Clindamycin for acne: what is it, benefits, side effects

If you’ve dealt with acne, you’ve probably tried it all—special scrubs, cleansers, creams, and lotions. But did you know certain types of acne are best treated with antibiotics, like clindamycin? 

While this antibiotic is commonly prescribed for many different conditions, clindamycin for acne works best when the acne is harder-to-treat because there’s a bacterial component. 

If you are considering trying clindamycin for your acne, read on to learn everything you need to know about clindamycin, from its uses to its side effects.

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Clindamycin (or clindamycin phosphate) is an antibiotic used to treat a variety of medical conditions. When given by mouth, it can help with infections like malaria and vaginal infections. Topically, clindamycin can help treat skin conditions like acne. 

As an antibiotic, oral clindamycin can treat a variety of diseases, including (Murphy, 2021):

• Blood infections (septicemia)

• Methicillin-resistant Staphylococcus aureus (MRSA)

• Gynecologic infections, like vaginosis

• Bone and joint infections

• Skin infections

• Streptococcal pharyngitis (strep throat)

• Malaria

Clindamycin lotion and gel are FDA-approved to treat acne (also called acne vulgaris), one of the most common skin conditions. Experts estimate that acne affects 40–50 million people in the U.S. at any given time (AAD, n.d.).

Clindamycin cream is typically used vaginally to treat bacterial vaginosis, a common cause of vaginal discharge.

Clindamycin kills bacteria by getting inside their cells and stopping protein production. To better understand how clindamycin treats acne, let’s take a look at how acne develops. 

Acne blemishes occur when pores in your skin get clogged with oil and dead skin cells. On top of that, bacteria that usually live on your skin (like C. acnes) can get into the clogged pores. When this happens, the microbes grow, leading to bacterial infection and inflammation. Topical treatments, like clindamycin lotion or gel, work to kill bacteria that can get trapped inside pores and decrease inflammation (Sutaria, 2021). 

Clindamycin may be an effective acne treatment, but because of growing antibiotic resistance, most dermatologists use it only in combination with other acne treatments, like topical retinoids and over-the-counter benzoyl peroxide (Zaenglein, 2018).

Studies back this up, too. Research suggests that a combination of isotretinoin (a derivative of vitamin A) with topical clindamycin improved acne lesions with very few side effects (Faghihi, 2017). Other studies propose that a combination of benzoyl peroxide and topical clindamycin are more effective than either treatment alone (Zaenglein, 2018). 

This antibiotic comes in both oral (pill) and topical forms. The oral forms generally come in 75 mg, 150 mg, and 300 mg doses. 

For acne, people typically use 1% clindamycin gel or 1% clindamycin lotion. Some dermatologists may recommend a topical solution or foam formulation of clindamycin for your acne.

While clindamycin is available as a generic medication, you can also find it under the brand names Cleocin T, Clindagel, Clinda-Derm, and Evoclin, among others (UpToDate, n.d.). 

Some combination treatments currently available include: 

• Acanya, Benzaclin, and Duac—These are all combinations of clindamycin and benzoyl peroxide.

• Ziana—This is a combination of clindamycin and tretinoin. 

Topical clindamycin is generally considered safe and well-tolerated. But like all drugs, there are potential side effects at the application site, including (DailyMed, 2021):

• Burning

• Itching

• Dryness

• Peeling

• Redness

• Oily skin

Abdominal upset or other gastrointestinal problems may arise with topical clindamycin formulations. Serious side effects are rare, but you should seek medical advice immediately if you develop any of the following:

• Severe headache

• Diarrhea

• Stomach cramps

• Bloody stool

• An allergic reaction (redness, swelling, or itching at the site of application)

If you are pregnant or may become pregnant, it’s important to know that the FDA categorizes oral clindamycin as pregnancy class B. That means that there is not enough good data to know if these pills are safe or not in pregnancy. Oral clindamycin may be found in breast milk, so your healthcare provider may choose a different medication if you are nursing. 

There is no evidence to suggest that the topical forms of clindamycin are unsafe. Still, you should always check with your healthcare provider, especially if you are pregnant, trying to become pregnant, or nursing (DailyMed, 2021).

Another clindamycin warning is the potential for developing bacterial colitis, specifically C. difficile-associated diarrhea (CDAD). Again, this happens more with the oral forms of clindamycin (UpToDate, n.d.). 

Most insurance companies cover this medication, so check with your prescription plan before you go shopping. On average, topical clindamycin costs from $20 to over $200, depending on the brand and the form you choose (GoodRx.com, n.d.)

When used in combination with other acne treatments, topical clindamycin may help clear up your inflammatory acne. Talk to your healthcare provider to see if this treatment is right for you.

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Current version

November 02, 2021

Written by

Maria del Russo

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.