Staph is the common term referring to several species of staphylococcus bacteria. The prevalence of staph in the environment makes these germs a frequent cause of human infections. Although staph can invade any body tissue, minor skin infections are most common. Simple, non-spreading staph infections of the skin often heal without antibiotics. Medical evaluation and other forms of treatment, however, may be necessary to ensure your safety and prevent unintentional spread of the bacteria.
Simple Skin Infections
Staph invades the skin through the hair follicles. Skin scraping caused by shaving may facilitate invasion of the hair follicles, leading to crops of superficial pus-filled pimples. The face, neck, underarms and groin are the usual sites for this condition, known as folliculitis. A boil, or furuncle, is a deeper infection of a hair follicle. A pocket of bacteria and pus extends into the deep layers of the skin, forming an abscess. An interconnected group of boils is called a carbuncle.
Folliculitis, boils and carbuncles are considered simple staph infections because they are confined to the skin; the bacteria have not spread into the blood or soft tissues. In a healthy person, these simple infections often heal with local treatment and antibiotics are not needed. However, simple staph skin infections may progress to a more serious infection called cellulitis, in which the bacteria invade the soft tissue that underlies the skin. Oral or intravenous antibiotics are necessary to cure cellulitis.
Standard Treatment
With good hygiene, folliculitis usually resolves on its own. Keep the area clean by washing with soap and water at least once a day. If you have persistent or recurring folliculitis, your doctor may recommend washing with an antiseptic or antibacterial product. For stubborn cases of folliculitis, your doctor may prescribe a topical antibiotic cream or lotion.
Applying a warm compress to a small boil often leads to spontaneous drainage of the pus. Do not squeeze a boil because this may cause bacterial invasion of the surrounding tissue. If the boil drains after applying a warm compress, cover the area with a bandage or gauze pad to prevent spread of the bacteria to other sites on your skin or to other people. Change the bandage if it is soiled with drainage fluid or the dressing gets wet. Wash your hands with soap and water after touching the boil or changing the bandage. Clothing or towels that contact the boil should be washed in hot water and laundry detergent to kill the bacteria. Clean any surfaces contaminated by the drainage fluid.
If you have a carbuncle or a boil that fails to drain after applying a warm compress, cover the area with a bandage and call your doctor. She will drain the abscess by making a small incision in the skin. Do not puncture a skin abscess at home. Follow your doctor's instructions about how to care for the healing abscess. Antibiotics are usually not necessary after drainage of a large boil or carbuncle.
Exceptions
If you have a weakened immune system because of HIV/AIDS, cancer treatment, organ transplant medications or another medical condition, your doctor may prescribe oral antibiotics to prevent the development of cellulitis. Antibiotics may also be prescribed for infants, young children and the elderly. If you have an abscess near your genitals or on your hand or face, your doctor may prescribe antibiotics because these areas are difficult to drain completely.
Watch for Cellulitis
The greatest risk associated with a simple staph skin infection is possible progression to invasive cellulitis. Signs and symptoms to watch for include development of a fever or chills; spreading redness and warmth in the skin around the abscess; rapid growth of the abscess; and dizziness. If you develop any of these signs and symptoms, call your doctor right away. If you cannot reach your doctor, go to the nearest emergency room or call 911.
References
- MayoClinic.com; Staph Infections; June 2011
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D. et al, editors; 2004
- "Clinical Infectious Diseases"; Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections; Dennis L. Stevens, M.D., Ph.D. et al; November 2005
- Johns Hopkins Medicine; Folliculitis; John G. Bartlett, M.D.; March 2011
- Johns Hopkins Medicine; Furuncle/Carbuncle; Paul Auwaerter, M.D.; March 2011
- "Clinical Infectious Diseases"; Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children; Catherine Liu, M.D. et al; January 2011
- Johns Hopkins Medicine; Cellulitis/Erysipelas; John G. Bartlett, M.D.; March 2011
