Key takeaways
Mupirocin is not available over the counter.
Some over-the-counter products may help with minor cuts or skin irritation, but they are not direct substitutes for mupirocin.
A healthcare provider should check suspected skin infections.
When you’re dealing with a skin infection, it’s natural to look for a quick pharmacy option, especially if the affected area looks minor. But not every topical antibiotic is meant to be used without medical guidance.
Mupirocin is one of those medications. Here’s what you need to know about getting it and why your healthcare provider’s guidance matters.
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Is mupirocin available over the counter?
No, mupirocin is not available over the counter. It is a prescription topical antibiotic, sold generically and under brand names such as Bactroban and Centany. Mupirocin is used to treat certain bacterial skin infections, including impetigo, and may also be prescribed for Staph or methicillin-resistant Staphylococcus aureus (MRSA) in the nose when appropriate. It comes as a topical ointment or cream, with a specific nasal formulation of mupirocin designed for use in the nose. You should not put standard skin ointment inside your nose unless your healthcare provider specifically directs you to do so.
“Mupirocin is a very useful prescription topical antibiotic ointment, but it is not something you can just grab off the shelf like triple antibiotic cream,” says Mikel D. Daniels, a board-certified podiatric surgeon and managing member of WeTreatFeet Podiatry in Owings Mills, Maryland. “It is a medication that targets certain bacteria, especially Staph, including some resistant strains. Because of that specificity, it has to be used correctly.”
Why mupirocin requires a prescription
Mupirocin requires a prescription because it is an antibiotic, and antibiotics need to be used carefully to reduce the risk of resistance. “Antibiotic resistance happens when the microorganisms that the antibiotic is attacking are no longer susceptible to the medication, and grow anyway,” says Purvisha Patel, MD, a board-certified dermatologist and Mohs and cosmetic surgeon at Advanced Dermatology & Skin Cancer Associates of Germantown, Tennessee. “When strains of bacteria become resistant, stronger antibiotics are needed to treat the infection, which can also result in more side effects.”
A prescription also helps ensure that mupirocin is used for the right type of infection. Not every rash, sore, or irritated patch of skin is bacterial since many are fungal or viral, and using an antibiotic when it is not needed may delay the right treatment.
Correct use matters, too. “Even when mupirocin is appropriate, it has to be applied correctly (a thin layer) for the exact number of days doctors recommend,” Dr. Daniels says. Using too much, applying it to the wrong area, or stopping too early may make treatment less effective.
Mupirocin side effects and safety warnings
Like any medication, mupirocin can cause side effects, although they are usually limited to the area where it is applied. Common side effects may include:
- Burning
- Itching
- Dryness
- Rash
- Dermatitis
- Hives
- Pain at the application site
“If the cream is spread over large areas of broken skin, more of the drug can be absorbed, which can increase the chance of side effects,” Dr. Daniels says.
Serious side effects are rare but may include severe allergic reactions, secondary infections, or Clostridium difficile (C. difficile)-associated diarrhea, though this is extremely rare with topical antibiotics. Because mupirocin is applied to the skin, it’s also important to ask a healthcare provider before layering it with other topical products, including medicated creams, ointments, or topical anesthetics, since these should be spaced appropriately to ensure proper benefit.
Seek immediate medical attention if you experience symptoms of a severe allergic reaction or other serious side effects, and notify your prescribing provider.
What to do if you think you need mupirocin
See a healthcare provider if you have redness, pain, swelling, drainage, or other signs of infection after a cut, insect bite, scrape, or skin irritation from conditions such as eczema or scabies.
“I always follow this simple rule: if you are even considering the need for a ‘stronger prescription cream,’ you should probably have that area checked,” Dr. Daniels says. “A trained eye can tell the difference between a simple superficial infection that might benefit from a topical antibiotic and a deeper infection that needs system-wide treatment.”
Before your appointment, write down your symptoms, including when they started, what the affected area looks like, and where it is located. You should also bring a list of current medications, supplements, allergies, and medical conditions, and let your healthcare provider know if you are pregnant, planning to become pregnant, or breastfeeding.
Over-the-counter alternatives to mupirocin
There are a few over-the-counter products sometimes used for minor cuts, scrapes, and burns, including:
- Bacitracin
- Polysporin (bacitracin/polymyxin B)
- Neosporin (neomycin/bacitracin/polymyxin B)
However, these are not direct substitutes for mupirocin 2% ointment and may not be appropriate for impetigo, MRSA, spreading infections, or deeper skin infections. Also note that the neomycin component of Neosporin can cause allergic skin reactions in some patients, which can be mistaken for an infection.
Some natural remedies, such as tea tree oil, Manuka honey, propolis, coconut oil, garlic, and olive oil, have been studied for antibacterial properties. However, they should not be used as replacements for prescription antibiotics. Avoid applying natural remedies to open, worsening, or infected wounds unless your healthcare provider says it is safe.
The importance of medical guidance for skin infections
It’s important to seek medical guidance for suspected bacterial skin infections, as they can worsen quickly without proper treatment. “Treating skin infections is important as they can get worse fast,” Dr. Patel says. “Depending on the organism, they can result in damage to surrounding tissue and structures, such as the eyes, as well.”
Signs of a more serious skin infection, such as impetigo or cellulitis, may include:
- Swelling
- Warmth
- Increasing pain
- Fever
- Chills
- Blisters
- Skin dimpling
- Spreading redness
If you notice these symptoms, contact a healthcare provider promptly. Seek immediate medical attention if symptoms are worsening quickly, you have a fever or chills, the infection is near your eyes, or the area becomes very painful.
Although self-diagnosis and treatment with OTC products may seem easier, a healthcare provider can confirm whether the infection is bacterial and recommend the safest treatment.
Expert takeaway
“As a pharmacist, I have seen patients mistake an allergic reaction to over-the-counter Neosporin for a worsening skin infection,” says Jeff Fortner, Pharm.D. “Because neomycin allergies are fairly common, your doctor may prescribe mupirocin not just because it’s stronger, but to treat the actual bacterial infection without irritating your skin further. And if it’s feasible, always remember to wash the area with mild soap and water before applying your prescribed ointment.”
- Impetigo: Diagnosis and treatment, American Family Physician (2014)
- Preventing and treating skin infections, Centers for Disease Control and Prevention (n.d.)
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