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.

How do I protect myself from MRSA?

Despite its virulence and its antibiotic resistance, MRSA infections are preventable.

1. Most importantly, wash your hands properly. Vigorously rub your hands with soap and warm water for 20 seconds (sing the Happy Birthday song twice, preferably to yourself) . Use an air dryer or paper towel; turn off the faucet and open the door with the paper towel, then discard.
2. If you use an alcohol hand sanitizer, it should be 60-95% alcohol. As with soap and water, you must rub vigorously for 20 seconds to displace the bacteria and viruses. Alcohols do not work if your hands are visibly soiled; in that case, use soap and water instead.
3. If you have a wound, then keep it completely covered, especially if you are an athlete.
4. Never shave your legs before getting a pedicure, as the small nicks can provide an entry for infection.
5. Never share make-up, razors, towels, or athletic attire and gear.
6. Place a towel between you and your locker room bench or gym equipment, and wash it in hot water after every use.
7. Insist that your healthcare professional wash his or her hands before contacting you.

How do you treat MRSA?

MRSA is resistant to methicillin, but in most cases, it is still sensitive to other antibiotics. In some instances it can be treated simply by properly draining the wound. Consult your physician to determine the best treatment for you.

Do schools need to be closed if a student has MRSA?

According to the CDC, in most instances, no. However, if your child is infected, then inform the school and his or her coaches. Physical areas that could be contaminated should be disinfected with a bleach or phenol solution and any open wounds on your child must be adequately covered to minimize risk to others.

MRSA is a type of staph bacteria that is resistant to methicillin, an anti-staph antibiotic. MRSA is a particularly virulent strain that can cause a life threatening infection, especially in frail or immunocompromised patients. It is more common than we thought; data from the CDC showed that there were about 94,000 cases of MRSA in the US in 2005 with over 18,000 deaths, more than from AIDS.

How do people get MRSA?

It can be acquired from a hospital, nursing facility, or other healthcare office. In these settings it is referred to as hospital-acquired MRSA. It afflicts elderly or ill patients and often enters the body where the skin has been compromised, such as a surgical wound or IV site.

MRSA can also infect healthy children and adults. For instance, it can be contracted from contaminated locker rooms, equipment, and spas, as well as from contact sports. It is this community-acquired MRSA that has been getting all the press lately, especially after the tragic death of a 17 year old high school girl in Virginia.

How do I know if I am infected?

An MRSA infection is indistinguishable from other staph infections. It commonly starts as a painful pustule that people mistakenly attribute to a spider bite. Poor spiders get a bad rap; unless you actually see a spider bite you, it’s probably not a spider bite. You could have an MRSA skin infection if you have:

• Red, painful pustules that can look like inflamed acne bumps
• Nonhealing wounds or wounds draining pus
• Inflamed boils which can range from pea sized to as large as an orange
• Fever, chills, or night sweats and a skin wound as described above
• Young children could also have honey colored crusted scabs, especially around the nose and mouth

If you suspect you are infected, you should see a physician as soon as possible. Distinguishing an MRSA infection from other infections can only be done by culturing bacteria from the wound.