Why do dermatologists always tell me to use Polysporin instead of Neosporin? | Anne Marie McNeill M.D., Ph.D

There are a number of topical antibiotics that are available over the counter.  The most common are Polysporin and Neosporin.  Neosporin is the one that most people have heard of, it has great brand-name recognition.  However, most dermatologists do not recommend using Neosporin.
Neosporin contains a mixture of 3 topical antibacterial medications: Neomycin, polymixin, and bacitracin.  Neomycin is one of the most common causes of an allergic contact dermatitis.  Often, if a patient applies Neosporin to a biopsy site, surgical site, or abrasion, after a period of time a red, itchy rash will form, sometimes with very small blisters.  This is an allergic contact dermatitis.    Patients will often think the site is infected, since it becomes red and somewhat tender.
When the skin is open, it is more prone to becoming sensitized to an allergen, so even if the patient wasn’t allergic to neomycin previously, an allergy can develop late in life after prolonged exposure to Neosporin.
For this reason, we often recommend Polysporin.  Polysporin does not have neomycin, it just has polymixin and bacitracin.  Although patients can be allergic to any medication, allergy to these medicines is very uncommon.
Alternative topical treatments for a biopsy site, surgical site, or abrasion include Aquaphor or mupirocin.  Aquaphor is not an antibiotic, just a healing balm.  Mupirocin (the generic name for Bactroban), is a prescription medication.  Both are also good treatments.
It is always best to keep any wound “soft” with either Polysporin, Aquaphor, or mupirocin.  It is a myth that a wound needs to scab or dry out to heal.  And avoid the Neosporin!

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