Mupirocin Ointment for Acne: Here’s What to Know About This Antibiotic’s Off-Label Use

Finding the right acne medication can be difficult, and it often takes some trial and error. So if you or your child has already tried first-choice acne medications - such as benzoyl peroxide or adapalene (Differin) - with limited success, know that there are other viable options.

In some cases, topical antibiotics, such as mupirocin, are worth considering. Mupirocin is a topical medication that's widely used to treat bacterial infections. While it's not FDA approved to treat acne, it's a potential off-label treatment.

Knowing more about mupirocin ointment for acne can help you decide if it's a good option for you or your child.

How does mupirocin treat acne?

It's normal for Staphylococcus ("staph") and Streptococcus ("strep")bacteria to live on your skin. But, sometimes, these bacteria build a home inside pimples, causing them to become infected.

This is where mupirocin ointments and creams may come in handy. Mupirocin works by stopping the production of certain proteins that bacteria need to live. This kills the bacteria - and may treat acne in turn. However, this benefit isn't set in stone. Mupirocin is not a proven treatment for acne.

A dermatologist will likely only prescribe you mupirocin if your acne is infected with bacteria and there are other factors at play. Otherwise, mupirocin will not likely help with your acne. And using mupirocin for acne may cause or contribute to antibiotic resistance. This means it may not work in the future if you need it again.

Can mupirocin treat cystic acne?

Mupirocin isn't a proven treatment for acne. But it may treat secondary infections that can happen with acne. Other medications are considered to be more effective for cystic acne.

Cystic acne typically involves painful cysts and nodules. It's also more severe than other forms of acne. An oral antibiotic, such as doxycycline (Vibramycin, Doryx), is one go-to medication for cystic acne. Topical retinoids, such as tretinoin (Retin-A), are beneficial too. Isotretinoin (Claravis, Absorica) is also effective at treating cystic acne when other medications don't work.

Good to know: Isotretinoin is associated with some serious side effects - most notably birth defects. Because of this risk, you'll need to enroll in the iPLEDGE medication safety program if you're prescribed isotretinoin. If you're able to get pregnant, you'll need pregnancy tests before and during treatment with the medication.

What is mupirocin FDA approved to treat?

If you've ever had a bacterial skin infection, your healthcare professional may have prescribed mupirocin to treat it. It comes as a 2% ointment and cream. Mupirocin cream is FDA approved to treat staph and strep skin infections in adults and kids ages 3 months and older.

Mupirocin ointment is also approved to treat impetigo (a contagious skin infection) in adults and kids ages 2 months and older. Impetigo is typically caused by staph or strep bacteria. The hallmark symptom is a honey-colored, crusted rash.

Keep in mind: Various forms of mupirocin - ointment, cream, and nasal ointment - were previously available under the brand name Bactroban. The manufacturer has since discontinued these brand-name products.

How to apply topical mupirocin for acne

Sometimes, people develop impetigo after scratching pimples or other parts of their skin. The instructions for applying mupirocin ointment for acne are the same as using it to treat impetigo.

Wash your hands with soap and water before (and after) applying mupirocin ointment. Then, place a small amount of mupirocin ointment on a gauze pad or cotton swab. (This is recommended in order to prevent extra mupirocin and bacteria from getting on your fingers.) Apply mupirocin to areas with acne 3 times a day.

If you're prescribed the medication, you'll likely be asked to apply mupirocin for no more than 10 days at once. But your dermatologist will tell you how long you should apply mupirocin for.

Can you use mupirocin on your face?

Yes, you can use mupirocin on your face. But avoid applying the medication near your eyes. This helps prevent irritation. If you accidentally get mupirocin in your eyes, wash them out with water right away.

How effective is mupirocin ointment for acne?

There actually aren't many studies about mupirocin for acne. So we don't really know how effective it is for this use. In general, current research shows that mupirocin ointment is most effective for treating bacterial skin infections, such as impetigo.

One study aimed to look at how effective mupirocin is at treating different types of acne. It did so by looking at three different acne treatment groups. One of the groups included people applying mupirocin nasal ointment for 10 days followed by a combination of first-choice medications for 12 weeks. These included oral doxycycline, topical clindamycin, and adapalene gel.

The investigators found that mupirocin improved acne when used in combination with these other medications. However, it didn't make a significant difference when compared to using the first-choice medications on their own.

Unless more supporting data becomes available, dermatologists will likely continue to recommend alternative topical antibiotics as first-choice treatments for acne.

Risks and side effects of mupirocin for acne

Like with all medications, mupirocin ointment has some potential side effects to be aware of. Since it's a topical medication, most of the side effects happen on the skin and are mild overall. Common mupirocin skin side effects include:

• Burning

• Stinging

• Pain

• Itching

Rash, nausea, and dry skin are less common but possible. These side effects are also typically mild. Reach out to your dermatologist if you have any side effects that are bothersome, get worse, or don't go away.

Serious side effects of mupirocin for acne

While rare, serious side effects have been reported by some people using mupirocin ointment. Anaphylaxis (severe allergic reaction) is one of them. If you're allergic to mupirocin or any of its ingredients, it's best to avoid this medication.

One of the inactive ingredients in mupirocin ointment is polyethylene glycol (PEG). This ingredient is commonly included in ointments to help the ingredients work together. But PEG can absorb into the body if it's applied to open wounds or damaged skin.

While very rare with a topical medication, too much PEG absorption could damage the kidneys. This can be dangerous if you already have kidney problems. Let your dermatologist know if you have kidney problems before starting mupirocin treatment.

Topical mupirocin's safety during pregnancy

Understanding which medications are safe to take during pregnancy is very important if you're pregnant or plan to become pregnant. According to research, mupirocin is a safe topical antibiotic to use during pregnancy. No birth defects were reported in small studies.

Alternatives to mupirocin ointment for acne

Since mupirocin ointment isn't commonly prescribed for acne, it's good to be aware of the other options.

The best acne treatment for you will depend on what you've tried before, any other health conditions you have, and your age. Certain acne medications are easily found over the counter (OTC). Others are prescription-only.

Common topical OTC acne treatments include:

• Benzoyl peroxide

• Salicylic acid

• Azelaic acid

• Adapalene

Notable topical prescription acne treatments include:

• Tretinoin (Retin-A, Atralin, Altreno)

• Tazarotene (Tazorac, Fabior, Arazlo)

• Clindamycin (Clinda-Derm, Clindagel, Cleocin-T)

• Minocycline (Amzeeq)

• Winlevi (clascoterone)

These prescription acne medications come as oral pills:

• Doxycycline

• Minocycline (Minocin)

• Oral contraceptives such as ethinyl estradiol / norgestimate (Ortho Tri-Cyclen 21, Ortho Tri-Cyclen 28)

• Spironolactone (Aldactone)

• Isotretinoin