Foam
- Solution
- Lotion
- Pad
- Gel/Jelly
The solution, lotion, pledgets, and most brands of gel are typically applied twice daily. It is important to apply topical clindamycin at approximately the same time(s) each day. Always follow the directions provided on your prescription label carefully, and consult your doctor or pharmacist if any part of the instructions is unclear.
Use topical clindamycin exactly as directed. Do not apply more or less of it, or apply it more often than prescribed by your doctor. Topical clindamycin is intended for external use on the skin only. If the medication comes into contact with your eyes, nose, mouth, or broken skin, rinse thoroughly with plenty of cool water.
Before Using Topical Clindamycin
Before commencing treatment with topical clindamycin, it is crucial to inform your doctor and pharmacist about any allergies you may have, particularly to clindamycin, lincomycin (Lincocin), or any other medications. Additionally, disclose all prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are currently taking or plan to take during your treatment. Your doctor may need to adjust the dosage of your medications or monitor you closely for potential side effects.
It is also important to inform your doctor if you have a history of or currently have:
- Inflammatory bowel disease (IBD), a condition characterized by swelling, irritation, or sores in the lining of the intestine.
- Severe diarrhea caused by an antibiotic. In such cases, your doctor may advise against using topical clindamycin.
- Asthma, eczema (sensitive skin prone to itching or irritation), or allergies.
If you are pregnant, planning to become pregnant, or are breastfeeding, discuss this with your doctor. If you become pregnant while using topical clindamycin, contact your doctor immediately.
Furthermore, if you are scheduled for any surgery, including dental procedures, inform the doctor or dentist that you are using topical clindamycin.
Be aware that abrasive or medicated soaps and skincare products containing alcohol may exacerbate the side effects of topical clindamycin. It is advisable to discuss the skincare products you intend to use during your treatment with your doctor.
Unless otherwise directed by your doctor, you may continue your normal diet.
Drug Interactions
While certain medications should not be used together at all, in other instances, two different medications may be used concurrently even if an interaction is possible. In such situations, your doctor might adjust the dosage or implement other precautions. When using clindamycin, it is vital that your healthcare professional is aware of any other medications you are taking. The following interactions have been identified based on their potential significance:
Medications Not Recommended for Use With Clindamycin
- Levoketoconazole
- Mifepristone
Medications That May Require Dose Adjustments When Used With Clindamycin
- Apalutamide
- Asciminib
- Avacopan
- Belzutifan
- Berotralstat
- Carbamazepine
- Ceritinib
- Cholera Vaccine, Live
- Clarithromycin
- Conivaptan
- Crizotinib
- Daridorexant
- Elinzanetant
- Enasidenib
- Enzalutamide
- Erythromycin
- Fedratinib
- Fluconazole
- Gepotidacin
- Imatinib
- Itraconazole
- Lanreotide
- Lazertinib
- Lefamulin
- Letermovir
- Lonafarnib
- Mavorixafor
- Mitapivat
- Mitotane
- Mobocertinib
- Nirogacestat
- Octreotide
- Omaveloxolone
- Pacritinib
- Palbociclib
- Phenobarbital
- Primidone
- Ranolazine
- Repotrectinib
- Ribociclib
Medications That May Increase Risk of Side Effects When Used With Clindamycin
- Atracurium
- Kratom
- Metocurine
- Tubocurarine
Additionally, discuss with your healthcare professional the use of your medicine in conjunction with food, alcohol, or tobacco, as these may also lead to interactions.
Other Medical Problems
The presence of other medical conditions may influence the use of clindamycin. Ensure you inform your doctor if you have any other medical problems, particularly a history of stomach or intestinal diseases like colitis (including antibiotic-associated colitis) or enteritis, as these conditions can increase the likelihood of gastrointestinal side effects.
Proper Use of Topical Clindamycin
Before applying the medication, thoroughly wash the affected areas with warm water and soap, rinse well, and pat dry. Apply enough medication to lightly cover the affected area. It is recommended to apply the medication to the entire area typically affected by acne, not just individual pimples, to help prevent new breakouts.
Avoid washing acne-affected areas too frequently, as this can dry out the skin and worsen acne. Washing with a mild, bland soap two to three times a day should suffice, unless you have oily skin. Consult your doctor if you have questions about washing frequency.
Topical clindamycin will not cure acne entirely. However, to maintain control over your acne, continue using the medication for the full duration of the prescribed treatment, even if your symptoms improve after a few days. You may need to use this medication daily for months or even longer. Discontinuing treatment too soon can lead to the return of symptoms. It is crucial not to miss any doses.
Specific Instructions for Different Forms:
For Topical Foam:
After washing or shaving, wait at least 30 minutes before applying the foam, as the alcohol content can irritate freshly washed or shaved skin. The foam is flammable; therefore, avoid open flames and do not smoke while applying the foam and for a short period afterward.
- Do not dispense the foam directly onto your hands, as it will begin to melt on contact with warm skin.
- Remove the clear cap and align the black mark with the nozzle of the actuator.
- Hold the can upright and press firmly to dispense. Dispense the amount needed to cover the affected area(s) directly into the cap or onto a cool surface.
