Medically reviewed by, Russell Braun RPH
It is inevitable that from time to time everyone will get some type of burn, scrape, scratch or cut that needs to be cleaned up. We have all been there. What is the best thing to do for these minor skin problems? Should you reach for Polysporin or Neosporin?
Which product is better and what the heck is in them anyway?
In the age of Dr. Google most people go searching to find out how to treat minor problems without asking their doctor. Pharmacies sell billions of dollars worth of Over The Counter (OTC) drugs every year. So when you have a wound do you really need Polysporin or Neosporin?
The ingredients in this products have been around for decades and come in multiple different dosage forms. This post will compare the products and discuss the best practices for their use. Finally, I will provide an overall winner.
1. Apples to Apples Comparison
Both Polysporin and Neosporin are made by Johnson and Johnson. Polysporin is a brand name product that contains two active ingredients, bacitracin and polymyxin B. Neosporin is also a brand name product that contains three active ingredients bacitracin, polymyxin B and neomycin.
All of the ingredients in both products are antibiotics. The main difference is the addition of one extra active ingredient, neomycin in Neosporin.
This is important to remember because when dealing with antibiotics many times less is better!
Normal Flora
Every day we live our lives with millions of bacteria covering the surface of our skin that are called normal flora. These bacteria are in a symbiotic relationship with us. Meaning we both benefit from them being there. They can live off of us and we need their protection from other “invasive” bacteria. That being said, when damage occurs to the skin in the form of a burn, scrap or cut those normal flora could be exposed to places they should not be.
In order to prevent the normal flora from causing infection, wounds should always be cleaned. In some cases antibiotics should be used. However, the more antibiotics we use increases the likelihood that bacteria will become resistant. Another problem is that we could kill off bacteria that were protecting us from more invasive germs.
Moral of the story, antibiotics are not always the answer!
2. Polysporin
The dosage of the two active ingredients are bacitracin 500 units and polymyxin B 10,000 units. The manufacturer recommends using a small amount on the affected areas three times per day. Polysporin is sold in a one ounce tube, which is enough for most small wounds.
What is Polysporin ointment used for?
| Use for | Cuts Scrapes Burns |
| Do not use if | Deep wounds Animal bites Serious burns |
| Ask a doctor | Use longer than 1 week Condition gets worse Rash develops |
Pros:
- Only two antibiotics, which kill most types of bacteria commonly found on the skin.
- Contains Polymyxin B, which is bactericidal, meaning it kills bacteria instead of just slowing their growth.
- Does not contain neomycin, which is more likely to cause allergy.
- Can reduce scarring from keeping the wound moist.
- Potential to lower risk for infection.
Cons:
- Does not kill as many types of bacteria as Neosporin.
- Bacitracin is bacteriostatic, meaning is just slows bacteria growth, but does not kill them.
- Is a brand name product that is more expensive than generic alternatives.
Dosage forms:
- Ointment
- Cream
- Eye ointment
Side effects:
- Inflammation of the skin due to allergic reaction.
Cost:
- Cost is ~$11.66 for a 1 ounce tube.
- Generic versions can be less than half the price.
- HelpRx.info offers coupons for brand name Polysporin, depending on your pharmacy this may be cheaper than generic versions.
3. Neosporin
Neosporin contains both antibiotics present in Polysporin plus neomycin. Neomycin is an amino-glycoside antibiotic that has wider range of bacteria that is kills. The dosages per gram found in Neosporin are:
- Bacitracin 400 units
- Polymyxin B 5,000 units
- Neomycin 3.5mg
As you can see Neosporin has less bacitracin and Polymyxin B per gram than Polysporin. Even through Neosporin is a more widely recognized brand, most dermatologist do not recommend it over Polysporin.
Why is that you ask?
Even though it would seem that three antibiotics would be better than just two, that is not the case. Polysporin is able to prevent infection from bacteria commonly found on the skin. Exposing the bacteria to the third antibiotic and lower doses of the two found in Polysporin increases the risk of resistance.
What is stronger than Neosporin?
