Reviewed by Evan Lewis, PhD. Last updated August 2026.
People ask why Neosporin is no longer recommended because of two public facts, not a scandal. It contains neomycin, one of the most frequently positive allergens in North American patch testing, and the American Academy of Dermatology's Choosing Wisely list says not to routinely put topical antibiotics on a surgical wound. Nothing was recalled.
What is actually in Neosporin?
Three antibiotics. The original ointment lists bacitracin zinc, neomycin sulfate and polymyxin B sulfate as its active ingredients on its published label.
That third name matters, because the company also sells Simply Neosporin, which drops the neomycin and keeps bacitracin and polymyxin B. Polysporin has always been that same two-antibiotic combination.
So the shelf already contains the answer to the question. There's a version with neomycin and a version without, sitting next to each other.
Why do dermatologists not like Neosporin?
The clearest statement is on the AAD's Choosing Wisely list, and it isn't about Neosporin by name. It says do not routinely use topical antibiotics on a surgical wound. The reasoning given is that the reduction in infection compared with a non-antibiotic ointment or none at all is small, and that the risk of wound irritation and contact dermatitis is not.
Behind that sits a trial people still cite thirty years later. In 1996, 922 patients with 1,249 wounds after dermatologic surgery were randomised to plain white petrolatum or bacitracin ointment. Infection rates came out equally low, and four patients in the bacitracin arm developed allergic contact dermatitis while the petrolatum arm had none.
Equal benefit, more allergy. That is the whole argument, and it's a narrow one about clean surgical wounds rather than a blanket verdict on your bathroom cabinet.
How common is a neomycin reaction?
Common enough to sit near the top of the list. In the North American Contact Dermatitis Group's 2007 to 2008 cycle, neomycin was positive in 10.1% of patients tested, the third most frequent allergen after nickel and Myroxylon pereirae. Bacitracin was positive in 7.9%.
Two things about that number are worth saying so it isn't misread.
The first is that these are people referred for patch testing because something on their skin was already misbehaving, so the rate in the general population is lower. The second is that neomycin positivity has been falling across later NACDG cycles, down to around 6.8% in the 2019 to 2020 data.
What it means practically: if a cut looks angrier and itchier three days after you started putting ointment on it, an allergic reaction to the ointment is a genuine possibility and not a wild theory.
Is Polysporin the same as Neosporin?
No, and which one is the default depends on which country you're standing in.
| Neosporin Original | Polysporin | |
|---|---|---|
| Antibiotics on the label | Bacitracin, neomycin, polymyxin B | Bacitracin, polymyxin B |
| Contains neomycin | Yes | No |
| The default in the US | Yes | Sold, less prominent |
| The default in Canada | Harder to find | Yes |
| Still an antibiotic | Yes | Yes |
Dropping neomycin removes the most common of the three allergens. It doesn't make the tube allergy-proof, because bacitracin has its own patch-test rate, and it doesn't change the Choosing Wisely point, which is about topical antibiotics as a category.
Is Neosporin an antiseptic or an antibiotic?
An antibiotic, and the distinction is the reason for a lot of the confusion.
An antiseptic acts broadly on microorganisms on skin. An antibiotic targets bacteria through a specific biological mechanism, which is also why bacteria can become resistant to it and why nobody worries about resistance to soap.
Neosporin is three antibiotics in an ointment base. It isn't antifungal, which is worth knowing if what you're putting it on is itchy and scaly rather than a cut.
Does Neosporin stain clothes, and does it expire?
It doesn't stain the way iodine famously does. It is a petrolatum-based ointment, so what it leaves is a grease mark, which washes out of most fabric and is a nuisance on a bedsheet.
The expiry date is real. It's the point past which the manufacturer will no longer vouch for the potency of the antibiotics, and an ointment that's been in a hot car for two summers has had a harder life than the date implies. If you're reaching for something once a year, buying the small tube is the sensible move.
What people use instead
The mainstream advice is duller than the internet version of it, and worth stating properly.
- Clean it. Running water and gentle washing does the bulk of the work on a minor cut or scrape.
- Cover it. A covered wound stays moist, and that is the part of the routine with the best evidence behind it.
- Plain petrolatum, if you want an ointment. That's what the 1996 trial compared against, and it came out level on infection with no allergy.
- Keep an eye on it. Spreading redness, heat, swelling, pus, a red streak running away from the wound, or a fever, means stop reading articles and get it looked at.
