A Guide to Staphylococcal Skin Infections
Staphylococcus or “staph” bacteria commonly inhabit the skin surface. This colonization is generally harmless since the skin acts as an effective barrier to outside pathogens. Breaks in the skin, however, from cuts, abrasions or insect bites can act as a point of entry for bacterial infection. Staphylococcus aureus is a specific pathogenic strain that is a common cause of cutaneous bacterial infections worldwide, including impetigo, folliculitis, furuncles, abscesses and cellulitis. Any healthy individual can contract S. aureus infection, but children, the immunocompromised, diabetics, and those with conditions such as eczema that disrupt skin integrity are at higher risk for staph infections in Florida.
S. aureus is a frequent cause of impetigo, a highly contagious eruption predominantly seen in children. Impetigo presents with pustules, blisters and erosions that ooze yellow fluid, creating a honey-colored crust. Lesions often cluster around the nose and mouth but can occur anywhere on the body. Topical treatment with prescription mupirocin ointment is usually sufficient, especially in children, although extensive cases may require oral antibiotics. Good hygiene measures, such as frequent handwashing help prevent recurrence and limit spread to others.
S. aureus is likewise the most common cause of bacterial folliculitis, an infection of the superficial portion of the hair follicle. It presents with follicular pustules, pink papules and itching. Any hair bearing area can be involved, especially the scalp, beard and armpits. Shaving creates microscopic abrasions of the skin which can promote spread. If necessary, diagnosis can be confirmed by culture of the pustules. Treatment with topical or oral antibiotics depending on the extent of the infection is generally curative. Antibacterial cleansers also help dry up the pustules and prevent recurrences.
Deeper penetration of S. aureus bacteria into the hair follicle will produce furuncles, commonly called boils. Furuncles are red, inflamed lumps that can be painful and warm to the touch. Drainage with warm compresses is often the first line of treatment. Warm compresses are easily performed at home by applying a clean cloth soaked in warm tap water to the affected area for 10 mins three times a day. Oral antibiotics may be necessary if drainage alone fails. A larger furuncle is similar in appearance to a cutaneous abscess which is a collection of pus under the skin. Treatment of an abscess often requires incision and drainage by a healthcare provider in addition to antibiotic therapy.
Cellulitis is a bacterial infection of both skin and subcutaneous tissue that can also be caused by S. aureus. Cellulitis presents with advancing redness, warmth, and swelling often surrounding a cut or wound. It frequently occurs on the leg but may occur anywhere on the skin. Because cellulitis involves deeper tissues and can spread rapidly, oral or even intravenous antibiotics are usually required.
Some S. aureus strains have developed resistance to penicillin antibiotics. Methicillin-resistant Staphylococcus aureus or MRSA initially emerged in hospitals but now can be found in the community setting. Bacterial culture will determine if the strain is MRSA positive. Fortunately, community-acquired MRSA infections are usually sensitive to alternative antibiotics such as doxycycline or ciprofloxacin.
Many superficial infections are self-limited, especially in healthy individuals. Simple preventive measures can reduce the risk of exposure:
- Wash hands frequently.
- Cover cuts until healed.
- Avoid picking or scratching bites and acne.
- Avoid sharing personal items such as razors.
If you think you may have contracted a skin infection, consult your dermatologist for further evaluation.
Learn more about how to prevent and treat staphylococcal skin infections (staph infections) in Florida at Skin Wellness Physicians. Call (239) 732-0044 or contact us online to schedule a consultation.
