Kimberly is a 21-year-old college student. As a child, she had eczema, currently she is disease-free and only has very dry and sensitive skin. For some time now, she has repeat bouts of Folliculitis (infection of the hair follicles) on the lower legs and superficial skin infection on the cheek. Each time, she was successfully treated with oral antibiotics, but she wonders why the skin infections keeps coming back.
Kimberly is not alone in experiencing such recurrent bouts of skin infection. Individuals with eczema have itchy, red and peeling skin. Their skin barrier is often breached, making them susceptible for skin infection. Worst of all, each episode of skin infection can trigger a worsening or flair of previous eczema (much like Kimberly). The same phenomenon may be seen in patients with Topical Steroid Withdrawal Syndrome, as many patients often complain about recurrence and worsening of their skin flare.
There may be another explanation. There are a small percentage of people who have Staph Aureus (a gram-positive bacteria) living inside their noses. They are so-called Staph carriers. The nasal cavity serves as a reservoir for the bacteria to spread to any part of the body where a breach of the skin barrier exists.
After seeing the third dermatologist about her problem, Kimberly finally had a culture swab performed from her nasal cavities (a very simple and gentle procedure). Essentially, the physician takes a culture probe (Q tip) and gently rubs it inside the nose. The probe is then sent for bacteria culture analysis.
Yes, the results proved Kimberly had Staph Aureus. Her dermatologist instructed her to apply topical antibiotics (Mupirocin) twice a day to inside the nose. Since the treatment was initiated, Kimberly has not had any additional skin infection.
Bottom line, if you have a recurrent skin infection. It is a good idea to see your physician and ask about whether or not you may be a Staph carrier. Also, flairs of eczema can be prevented. The simple culture analysis followed by daily topical application of antibiotics inside the nose can significantly reduce and prevent additional skin infection. Lastly, in general, the culture swab can be performed on patients of all ages.
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