Sometimes rashes and surgical wounds become infected with bacteria. Doctors treat these infections with antibiotics, which are medicines that can kill bacteria.

However, doctors may prescribe antibiotics even when there is no infection. Most of the time, that’s not useful and it can do more harm than good. Here’s why:

Antibiotics usually don’t help if your skin is not infected

Eczema causes dry, itchy, red skin. People with eczema often have high amounts of bacteria on their skin, but that doesn’t mean they have an infection. Even so, some doctors treat eczema with oral antibiotics, in pill or liquid form.

Antibiotics do not help the itching, redness, or severity of eczema. And the skin bacteria usually come back in a month or two.

You can control eczema better with moisturisers and the other steps below. To relieve itching and swelling, ask your doctor about creams or ointments containing a steroid (also called a corticosteroid) or other medicines.

Most surgical wounds don’t need antibiotics

Some doctors use antibiotic creams or ointments to prevent infection in surgical wounds. However, most surgical wounds have a very low risk of infection. Antibiotics don’t make the risk any lower. In fact, petroleum jelly (Vaseline and generic) is cheaper and less likely to irritate the wound.

Antibiotics have risks

Oral antibiotics for eczema can have side effects, including upset stomach, vomiting, diarrhoea, and vaginal yeast infections. They can also cause allergic reactions such as rashes, swelling, itching, and trouble breathing.

Antibiotic creams and ointments can actually slow down the healing of wounds. And they can cause redness, swelling, blistering, draining, and itching.

Using antibiotics when you don’t need them helps drug-resistant bacteria grow. These bacteria are harder to kill. They can cause illnesses that are harder to cure. This increases the risk of complications and side effects. The resistant bacteria can also be passed on to others.

When do you need antibiotics?

Antibiotics should be prescribed for eczema when there are signs of a bacterial infection, such as:

  • Pus-filled bumps, or cracks and sores that ooze pus
  • Honey-colored crusting
  • Very red or unusually warm skin
  • Possibly fever.

Antibiotics should be prescribed for surgical wounds:

  • When the wound shows signs of a bacterial infection, such as redness, pain, swelling, warmth, pus, oozing, and yellow crusting.
  • Sometimes when a patient has a fever, sweats, or chills.
  • When the wound is in an area of the body that is more likely to get infected (such as the groin).

Safeguard your skin

Eczema:

  • Moisturise often during the day.
  • Use mild unscented skin cleansers and moisturisers. Avoid products with alcohol or dyes.
  • Short, cooler baths and showers are better than long hot soaks.
  • After washing, pat the skin partly dry. Then apply moisturiser right away on your damp skin.
  • Avoid things that make your skin worse. These can include scratchy fabrics, cigarette smoke, strong soaps, detergents and cleaning products.
  • Try to prevent scratching. It can lead to infection. Cut your fingernails short. Light cotton gloves can help prevent scratching at night.

Surgical wounds:

  • Before you leave the hospital or doctor’s office, make sure you know how to care for your wound. Ask where to call if you have questions.
  • Always clean your hands before and after caring for your wound.
  • Don’t scratch the wound. That can slow the healing. Talk to your health professional if itching is a problem.
  • Avoid activities that could cause your wound to pull apart, such as lifting and straining.
  • Eat well to heal well. A healthy diet helps wounds heal.

This report is for you to use when talking with your health professional.

Further information

Antibiotics: Health Navigator
Antibiotic resistance: Health Navigator, Ministry of Health

It’s OK to ask questions
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.

You can also download this information as a pdf (465 KB).

© 2016 Consumers Union of United States, Inc, (101 Truman Ave, Yonkers, NY 10703-1057) Adapted from Consumer Reports (2016), Antibiotics for your skin. When you need them — and when you don’t, developed in co-operation with the American Academy of Dermatology. Choosing Wisely does not assume any responsibility or liability arising from any error or omission or from the use of any information in these resources.