Clindamycin for Hormonal Acne

Antibiotics such as clindamycin can be a good way to quickly tackle the symptoms of an inflammatory condition such as acne.

However, before reaching for the prescription pad, consider your alternatives.

While clindamycin can be effective short term, it’s a medication that comes with quite a few side effects.

Therefore, in this article, we will talk about how clindamycin works for hormonal acne, what benefits it can provide for acne-prone skin, and what are some side effects you need to watch out for when using this component orally and topically.

Additionally, we will also provide some natural and effective alternatives to clindamycin that can help you get rid of hormonal acne without using medications.

What is Clindamycin?

Clindamycin is an antibiotic that belongs to a class of medications called lincomycin or lincosamides.

It is commonly used to treat bacterial infections, including joint infections, pelvic inflammatory disease, periodontal disease, and endocarditis, inflammation of the inside lining of the heart chambers and valves.

However, due to its ability to make it hard for some strains of bacteria to proliferate, clindamycin has been prescribed as an acne medication to help destroy the overgrowth of the acne-causing bacteria in those dealing with this condition.

How Does Clindamycin Work for Acne?

Clindamycin attacks a few strains of bacteria, including streptococcal, staphylococcal, and anaerobic bacteria, which are a type of bacteria that thrive and proliferate in an airless or oxygen-free environment.

This type of bacteria generally lives in the gastrointestinal tract; however, one particular strain that occupies the hair follicles and sebaceous glands, known as C. acnes, and is the primary culprit behind acne, also belongs to this anaerobic family.

Now, C. acnes is a bacterium that is generally commensal or neutral, meaning it is a part of our microbiome and doesn’t cause harm in a healthy system.

However, when certain conditions occur, such as increased oil production, which blocks the pores and provides an airless or oxygen-free environment this bacterium needs to thrive, it can become pathogenic and produce proteins that cause inflammation and trigger the immune system into a fight mode, leading to a swollen area on the skin we see as a pimple.

This is where clindamycin comes in as a potential remedy for this inflammatory condition, as the action of this component prevents this strain of bacteria from proliferating or reproducing by blocking it from making the proteins it needs to create new cells.

Clindamycin is available in topical and oral forms, both prescribed by a doctor and is used as a short-term therapy due to the potential to cause adverse effects if used for a prolonged period.

Side Effects of Using Clindamycin for Acne

Like every other component found in oral medications or topical ointments, clindamycin can potentially cause some adverse effects.

Therefore, here are a few side effects that can be experienced by using oral and topical clindamycin, which should be a good indication this component isn’t working for you:


Allergic reactions are one of the most common side effects of clindamycin and can occur from using this antibiotic in both oral and topical forms.

Common symptoms of an allergic reaction to clindamycin include difficulty breathing, blisters, rashes, red skin lesions, sores, ulcers on the skin, and fever and chills.

If you experience any of these adverse effects after using clindamycin, it is essential to seek medical help, as allergies can progress relatively quickly and start mild but develop into life-threatening conditions.

Imbalanced Microbiome

An imbalanced microbiome is another common side effect of taking clindamycin or any antibiotic because the microbiome is composed of bacteria, most of which are good and beneficial for our system.

However, when taking a medication that destroys bacteria, such as an antibiotic, this means that you are killing all bacteria and not just the bacteria that is overgrown and causing issues, such as acne.

An antibiotic doesn’t recognize good bacteria from bad and will destroy them all, which can lead to an imbalance of the microbiome where there are not enough good bacteria left to help fight against the bad ones, leading to other forms of bacterial colonization, which can cause issues such as infections.

Bacterial Resistance

Taking antibiotics such as clindamycin for a prolonged period can also lead to bacterial resistance, which is a condition where the bacteria develops a biofilm that helps it protect itself from the action of the antibiotic and become resistant to it.

This can lead to bacterial infections that are much more difficult to treat because they are resistant to the thing we commonly use to treat them and will require a more aggressive approach, such as a combination of antibiotics or the use of other drugs that are not intended for this purpose.

Skin Irritation

Skin irritation is one of the most common side effects of topical clindamycin due to this component’s ability to dry out the skin and cause excessive flaking.

Additionally, most topical clindamycin ointments contain alcohol, which can lead to the skin feeling tight, itchy, or burning. In this case, you should either discontinue the treatment altogether or at least reduce usage.

Increased Sun Sensitivity

Topical clindamycin has been connected to causing increased sun sensitivity and sunburns due to its potential to dry out the skin and reduce its ability to protect itself from the burning UV rays.

It’s unclear whether oral clindamycin use can have the same effect; however, some commonly prescribed antibiotics for treating acne, such as tetracyclines, have been connected to sun sensitivity and even phototoxicity; therefore, always make sure to wear sunscreen with an SPF of 30 or more when using this medication topically or orally.


