Allergic Contact Dermatitis and Topical Antibiotics

J. Desiree Douglas, MPA, PA-C


Dermatology Nursing 

In This Article

Abstract and Introduction


Allergic contact dermatitis (ACD) due to topical antibiotics is very common. Neomycin and bacitracin are in the top ten most common allergens to cause allergic contact dermatitis. These allergens' synonyms, purpose, exposure sources, and avoidance tips are discussed.


Allergic contact dermatitis (ACD) is a type IV delayed sensitivity reaction. The physiology of this reaction was discussed in a previous issue of Dermatology Nursing (Douglas, 2009). Many substances can cause ACD including metals, fragrances, preservatives, and even topical antibiotics. Neomycin and bacitracin will be discussed in further detail.

The North American Contact Dermatitis Group found neomycin sensitivities affected 10% of all patients who were patch tested in 2005–2006. Bacitracin affected 9.2% of the same population. In a 10-year study of hand dermatitis, 7.7% of patients had a neomycin sulfate sensitivity and 7.4% had a bacitracin sensitivity (Warshaw et al., 2007).