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Have impetigo in right ear. Using moist pads, drill the ear for cell growth. Need factual and expert advice

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Orthopaedic Surgeon
Practicing since : 2011
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I have impetigo on my right ear. I took 2 course of keflex. And now I am on augmenting twice day and just finished one week of predisone. I also had two shots on my butt cheek containing a booster antibiotic. Finally went to a dermatologist and he said it is impetigo. He said to stop removing the scabs because new skin cells are trying grow. Howeve, I read all over the Internet that you should remove because the topical I have using for 7 weeks (mupirocin.) won't penetrate the scabs and blisters because the cream will work better. The dermatologist said to used second skin moist pads after I apply the ointment. He said next step involves a procedure of drilling small holes in my ear to promote new cell growth. Sounds weird. So, I need some factual information on anything else will help. I have had 4 visits to the doctor...1 dermatologist and the rest are general practioners at urgent care. It will soon be 2 months with this. Can anyone help me please?
Posted Tue, 22 May 2012 in Skin Rash
Answered by Dr. Aashish Raghu 1 hour later
Hi there.

Thanks for the query.

Impetigo is a bacterial infection of the skin and subcutaneous tissue. Characteristic presentation is with honey-colored crusts.

Usually it is recommended to gently wipe off the honey-colored crusts but since you are taking systemic antibiotics by injection, it is not necessary compulsorily to remove the crusts as the antibiotics are also acting from inside the body.

Topical Mupirocin is very effective for non-bullous impetigo, applied for 7 days course. You have mentioned you have blisters. Are they balloon like blisters? Kindly confirm.

The moist pads moistened with saline are very good in subsiding inflammation, pain and also removes the honey-colored crusts with ease. But avoid tugging and trying to remove the crusts as this can delay epithelization. The new epithelial cells usually grow into the wound in 2-5 days. Any kind of pressure or trauma will damage these cells and healing will be delayed and fear of spread of infection may occur.

Drilling tiny holes will allow pockets of epithelial cells to populate the areas and facilitate faster healing. The drilling is needed because lot of crusts and scabs present which overlap the healthy skin areas.

Eat healthy. Drink plenty of water. Avoid contact of the impetigo with water, pressure, and trauma.

I hope I have answered your query. I will be available to answer your follow up queries.

Wishing speedy recovery.


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Follow-up: Have impetigo in right ear. Using moist pads, drill the ear for cell growth. Need factual and expert advice 11 hours later
Thank you so much for your prompt response. I had two injections on two different visits to urgent care. So I am not on an injection antibiotics currently. I finish by 10 day course of oral antibiotics on Tuesday and they don't seem to be working. I have 2 questions..I read all over the internet to dry it out with topical calamine or a salt paste. I even see posts about putting a small amount of liquid bleach on it. I read that by keeping it moist it only promotes the germs to grow. Definitely different information by what my dermatologist told me. I need to know which viewpoint is accurate?

My second question is next steps. I think I need to see an ENT at this point. Am I seeing the right kind of doctor? I'm very worried that the condition will get worse when I finish the augementin. I'm also feeling very swollen and see signs of Edema.

Any thoughts you may have would be greatly appreciated. Oh.. The blister are kind of baloon like and they HURT!!
XXXXXXX in Atlanta
Answered by Dr. Aashish Raghu 7 minutes later

Thanks for the query.

Usually moist saline gauze is applied to loosen the crusts and help to remove them so hat the Topical antibiotics have better penetration and effect.

It is highly advisable to keep the impetigous area clean and dry at other times to prevent unwanted infection.

A Dermatologist is the best specialist to evaluate skin conditions like impetigo. When blisters are present, it is called Bullous impetigo. It usually responds to antibiotics like Fucidin, Mupirocin. You may take anti-inflammatory medication after consulting your Doctor to reduce the pain and edema of the skin. If present Antibiotic therapy isn't working, another course with different antibiotics may be tried for best results.

No need to worry. Just follow precautions to keep the area clean and dry. Avoid water falling on the affected area; avoid any pressure on the area as well. Follow your Doctor's advice and have complete faith in your Doctor for best Results.

I hope I have answered your queries.

Wish you a speedy recovery.

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