As of 2021, clindamycin is no longer recommended for use by those who are allergic to penicillin or ampicillin.

This is because clindamycin has been proven to cause more severe adverse reactions, such as C. diff., in those sensitive to these components.

This is assumed to be because of its activity against anaerobic bacteria, which can lead to disruption of the intestinal microbiome and the overgrowth of Clostridium difficile, which is a type of bacteria that can cause severe diarrhea, cramping, and fever.

Clindamycin Alternatives for Acne

A few alternatives of clindamycin are often advised or prescribed when a prescription is needed to reduce the severity of acne.

Some of these options include oral antibiotics such as:

  • Minocycline – a tetracycline antibiotic that can reduce inflammation and excessive oil production.
  • Aldactone – an antiandrogen oral medication that targets imbalanced hormones, particularly androgen overactivity, and helps reduce oil production to starve the bacteria out of their food source.
  • Amoxicillin – a safer alternative with fewer side effects prescribed for acne when drugs in the tetracycline or lincosamide class are not an option due to allergies or sensitivities.
  • Isotretinoin – or Accutane, which is typically prescribed to treat severe forms of acne or in the case of antibiotic intolerance or the development of antibiotic resistance.

On the other hand, topical clindamycin is usually replaced by:

  • Benzoyl peroxide – an antibacterial agent that infuses the pores with oxygen and destroys the overgrowth of bacteria.
  • Adapalene – a mild retinoid that dissolves cellular debris inside clogged pores, reduces inflammation, and helps the skin heal faster.
  • Tretinoin – or retinoic acid, which helps increase cellular turnover to stabilize the shedding of dead skin cells and reduce the cellular debris inside the pores bacteria needs to thrive.

Best Ways to Get Rid of Acne Without Medications

Medications are efficient at swiftly eliminating a condition or at least the symptoms associated with that condition.

However, most medications come with a lengthy list of side effects, and many can’t be used by everyone due to allergies, sensitivities, or underlying conditions.

But luckily, acne can be improved and even fully treated with options other than medications.

So, whether you’ve tried medications and it didn’t work out or had an adverse reaction to a prescription drug, other options can work out just as well or even better.

Here are some of the best ways to get rid of acne without medications:

Improve Your Diet

Improving your diet is one of the essential changes you should make to get rid of stubborn and long-lasting inflammatory conditions such as acne.

Adding more anti-inflammatory foods while minimizing the consumption of sugar, processed foods, and unhealthy fats can help you reduce inflammation inside the body and eliminate the root of acne.

Additionally, anti-inflammatory foods such as fatty fish, olive oil, turmeric, and ginger can help naturally balance the hormones, which can oftentimes be behind cystic or hormonal acne, as inflammation through the foods we eat has been proven to disrupt our hormonal balance.

Furthermore, adding more antioxidant foods such as berries and dark green leafy vegetables to your daily menu will help to reduce oxidative stress on the skin and boost your antioxidant capacity, which can help protect against the damage caused by some strains of pathogenic bacteria.

Finally, adding probiotics through foods such as yogurt, kefir, cottage cheese, sauerkraut, kimchi, tempeh, etc., can help balance the bacteria in your gut and promote more of the good bacteria to fight the overgrowth of the pathogenic strains, including the C. acnes bacteria.

However, while definitely most efficient in calming and balancing factors that often lead to hormonal acne, diet is also one of the most difficult changes you can make, as it usually requires a lot of trial and error before you find the right combination that works for your body.

Therefore, it’s always a good idea to have good guidance that will prepare you for all the steps you need to take to properly address your dietary concerns and optimize your menu with the right foods, which is why you must check out GoodGlow’s ebook, a guide packed with information on how to heal your skin by making smart diet changes and taking the guesswork out of the equation.

Adopt Healthy Lifestyle Habits

Destructive lifestyle habits, such as lack of sleep, prolonged stressful periods, and even excessive drinking and smoking, can often lead to issues such as imbalanced hormones and not only exacerbate inflammatory conditions such as acne but be the sole cause behind its formation.

For example, stress and lack of sleep are the two main causes of excess cortisol production, which is a stress hormone that directly stimulates the oil glands into producing excess oil, which will then get stuck inside the pores, clogging them and turning them into the airless environment the acne-causing bacteria need to proliferate.

On the other side, excessive drinking can also spike certain hormones due to to the high sugar levels alcohol contains and cause long-term inflammation that can result in acne.

Therefore, to keep your hormones balanced and, subsequently, your skin clear, introducing healthy lifestyle habits such as managing stress appropriately, avoiding harmful substances, and getting enough sleep wouldn’t be such a bad idea.