That last one isn't a formality. Deep wounds, burns, animal bites, anything from a dirty surface, anything on a person with diabetes or poor circulation, and anything that isn't clearly improving needs a professional rather than a cabinet. Nothing you buy over the counter is a substitute for that.
Where a two-ingredient bottle comes into it
Being straight about what we make: EZ Clear Skin is a cosmetic, not a first-aid antibiotic, and it isn't a replacement for one. It's aqueous iodine and distilled water. Two ingredients.
What people notice about it is sensory and it's a property of the liquid rather than a claim about your skin. There's no alcohol in it, so there's nothing in the bottle that produces the sting people brace for. It's decolorized, so it doesn't leave the brown mark that made everyone abandon iodine in the first place. For contrast, an FDA-registered Decolorized Iodine label on DailyMed lists 45% alcohol and warns that it will stain skin and clothing. That's the pharmacy version of gentle.
Common questions
Why is Neosporin no longer recommended?
It hasn't been withdrawn. The AAD's Choosing Wisely list advises against routinely using topical antibiotics on a surgical wound, because the infection benefit over plain ointment is small and the contact dermatitis risk is not. Neosporin also contains neomycin, a frequent patch-test allergen.
Why do dermatologists not like Neosporin?
Mainly the neomycin. It was positive in 10.1% of patients in the 2007 to 2008 North American Contact Dermatitis Group cycle, third behind nickel. A 1996 randomised trial also found plain petrolatum matched bacitracin on infection rates while producing no allergic reactions.
Is Polysporin better than Neosporin?
Polysporin leaves out neomycin, which removes the most commonly positive of the three antibiotics in Neosporin Original. It is still a topical antibiotic, and bacitracin has its own patch-test rate of around 8%, so it is a narrower change than it sounds.
Is Polysporin the same as Neosporin?
No. Neosporin Original lists bacitracin zinc, neomycin sulfate and polymyxin B sulfate. Polysporin lists bacitracin zinc and polymyxin B sulfate. Polysporin is the shelf default in Canada, Neosporin in the United States.
Is Neosporin an antiseptic?
No, it is an antibiotic ointment. Antiseptics act broadly on microorganisms on skin, while antibiotics target bacteria through a specific mechanism. Neosporin is also not antifungal, which matters if what you are treating is itchy and scaly rather than a fresh cut.
Does Neosporin stain clothes?
Not in the way iodine does. It is a petrolatum-based ointment, so it leaves a grease mark rather than a colour stain, and that generally washes out of fabric.
Is expired Neosporin safe to use?
The expiry date is the point past which the manufacturer no longer guarantees the potency of the antibiotics. Heat shortens that in practice. If you use it once a year, buy the small tube rather than relying on an old one.
When should a cut be seen by a professional?
Spreading redness, heat, swelling, pus, a red streak running from the wound, or a fever. Also deep wounds, burns, bites, anything from a dirty surface, and any wound on someone with diabetes or poor circulation. Do not manage those at home.
The bottom line
Neosporin isn't dangerous and it wasn't taken off the shelf. The doubt is narrower than the search phrasing suggests: one of its three antibiotics is a frequent contact allergen, and for clean surgical wounds a plain ointment has matched it on infection without the allergy risk.
If you've had a cut turn itchier and angrier a few days into using an ointment, that history is worth mentioning to a clinician. And if a wound is deep, dirty or getting worse, none of this is the article you need.
Related: does iodine stain skin, clear versus brown iodine explained, and does iodine sting.
Evan Lewis, PhD, specializes in natural and nutritional therapies for the prevention and management of chronic diseases and their complications. His research spans chronic disease, diabetes complications, clinical nutrition, and nerve health, including the development of topical iodine therapy for foot care and wound health. IodinePure products are listed with Health Canada as cosmetics and are not first-aid antibiotics. This article is general information, not a diagnosis.
Sources: DailyMed product labels, Neosporin Original and Decolorized Iodine. American Academy of Dermatology, Choosing Wisely. Fransway AF, Zug KA, Belsito DV, et al. North American Contact Dermatitis Group patch test results for 2007-2008. Dermatitis. 2013;24(1):10-21. Smack DP, Harrington AC, Dunn C, et al. Infection and Allergy Incidence in Ambulatory Surgery Patients Using White Petrolatum vs Bacitracin Ointment. JAMA. 1996;276(12):972-977.
