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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Recurrent Impetigo, Atopic Dematitis. On Cephalexin, Clindamycin. What Is Recommended?

Hello I was hoping to get some help with recurrent impetigo I was having on my face? For a quick history I am a male in my twenties with no other history besides atopic dermatitis and prior history of impetigo (longest episode prior was 10 days to clear). Over the last 7 weeks I have had recurrent episodes of impetigo. In the past it was only around my nose, but with this episode it extended between by eye brows, at the temples, and also at the chin . In the past I was put on mupirocin, but it seems to cause an allergic reaction causing the skin to be even more inflamed. I have completed a 3 week course of Cephalexin 500 mg 4x/day during which I had a flare up. Next I was given Clindamycin gel which has helped, but doesn t appear to clear the areas completely. Then I was placed on Rifampin and Clindamycin orally for 10 days. While the large honey colored crusts are gone, I still get honey color crusts on the hair when I shave my face (new razor ever day, and wash thoroughly between shaving strokes). I also have large red marks from where the honey colored crusts were (even though I haven t seen them for over a week). I was wondering if there was anything that you could recommend? In addition I notice that whenever I get an impetigo episode my face gets very oily all over. While there are no longer any large honey colored crusts my face continues to be very oily (normal for me is dry skin with my atopic dermatitis), could this be bacterial overgrowth? Thank you very much in advance for any insight you could provide.
Fri, 2 Aug 2013
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Ophthalmologist 's  Response
Hi..
On the top of atopic dermatitis, impetigo is difficult tolerate.
Atopic dermitis can be in the form of remissions and exacerbations because of dry skin and mucous membranes where as impetigo is a bacterial infection which can come by contact sports. It can spread very easily from the already existing lesions.
You are already on medications. So what you have to do is strictly maintain hygiene. Do not rub on the lesions.
You may have to continue with medications for a prolonged period.
Don't worry and keep taking medicines and consult your physician for follow up. Take care..
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Recurrent Impetigo, Atopic Dematitis. On Cephalexin, Clindamycin. What Is Recommended?

Hi.. On the top of atopic dermatitis, impetigo is difficult tolerate. Atopic dermitis can be in the form of remissions and exacerbations because of dry skin and mucous membranes where as impetigo is a bacterial infection which can come by contact sports. It can spread very easily from the already existing lesions. You are already on medications. So what you have to do is strictly maintain hygiene. Do not rub on the lesions. You may have to continue with medications for a prolonged period. Don t worry and keep taking medicines and consult your physician for follow up. Take care..