Try Supplements

Supplements are components that contain vitamins, antioxidants, and minerals that help improve your health, balance your hormones, reduce inflammation in the body, and by extension, reduce the severity of some inflammatory conditions, including those that appear on the skin.

For example, selenium, vitamin C, and pantothenic acid are essential components and a few of the most efficient natural treatments for acne that can help reduce inflammation, control oil production, and even combat oxidative stress.

Furthermore, supplements such as omega-3 will replenish the fatty acids your body needs to have a healthy inflammatory response and help promote balanced hormones, which can help keep your skin clear.

Therefore, if you’ve tried the dietary and lifestyle changes discussed above but still haven’t seen any positive changes, introducing an extra boost into your daily routine may help you get the desired results.

Have an Excellent Skincare Routine

Besides treating the internal part through diet changes and lifestyle improvements, you should also tackle the external part, which is where acne is the most obvious – your skin.

Having a skincare routine that consists of gentle cleansers, exfoliating actives, hydrating serums, nourishing moisturizers, and protective sunscreens can help soothe the visible inflammation on your skin and improve the appearance of this condition.

Additionally, since acne is an incredibly complex condition, there is no way that you can pinpoint exactly what might be causing it.

Therefore, even if you assume that hormonal imbalances and other underlying health issues are to blame, don’t be surprised if the inflammation fully subsides and acne clears up after introducing the right skincare products in your routine, which will work together to help keep your skin healthy.

Sometimes the problems we are dealing with are much simpler than we think, and making various simple and challenging changes can help us achieve the desired results!

Request Prescriptions for Topicals

If you have decided to visit a doctor for your acne, chances are they might advise you to take antibiotics to reduce the severity of the inflammation and clear up your skin.

However, while doctors are professionals trained to provide the quickest remedy for a condition or a disease their patient is dealing with, taking oral medications, more often than not, comes with side effects, which are often neglected or overlooked because they are effective at treating the primary issue.

So, while your doctor knows best, there’s nothing wrong with asking for alternative acne treatments, as there are many of them, and if you are wary of the potential side effects that might come with using antibiotics, chances are there are other things that can help you.

Therefore, don’t be afraid to communicate with your doctor and ask for alternatives to antibiotics, even if that’s a prescription for a topical medication or natural methods such as diet and lifestyle changes, taking supplements, improving your skincare routine, or considering professional treatments.

Frequently Asked Questions

Does Clindamycin Work on Blackheads?

Clindamycin is excellent at destroying the overgrowth of bacteria causing inflamed pimples; however, it won’t affect or remove non-inflammatory comedones such as blackheads because they are not caused by bacterial overgrowth.

Can Clindamycin Get Rid of Severe Acne?

Clindamycin can get rid of severe acne; however, the results are often not permanent, and acne can return after taking this antibiotic.

How Long Does Clindamycin Take to Work for Acne?

Clindamycin treatment starts working against bacteria right away; however, depending on the severity of your acne, it might take a week for results to start becoming obvious and include reduced redness, smaller and drier pimples, scabs in the place where a pimple used to be, and less frequent breakouts.
A complete clindamycin treatment usually lasts three to five months, which is enough time for acne to be significantly reduced or fully cleared.

Does Clindamycin Remove Acne Scars?

While clindamycin is effective against bacterial conditions such as acne, it won’t remove hyperpigmented or atrophic acne scars.
However, when combined with products like tretinoin, both treatments can lead to positive outcomes such as brightening and fading of discolored acne scarring and improving textural issues from atrophic acne scars.

Is Clindamycin Safe for Everyday Use?

Clindamycin should be used the way your doctor instructs you to use it after assessing your concern and how your skin responds to the treatment.
However, while clindamycin can be used daily for a short time, it isn’t safe for prolonged periods due to the risk of causing a microbial imbalance and leading to adverse effects such as rashes, inflammation, and irritation.

Is Clindamycin High-Risk?

Clindamycin doesn’t increase the chance of birth defects, and as such, it isn’t classified as a high-risk teratogen; however, it’s generally not advised to be used during pregnancy due to the risk of potentially unknown side effects.
Additionally, clindamycin is a high-risk medication for C. diff. infections, with an odds ratio of about 17-20 compared to no antibiotic exposure, meaning that taking this antibiotic can increase the risk of developing symptoms related to this infection, which usually include diarrhea, abdominal cramping, and fever.

Originally Published: March 30, 2023

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Analyzed by Simone Sydel

Hi, I’m Simone Sydel, a licensed esthetician and acne expert dedicated to helping others solve their skin issues including acne, eczema, and UV damage. I specialize in testing and reviewing the latest acne treatments and beauty products, offering honest, practical advice for skincare. I’ve helped hundreds of clients clear their skin and my skincare product reviews have been read by several hundred thousand people. Thanks for visiting!

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