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Is Boil Inside Nose Folliculitis A Cause For Concern?

Posted on Thu, 4 Sep 2014

Question: Hi,

I have scalp follicities past 6 months. have tried several diffrenet anti biotics. domixiclin worked out of all but once i stoppped it came back.

i stopped antiobiotics 3 weeks back.

have over 50 boils in the head. Past 4 days, i started having boils in the face and also inside the nose. since yesterday i have it inside both nose.

i consulted a ENT and a dermatologist. they both have prescribed two different antio biotics. which one do i take
is boil inside nose follicities dangerous? as i read online it may lead to cst.

the antiobotics prescribed were azithromycin and bacterium ds.

should i take any additional tests for follicities inside the nose. im really worried as in four days i got inside both nose.

Answered by Dr. Dr. Kakkar (25 minutes later)

Brief Answer:
Eradicate nasal carrier state

Detailed Answer:
Hello and welcome back to healthcaremagic

As discussed with you previously, you are most likely a nasal carrier of staph aureus. I suggested you Amoxycillin+clavulanic acid (Augmentin) and T-Bact ointment to be applied just inside the nares to eradicate carrier state. What was the response to that?

The issue in your case is not which antibiotic would treat an episode of folliculitis but the real issue is to eradicate carrier state and thus prevent a recurrence.

You may take either Azithromycin Or Bactrim DS Or Augmentin Or Doxycycline. Either of these would treat folliculitis within 7-10 days but you also need to eradicate the nasal carrier state.

Did you apply T-bact ointment just inside the nares, as discussed? Short-term (4–7 days in duration) topical nasal application of mupirocin is the most effective treatment for eradicating nasal carriage with staph aureus.

However, if this proves ineffective systemic eradication treatment (e.g. Oral Rifampin administered in combination with another oral antibiotic e.g either Bactrim DS Or Doxycycline), in addition to mupirocin nasal ointment, is the treatment of choice.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (12 minutes later)

Hello doctor,

I was really confused as i had consulted local derm here who gave e dox dt. i followed that. and then i had serious gerd. (gastritis). so i discontinued all antiobiotics.

using e dox dt (doxyclycline) actually cleared it but after i stopped it came back worse. now i have it in my face n inside nose.

i XXXXXXX used the oinment inside nose yet. i will start doing it today.

so i am going to take bactrius ds tablet one in the morning, and one at night. and apply t bact ointment inside the nose daily. right?

should i apply the oinment inside nose only where the boils are or all around inside the nose ? can i use a ear bud cotton to apply it ?

also please tellme how serious is boil inside nose ?
I couldn't find t bact but i got a different brand called Supirocin which is a mupirocin oniment. can i use this?

Answered by Dr. Dr. Kakkar (6 minutes later)

Brief Answer:
Oral + topical antibiotic

Detailed Answer:
Hi.

Apply T-bact all round, including the boil. Can use an ear bud/applicator.

It is Ok to take Bactrim DS twice daily. The boil inside the nose requires you to take an oral antibiotic since it can cause a lot of pain and discomfort. The nose and upper lip area is considered to be the "Danger Zone of the face" as skin and soft tissue infection in this zone may rarely spread via the blood stream to the brain and meninges. Therefore the need to start on oral antibiotic i.e Bactrim DS as soon as possible

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (4 minutes later)

Thanks for your response. I'll take it.

Its been 4 days since i have boils inside both nose. so il start it right away. hope that 4 day delay will not cause any issue.

is there a special nasal mupirocin oinment for nasal or will any general mupirocin oinment can be applied?

Answered by Dr. Dr. Kakkar (5 minutes later)

Brief Answer:
Folliculitis

Detailed Answer:
Hi.

Can start antibiotics even now.

There is no special nasal preparation of mupirocin. It is the same ointment that you use for skin

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (47 minutes later)

Final question doctor, i have GERD. I might get severe gastritis while taking antiobiotics. can i take nexium 40 ppi before i take the antiobiotics to prevent gerd?

does taking ppi and antiobiotic reduce the effectiveness of the medicine?

Answered by Dr. Dr. Kakkar (31 minutes later)

Brief Answer:
Can take PPI

Detailed Answer:
Hi

Yes, you can take PPI before taking antibiotic. It won't affect the efficacy of antibiotic

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (22 hours later)

Hello doctor,

so i took the tablet and now in the left nostrisl, one boil has burst and the puss was left there. i didn clean it as i wasn sure what to do. its dried up now.

in the right nostril, there were two small boils, white in colour. one of it broken by itself. one still is the same. so should i clean the area or leave it as it in? the other boil is close to it so unsure what to do.

i had been applying the oinment last night and twice this morning. besides that i didn clean inside nose .

if we leave the broken puss inside to dry up without cleaning is it k?
btw i also have running nose and sore throat .. so can i take montek lc along with this?

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Continue with antibiotics (oral + topical)

Detailed Answer:
Hi.

The excess of it will drain down by itself. Otherwise no need to manipulate to extract the pus. You may leave it as it is. Keep applying the ointment, twice daily. The oral as well as topical antibiotic will dry it up.

Can take montek-lc with the above medications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 minutes later)

doctor, i used a cotton ear bud to apply the oinment. while applying i pulled out while applying oinment and the excess and it all came out.

now ive applied oinment on the area.

both the boils excess have come out. is it k?

Answered by Dr. Dr. Kakkar (18 minutes later)

Brief Answer:
Recurrent folliculitis

Detailed Answer:
Hi.

Yes, it is absolutely Ok.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (24 hours later)

Thanks doctor.

Can I also apply the mupricon oinment to scalp? i still have ones in head.

i have few small ones on lip and chin too.

btw, i still have running nose, dry cough and body tired (been down with cold since a week). Can I take chericof and dolo 650 with the antibiotic? or please prescribe a syrup and tablet for the same.

Answered by Dr. Dr. Kakkar (46 minutes later)

Brief Answer:
Recurrent folliculitis

Detailed Answer:
Hi.

Yes, apply mupirocin ointment to all the lesions, on the scalp and face as well.

Yes, you can very well take chericof and dolo650 mg for fever and cough along with the antibiotic.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar