We are a germaphobic society. This is partly for good reason; MRSA, an aggressive staph infection, lurks everywhere, and we are constantly on watch for some deadly bird flu to descend upon us.
Despite threats such as these, the truth is our immune systems are incredibly effective at fighting off infection. Many of the medications we take to combat or prevent infections are unnecessary – antibiotics for a cold being the consummate example – and in some instances do more harm than good.
So it’s no surprise that many skin surgeons (including me) use plain Vaseline® (white petrolatum) or Aquaphor Healing Ointment® instead of topical antibiotics for their post-operative wound care.
Studies have shown that there is little difference between plain Vaseline and a topical antibiotic in preventing a wound infection. Your skin and immune system have worked on the problem of preventing infections for millions of years; they are quite good at it, especially if the wound is clean to begin with, as in surgery. In most of these instances you don’t need an antibiotic at all – the wound will heal well with or without it.
So why not use an antibiotic ointment “just in case”?
Because the two most commonly used topical antibiotics, bacitracin and neomycin, have a high risk of causing contact dermatitis. Contact dermatitis — a bright red, scaly, very itchy rash — is what you get, for example, when you are allergic to poison ivy or nickel. If you have ever had a case of contact dermatitis, then you know it can be quite impressive: weeping or crusted blisters that are very uncomfortable. In fact, most phone calls that we get from post-surgical patients who think they have an infected surgery site actually turn out to be an allergic reaction to the antibiotic ointment. It’s a classic case of doing more harm than good.
The next time you have a surgery on your skin, or even if you have a minor cut at home, clean it with plain soap and water and consider using Vaseline. It will save you money (and may save you a visit to your dermatologist to treat your new itchy rash).
Of course, there are exceptions. If you think you have an infected wound, then see your physician as soon as possible.