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Suggest treatment for impetigo

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Posted on Tue, 27 May 2014
Question: Hello i was diagnosed with impetigo last wed and the doctor prescribed oral antibiotics and mupirocin a week later i dont notice improvment I still have itching and redness
doctor
Answered by Dr. Dr. Kakkar (37 minutes later)
Brief Answer:
Need more information

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through you query.

I could notice that you have bumps mainly in the shaving area/beard area. I would keep a possibility of either Sycosis Barbae OR Pseudofolliculitis Barbae.

I would like to gather some more information from you in order to be able to help you better.

--Are they painful?
--Do you get recurrent bumps in this area?
--Do you get them regularly after shaving? How often do you shave?
--Which antibiotic are you currently on?

regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Dr. Kakkar (13 minutes later)
I dont get them like that as for pain its not painfull but is itching and the itch causes a burning sensation
doctor
Answered by Dr. Dr. Kakkar (13 minutes later)
Brief Answer:
Pseudofolliculitis barbae

Detailed Answer:
Hi.

I would keep a possibility of pseudofolliculitis barbae. If I was you treating doctor, I would have asked you to apply a moderately potent steroid cream like Fluticasone in combination with an antibiotic e.g Mupirocin (Fluticasone+mupirocin combination ointment is available) twice daily to the affected area. I would have also advised an empirical oral antibiotic for a week OR 10 days (My choice of oral antibiotic would have been Amoxycillin 500mg in combination with clavulanic acid 125 mg, thrice daily, for a week OR Cephalexin 500ng thrice daily OR Cefadroxil 500mg twice daily, for a week). That would take care of the infection.

Pseudofolliculitis barbae/Rajor bumps is prone to develop at sites such as beard in males and pubic area in both males and females. Pseudofolliculitis barbae arises after shaving and when the hairs regrow they curl back onto itself and can re-enter skin thus causing razor bumps. Rajor bumps can sometimes also get infected with bacteria. Shaving creates a sharp edge at the tip of hair and when the hair regrows and curls back onto itself and re-enters skin it causes irritation at that site where the sharp edged hair re-enters, visible as a bump.

If possible, let the beard grow for 30 days to eliminate ingrown hairs.

When you are ready to shave again, take the following precautions:

1. Shave while showering. Warm water makes the hair soft or one can use a wet washcloth soaked in warm water in that area before shaving.
2. Use a shaving cream/gel for moisturising which makes the hair soft.
3. Avoid a close shave OR use a single blade razor. 4.
Don't use clippers because clippers can make the hair go awry in all directions
5. Don't use dull razors
6. Shave in the direction of the follicle, not against the grain. Do not stretch the skin.
7. At night, apply a lotion containing glycolic acid to the affected areas. This exfoliates the surface skin cells and reduces the likelihood of new inflamed spots.

Another treatment that may be considered is laser hair removal if you have no problem with having the beardless look. In some cases, this is much more effective than any other measure.

hope this helps you


take care
regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Dr. Kakkar (46 minutes later)
I have using kaflex 500 mg 3 times daily sence las wed aswell as rubbing murpirocin 2% 3 times daily on the affected area i still notice puss coming out of some areas
doctor
Answered by Dr. Dr. Kakkar (16 minutes later)
Brief Answer:
Pseudofolliculitis Barbae

Detailed Answer:
Hi

I would rather suggest that you continue with oral keflex for 5 more days. Simultaneously you could change over from mupirocin 2% ointment to topical benzoyl peroxide 2.5% gel (the same thing is used for acne), twice daily application.

If you do suffer from recurrent rajor bumps you could continue with benzoyl peroxide gel and use it as an aftershave, to prevent new rajor bumps from forming.

regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9628 Questions

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Suggest treatment for impetigo

Brief Answer: Need more information Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through you query. I could notice that you have bumps mainly in the shaving area/beard area. I would keep a possibility of either Sycosis Barbae OR Pseudofolliculitis Barbae. I would like to gather some more information from you in order to be able to help you better. --Are they painful? --Do you get recurrent bumps in this area? --Do you get them regularly after shaving? How often do you shave? --Which antibiotic are you currently on? regards