Skin and Rashes

Introduction

The most common skin problems encountered while traveling are rashes, sunburns, and minor lacerations. Rashes are due to allergy or irritation of the skin from anything ranging from ingesting different foods or medicines to contact of the skin (contact dermatitis) to some plants, certain detergents or chemicals or metals, and some insect bites or stings. These skin conditions are usually confined to the outer layer of the skin (epidermis), are often benign, and will usually resolve/heal on their own.

Breaks in the skin can allow bacteria to penetrate and cause infection in deeper layers of the skin, called cellulitis. Although any wound can become infected, animal or human bite wounds are at particularly high risk of infection, because they often penetrate deeply into the skin and contain bacteria from the biter's mouth. Signs of serious wound infection include redness surrounding the wound or spreading away from the wound, pus draining from the wound, pain, and fever. Any of these signs should prompt you to seek immediate medical attention.

Large or deep lacerations may require additional treatment, such as skin glue, sutures or staples. Large bleeding lacerations could result in dangerous blood loss. See the Bleeding section.

Treatment

Hydrocortisone is a topical steroid cream can be used for minor rashes to relieve the skin itching, burning and redness. Triamcinolone is a prescription-only topical steroid cream that is more potent than hydrocortisone and may provide additional relief in some circumstances, but should not be used on the face or genitals. DiphenhydrAMINE (generic for Benadryl®) can be used for skin irritation caused by allergic reaction. Mupirocin (generic for Bactroban®), a topical antibiotic ointment, may be used on abrasions or lacerations to prevent or treat infection.

If you develop a skin infection with redness surrounding a wound, consider using an antibiotic such as trimethoprim-sulfamethoxazole (generic for Bactrim®), doxycycline, clindamycin, or cephalexin (generic for Keflex®). Note that doxycycline is not for use in children. For infected wounds caused by animal or human bites, consider using the antibiotic amoxicillin-clavulanate (generic for Augmentin®), which treats the most common types of bacteria known to infect these wounds. Consider starting amoxicillin-clavulanate if you suffer a large or deep animal or human bite, even if there is no immediate sign of infection, to prevent development of future infection.

For lacerations (cuts), EMLA is a cream that helps to numb the skin for laceration repair. Cyanoacrylate (generic for Dermabond®) is a skin glue used to close superficial wounds to help them heal.

When To Worry

Seek immediate medical care if you have any of the following:

  • spreading redness
  • draining pus
  • fever
  • feeling ill from a wound
  • worsening rash
  • rash over a large area of the body
  • bite from a wild animal (you may need rabies treatment)

Pediatrics

Quick Guide

If you have

  • itching or burning skin
  • skin redness or bumps in a small area of the skin
  • exposure to a possible allergen
  • no fevers

You may have

skin rash (dermatitis)

Consider using

hydrocortisone cream (OTC strength), one topical application to affected area up to 3 times per day as needed

OR

triamcinolone (generic for Kenalog®, Rx strength) one small application to the skin up to 3 times per day

If you have

  • a red scaly rash
  • rash in between the toes or in folds of skin such as in the groin
  • history of wearing damp socks or walking barefoot in public areas
  • contact with someone who has a fungal infection
  • no fevers

You may have

fungal infection (athlete's foot, jock itch, ringworm; also known as tinea pedis, tinea cruris, tinea corporis)

Consider using

clotrimazole cream, one topical application to affected area every 12 hours

If you have

  • small area of skin that is red, warm to touch, painful to touch
  • a small abrasion or laceration with surrounding redness
  • no fever

You may have

minor wound infection

Consider using

triple antibiotic ointment (generic for Neosporin® Pain Relief, OTC strength) one small application to the skin up to 3 times per day

OR

mupirocin cream (generic for Bactroban®, Rx strength), one topical application to affected area daily for 7 days

If you have

  • fever 100.4°F or higher
  • skin that is red, warm to touch, painful to touch
  • pus draining from skin

You may have

cellulitis

Consider taking

cephalexin (generic for Keflex®) 500 mg every 6 hours for 7 days

OR

trimethoprim-sulfamethoxazole (generic for Bactrim®) 800 mg-160 mg twice a day for 7 days

OR

clindaymcin 450 mg every 8 hours for 7 days

and seek emergency medical care

If the above medications are unavailable or if an allergy is present, either doxycycline OR amoxicillin-clavulanate may be considered as an alternative, although they may be less effective. Note that doxycycline may not be used in children.