If you think you need a product that is “stronger” than Neosporin talking to your doctor is a must. Some may think that mupirocin ointment (brand name is Bactroban) is stronger because it can be used for resistant bacterial skin infections. However, your doctor needs to make the call as to if you need mupirocin, which is why it is prescription only.
Antibiotic resistance
A combination of three antibiotics, which is found in Neosporin, is more than enough for minor wound care. Anything more would be overkill to be used outside the guidance of a healthcare professional. Please take this advice and remember that antibiotic resistance is a real issue! According to the World Health Organization (WHO) it is one of the biggest threats to global health.
What is Neosporin used for?
| Use for | Cuts Scrapes Burns |
| Do not use if | Deep wounds In the eyes Serious burns |
| Ask a doctor | Conditions worsens Before using for longer than 1 week |
Pros:
- Contains three different types of antibiotics, which kill a wider spectrum of bacteria.
- Both Polymyxin and Neomycin are bactericidal, which means they kill bacteria, not just slow their growth.
- Can reduce scarring from keeping the wound moist.
- Potential to lower risk for infection.
Cons:
- Contains lower doses of bacitracin and polymyxin B per gram than Polysporin. In addition adding a third antibiotic could increase the risk of bacterial resistance.
- Is a brand name product that is more expensive than generic alternatives.
- Neosporin may have other ingredients, such as numbing agents or pain killers which may be easily confused with the base product.
Dosage forms:
- Ointment
- Cream
- Eye ointment
Side effect:
- Redness, itching and burning of the skin, also called contact dermatitis.
- Swelling and pain at the wound site.
- Blisters, usually a sign of allergy to neomycin.
Cost:
- Cost is ~$6.88 for a 1 ounce tube.
- Generic versions can be around 1/3 cheaper.
4. Is triple antibiotic ointment the same as Neosporin?
Triple antibiotic ointments and creams are generally the same as Neosporin. To be sure you must read the label and see if the active ingredients are the same.
If they contain works like pain relief, or multi action that could mean they have another ingredient. Typically these other ingredients are not additional antibiotics. Rather they are mostly pain relievers or numbing agents.
Pharmacy store brands such as CVS, Walgreens or Rite Aid make generic versions of these products that simply say double or triple antibiotic ointment. Additionally, there are other generic manufacturers that make these products as well. Either of these options will be less costly than brand name Polysporin or Neosporin.
5. Key Points for Polysporin and Neomycin
1. Deep wounds should not be treated at home. These will result in large scars without the proper treatment. Generally anything longer or deeper than 1/2 inch, with a wide gap or exposing fatty tissue or bone needs stitches.
2. Make sure you check the ingredients before you buy. Don’t pay more for ingredients you don’t need.
3. Use the medication three times a day as directed. If not, you increase the likelihood of antibiotic resistance.
4. Do not use large amount of the medication or put on areas that are not close to the wound. Intact skin more than a finger width from the wound does not need medication.
5. Do not place either medication inside the wound, mouth, eyes or nose unless directed by your doctor. These areas may allow the product to be absorbed in your bloodstream. These antibiotics could be toxic and cause organ damage if taken up into the blood.
6. Using topical antibiotics such as Polysporin and Neosporin too often could lead to infection by bacteria they do not kill. One potential bacteria is Methicillin Resistant Staphylococcus Aureus (MRSA). Keep in mind that every minor scrape will not require antibiotic ointments.
So, What is the best antibiotic ointment?
In most cases Polysporin will provide the following benefits that make it the best antibiotic ointment for over the counter use.
- Help prevent scaring by keeping wound moist.
- Prevent bacterial infection.
- Less chance of allergic reaction.
- Lower chance of bacterial resistance forming.
Keep in mind that from a price standpoint a generic double antibiotic ointment will work just as well as Polysporin. Therefore, that is the overall best option one example below. Remember there are many generic options, just make sure they have the same ingredients.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Share your story
Have you used Polysporin or Neosporin? Also, please share how they worked for you. Chime in below with your comments and thoughts.