- If the can feels warm or the foam appears runny, you can place it under cold running water.
- Gently massage a small amount of foam into the affected areas with your fingertips until it disappears.
- Discard any unused foam that was removed from the can.
This medication contains alcohol and may sting or burn upon application. It has an unpleasant taste if it comes into contact with the mouth or lips. Avoid getting the foam in your eyes, nose, or mouth, or on other mucous membranes. If accidental contact occurs, rinse affected eyes immediately and carefully with large amounts of cool tap water. If burning or pain persists, consult your doctor.
It is important not to use this medicine more often than prescribed, as it may cause excessive dryness or irritation.
For Topical Solution:
Similar to the foam, wait at least 30 minutes after washing or shaving before applying the solution to avoid irritation from the alcohol content. This solution is also flammable; keep it away from heat, open flames, and smoking.
- This medicine comes in a bottle with an applicator tip. Use a dabbing motion rather than a rolling motion to apply the medicine directly to the skin.
- Tilt the bottle and press the tip firmly against your skin. Adjust pressure as needed to control the flow.
- If the applicator tip becomes dry, turn the bottle upside down and press the tip several times to moisten it.
As with the foam, the alcohol in the solution may cause stinging or burning. Avoid contact with eyes, nose, mouth, and other mucous membranes. If accidental contact occurs with the eyes, rinse immediately and carefully with large amounts of cool tap water. Seek medical attention if burning or pain persists.
Do not use this medicine more often than prescribed, as it may lead to excessive dryness or irritation.
For Topical Suspension:
Shake well before applying.
Dosage and Administration
The dosage of clindamycin will vary depending on the individual patient and the specific medical condition being treated. Always follow your doctor's orders or the directions on the prescription label. The following information represents average doses:
- Foam (for acne): Adults and children 12 years of age and older should apply once daily to acne-affected areas. Use in infants and children up to 12 years of age must be determined by a doctor.
- Gel, Solution, and Suspension (for acne): Adults and children 12 years of age and older should apply two times a day to acne-affected areas. Use in infants and children up to 12 years of age must be determined by a doctor.
Missed Dose
If you miss a dose, apply it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not apply extra medication to compensate for a missed dose.
Storage
Store the medication in a closed container at room temperature, away from excessive heat and moisture (avoid storing in the bathroom). Do not freeze. Clindamycin foam should not be exposed to temperatures above 120°F (49°C) and the container should not be punctured or incinerated.
Dispose of unneeded medications in a manner that prevents pets, children, and others from accessing them. Do not flush this medication down the toilet. Utilize a medicine take-back program if available in your community. Always secure safety caps and store medication in a safe location, out of sight and reach.
Precautions and Potential Side Effects
If your acne does not improve within approximately 6 weeks, or if it worsens, consult your healthcare professional. Full improvement of acne may take 8 to 12 weeks of consistent treatment.
If your doctor has prescribed another medication for topical application alongside clindamycin, it is best to apply them at different times to minimize skin irritation and ensure proper efficacy. Applying them simultaneously may cause them to be less effective.
Diarrhea
In some patients, clindamycin can cause diarrhea. Severe diarrhea may indicate a serious side effect. Do not take any anti-diarrheal medication without consulting your doctor first, as some may worsen or prolong the diarrhea. For mild diarrhea, only medications containing attapulgite (e.g., Kaopectate, Diasorb) may be appropriate. Consult your healthcare professional if mild diarrhea persists or worsens.
Cosmetics and Skin Care
You may continue to use cosmetics while undergoing treatment for acne with clindamycin. However, it is recommended to use only "water-based" cosmetics and to avoid excessive or frequent application, as this may aggravate acne. Consult your doctor for guidance on cosmetic use.
Potential Side Effects
Along with its intended benefits, clindamycin may cause unwanted side effects. While not all side effects may occur, some may require medical attention.
Side Effects Requiring Immediate Medical Attention:
- Severe abdominal or stomach cramps, pain, and bloating
- Diarrhea (watery and severe), which may also be bloody
- Fever
- Increased thirst
- Nausea or vomiting
- Unusual tiredness or weakness
- Unusual weight loss These side effects may persist for several weeks even after discontinuing the medication.
Side Effects Requiring Prompt Medical Attention:
- Skin rash, itching, redness, swelling, or other signs of irritation not present before treatment.
Common Side Effects That May Resolve During Treatment:
- Dryness, scaliness, or peeling of the skin (particularly with the topical solution)
- Mild abdominal pain
- Mild diarrhea
- Headache
- Irritation or oiliness of the skin
- Stinging or burning sensation on the skin
If any side effects persist, are bothersome, or if you have questions, consult your healthcare professional. Report any other observed side effects to your healthcare provider.
How Do You Apply Topical Clindamycin? - Skin Savvy Dermatology
Brand Names
Clindamycin is available under various brand names, including:
- Cleocin T
- Clindacin ETZ
- Clindacin P
- Clindacin Pac
- Clinda-Derm
- Clindagel
- ClindaMax
- ClindaReach
- Clindets
- Evoclin
- Z-Clinz
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