If you have

  • bite from animal or human that penetrated the skin

You may have

bite wound (at risk for infection)

Consider taking

amoxicillin-clavulanate 875 mg-125 mg twice a day for 7 days

and seek emergency medical care

If amoxicillin-clavulanate is unavailable or if an allergy to penicillins is present, doxycycline may be considered as an alternative. Note that doxycycline may not be used in children.

If you have

  • spreading redness
  • draining pus
  • fever
  • feeling ill from a wound
  • rapidly worsening rash
  • rash over a large area of the body
  • crunchy sensation when pushing on rash
  • bite from a wild animal (you may need rabies treatment)

You may have

cellulitis, necrotizing fasciitis or other life-threatening medical condition

You should

seek emergency medical care

Reference

predniSONE

Prednisone is a corticosteroid used to treat inflammation (not the same as an anabolic steroid, like testosterone). It is a versatile and common medication used in a wide variety of diseases. One common use of prednisone is to treat the inflammation in the airways that happens with an asthma attack. Prednisone can also be used to treat severe allergic reactions, including anaphylaxis if used with epinephrine. Prednisone is often used in conjunction with albuterol which takes minutes to start treating the symptoms of asthma, while prednisone takes hours to work. This medication should be taken with food.

Prescription only

GeneralMedication

trimethoprim-sulfamethoxazole

Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim, and also abbreviated SMZ-TMP) is an antibiotic. It can be used to treat urinary tract infections and skin infections, and can be used to treat infections caused by MRSA (Methicillin-resistant S. aureus) bacteria.

Prescription only

InfectionMedication

hydrocortisone

Hydrocortisone cream is a steroid that treats skin irritation. It can be used for most non-infectious minor skin irritations, such as minor allergic reactions. Common uses include eczema, insect bites, poison ivy, poison oak, poison sumac, irritation due to soaps, detergents, cosmetics, or jewelry.

GeneralMedication

mupirocin

Mupirocin (generic for Bactroban) is an antibiotic ointment. Mupirocin can be used to treat a localized skin infection, including infections caused by methicillin-resistant S. aureus bacteria (MRSA).

Prescription only

InfectionMedication

amoxicillin-clavulanate

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate pediatric

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate suspension

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin capsule

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

InfectionMedication

triamcinolone

Triamcinolone is a corticosteroid cream. It is used to reduce inflammation and itching of the skin. This medication is similar to hydrocortisone, but is stronger and only available by prescription. This medication is not an antibiotic and usually should not be used on infected skin.

Prescription only

GeneralMedication

amoxicillin pediatric

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

amoxicillin

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

trimethoprim-sulfamethoxazole pediatric

Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim, and also abbreviated SMZ-TMP) is an antibiotic. It may be used to treat urinary tract or ear infections in pediatric patients. Other antibiotics are usually preferred as first-line treatment options. The suspension form of this medication contains sulfamethoxazole (SMX) 200 mg and trimethoprim (TMP) 40 mg together in each 5 mL liquid. Dosing is based on the trimethoprim (TMP) component.

Prescription only

PediatricsMedication

prednisoLONE pediatric

Prednisolone is a corticosteroid used to treat inflammation (not the same as an anabolic steroid, like testosterone). PrednisoLONE, more commonly used by pediatric patients, is similar to, but should not be confused with, predniSONE, more commonly used by adults. One common use of prednisolone is to treat the inflammation in the airways that happens with an asthma attack. Prednisolone can also be used to treat severe allergic reactions, including anaphylaxis if used with epinephrine. Prednisolone is often used in conjunction with albuterol which takes minutes to start treating the symptoms of asthma, while prednisolone takes hours to work. This medication should be taken with food.

