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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on Feb 27, 2024.
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Last updated on Feb 26, 2024.

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What does clindamycin treat?

Clindamycin is an antibiotic that treats acne vulgaris, a type of acne caused by bacteria. Acne is a skin condition that mainly affects your face, back, shoulders and chest. It’s caused by a combination of factors like the overproduction of oil and an excess of bacteria. A sensitivity to androgens makes your skin produce excess oil, which gathers in your pores and follicles. This causes dirt to get trapped, which can cause inflammation and irritation. Additionally, it creates an environment for the bacteria Cutibacterium acnes (C.acnes) to survive.

C. acne is a type of bacteria that causes acne vulgaris. It’s part of your skin’s microflora, which refers to all the bacteria that live on your body. They keep your body running healthily, like supporting your digestive and immune systems. However, when an excess is produced on the surface of your skin, it can get trapped in your pilosebaceous unit and cause inflammation. As a result, nodules (hard spots), papules (spots with no pus) and pustules (spots with pus) form on your skin.

Antibiotics are recommended as one of the first lines of treatment for acne. Taking antibiotics, like clindamycin, can kill the bacteria and help treat your acne symptoms. If you have acne it’s also best to start treatment sooner rather than later, as the longer it’s left the more likely for scarring to occur. It can also cause hyperpigmentation especially if you are of Asian or African descent.

How does it work?

Bacteria require protein to grow and survive. Proteins in bacteria are made in a component called ribosomes. Within the ribosome, you have subunits called 50S subunits. Clindamycin works by interrupting the protein lifecycle by binding to the 50S subunit. And depending on the dosage and concentration, clindamycin either kills the bacteria or prevents it from growing.

Additionally, it can reduce the toxins produced by bacteria and enhance the immune system to destroy bacteria. Even after stopping treatment with clindamycin, the antibiotic effects remain. This is known as the postantibiotic effect, so your acne shouldn’t come back even after treatment stops.

How long does clindamycin take to work for acne?

Antibiotics work relatively quickly once absorbed by your body. But for the full effects, it can take up to six weeks. This also depends on the type of medication you’re using. If after this time you’re not seeing any improvements in your skin, contact your clinician online.

In the first few days or weeks of taking acne medication, it’s common for your skin to appear worse than before. However, this is usually a normal part of the process of clearing acne, called purging. Acne medication clears your skin by bringing impurities like unformed spots, germs, and other debris to the surface of your skin to clear them out.

What form does clindamycin come in?

Clindamycin is available in various forms including capsules, creams, gels, pessaries, and solutions. But for acne, it’s mainly used as a topical treatment in the form of gels, creams, lotions, and liquid solutions. A form with a higher concentration of active ingredients may be selected if your acne is particularly bad. But in general they all contain the same active ingredient and there isn’t much difference between them. So you can choose any of these forms according to your preference.

What treatments contain clindamycin?

There are a lot of acne treatments available that contain clindamycin. They come in different forms, with many containing an additional ingredient to help clear acne. Some are branded, whilst others are generic, which tend to be cheaper.

Dalacin T lotion - a liquid solution that is applied straight to your skin. A thin layer is applied about two times a day. It contains 10 mg of clindamycin per gram.

Duac gel - contains clindamycin and benzoyl peroxide, which is a keratolytic that helps break down the top layer of your skin to reduce breakouts. Comes in two different doses but both contain the same concentration of clindamycin 10 mg/g, only the concentration of benzoyl peroxide changes. It’s also available as a generic treatment.

Treclin gel - a gel containing clindamycin and tretinoin, a vitamin A derivative. Vitamin A speeds up the skin renewal process. This helps prevent breakouts and makes your skin look fresher. There's only one dose available: 10 mg of clindamycin and 0.025 mg of tretinoin per gram

Zindaclin gel - contains clindamycin phosphate an inactive version of clindamycin which converts into the active form once absorbed. It contains 1.2% clindamycin phosphate which is equivalent to 1% clindamycin.

In some cases, you might get prescribed clindamycin tablets. These come in three different doses 75 mg, 150mg and 300mg. Depending on the severity of your acne, your clinician will decide your dose and the duration of your treatment.

Are there any similar treatments to clindamycin?

There are many similar antibiotic treatments for acne such as doxycycline, erythromycin and lymecycline. All these come as oral tablets in different doses. Doxycycline and lymecycline are in the class of antibiotics called tetracyclines. They work by inhibiting protein synthesis in bacteria, which prevents bacterial growth.

Furthermore, erythromycin is a macrolide antibiotic, which works by disrupting protein production in bacteria and in higher doses it can kill them. Since there are many options you can choose from, if you're using one and it isn't working well for you, trying a different one might help.

Is clindamycin only available with a prescription?

It's important to note that any treatment involving clindamycin requires a prescription. Taking antibiotics unnecessarily can be harmful and lead to antibiotic resistance. Clindamycin is usually prescribed for moderate acne, so if your acne isn’t bad, your clinician may suggest trying a different treatment first.

How well does clindamycin work for acne?

Clindamycin is an effective acne treatment. In one study, patients using clindamycin had a 72% reduction in lesions compared to only 57% with oral tetracycline and 12% with placebo. Although it shows standalone treatment with clindamycin is effective, many studies have found it to be even more effective when combined with tretinoin and benzoyl peroxide.

One study that compared clindamycin with 1% clindamycin and 0.025% tretinoin (brand name Treclin) found the combined treatment to be significantly better at healing acne lesions. There was around a 68% decrease in acne lesions in the combined group compared to 56% for the tretinoin-only group and 57% for the clindamycin-only group.

Furthermore, in another study with 480 patients with moderate to moderately severe acne, the group receiving 1% clindamycin and 5% benzoyl peroxide (brand name Duac gel) had more improvement in their acne than the group that used only 5% benzoyl peroxide, 1% clindamycin, or a placebo. The combination group showed a greater reduction in inflammation, acne, and redness compared to the other three groups.

Is clindamycin safe?

Clindamycin is safe to use for most people, but depending on the treatment it might not be safe for pregnant women. For example, Treclin, a clindamycin treatment containing tretinoin, isn’t safe for breastfeeding and pregnant women. Dalacin T, which only contains clindamycin, can be used by pregnant women if necessary, but breastfeeding women should avoid it as there’s a chance of clindamycin entering their milk.

Additionally, treatments like Treclin and Duac gel shouldn’t be used with other products containing benzoyl peroxide, salicylic acid, medicated soaps or any other chemical abrasive. Using them alongside clindamycin could irritate your skin and cause the skin barrier to get damaged, which could make your acne worse.

Topical clindamycin is also safer than oral antibiotics. This is because it only kills the bacteria on the application site rather than affecting all the bacteria in your body. So the good bacteria needed for your body to run smoothly, won’t be affected. It’s also likely you won’t have digestive issues or stomach pain which are common side effects with oral antibiotics. Topical antibiotics do not enter your bloodstream like oral antibiotics, and even if they do it would be a small harmless amount.

What side effects are linked to clindamycin?

As with all medicines, using clindamycin can cause some side effects. The most common side effects include a tingling or burning sensation at the application site, redness, peeling, and increased sensitivity. However, the side effects will vary for each product. So it’s recommended to check the patient information leaflet to get the full list of side effects.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on Feb 27, 2024. Next review due on Feb 27, 2027.

Last updated on Feb 26, 2024.

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