Prescription only

PediatricsMedication

diphenhydrAMINE pediatric

Diphenhydramine (generic for Benadryl) treats allergic reactions. It may be used for both mild and severe allergic reactions.

PediatricsMedication

cephalexin

Cephalexin (generic for Keflex) is an antibiotic. It is used to treat respiratory infections, ear infections, skin infections, and urinary tract infections. It is in the cephalosporin category of antibiotics.

Prescription only

InfectionMedication

cephalexin pediatric

Cephalexin (generic for Keflex) is an antibiotic. It is used to treat respiratory infections, ear infections, skin infections, and urinary tract infections. It is in the cephalosporin category of antibiotics.

Prescription only

InfectionMedication

clindamycin

Clindamycin is an antibiotic. Is is used to treat serious respiratory tract, skin, and soft tissue infections. Clindamycin is used to treat infections cause by a class of bacteria called anaerobic bacteria. Clindamycin is sometimes used in place of penicillin-family antibiotics in people allergic to penicillin.

Prescription only

InfectionMedication

clindamycin pediatric

Clindamycin is an antibiotic. Is is used to treat serious respiratory tract, skin, and soft tissue infections. Clindamycin is used to treat infections cause by a class of bacteria called anaerobic bacteria. Clindamycin is sometimes used in place of penicillin-family antibiotics in people allergic to penicillin.

Prescription only

InfectionMedication

clotrimazole

Clotrimazole is an antifungal cream. It is used to treat fungal infections of the skin. Clinical improvement, with relief of itching, usually occurs within the first week of treatment.

InfectionMedication

triple antibiotic ointment

Triple antibiotic ointment (generic for Neosporin Pain Relief) is used to treat skin infections. Depending on the exact formulation, it may include bacitracin zinc, neomycin sulfate, polymyxin B sulfate, and pramoxine HCl. The bacitracin, neomycin and polymyxin components treat infection, while the pramoxine component provides pain relief.

InfectionMedication

diphenhydrAMINE

Diphenhydramine (generic for Benadryl, generic for Banophen) treats allergic reactions. It may be used for both mild and severe allergic reactions.

GeneralMedication

diphenhydrAMINE blisterpack

Diphenhydramine (generic for Benadryl, generic for Banophen) treats allergic reactions. It may be used for both mild and severe allergic reactions.

GeneralMedication

dexamethasone pediatric

Dexamethasone (generic for Decadron) is a corticosteroid used to treat inflammation (not the same as an anabolic steroid, like testosterone). It is a versatile and common medication used in a wide variety of diseases. One common use of dexamethasone is to treat the inflammation in the airway that happens with croup or with an asthma attack. Dexamethasone can also be used to treat severe allergic reactions, including anaphylaxis if used with epinephrine. This medication should be taken with food.

Prescription only

GeneralMedication

diphenhydrAMINE pack

Diphenhydramine (generic for Benadryl, generic for Banophen) treats allergic reactions. It may be used for both mild and severe allergic reactions.

GeneralMedication

valacyclovir

Valacyclovir (generic for Valtrex) is an antiviral used to treat viral illnesses including shingles and chickenpox, primarily in those with compromised immune systems. Valacyclovir can also be used to treat cold sores of the mouth and genitals caused by the herpes virus.

Prescription only

InfectionMedication

hydrOXYzine

Hydroxyzine (generic for Vistaril) is an antihistamine used to treat skin rashes, allergic reactions, itching, and anxiety.

Prescription only

GeneralMedication

acyclovir

Acyclovir is an antiviral used to treat shingles. Acyclovir can also be used to treat cold sores of the mouth and genitals caused by the herpes virus.

Prescription only

GeneralMedication

diphenhydrAMINE pediatric chewables

Diphenhydramine (generic for Benadryl) treats allergic reactions. It may be used for both mild and severe allergic reactions.

PediatricsMedication

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