Duration Health

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 cream can be used for minor rashes to relieve the skin itching, burning and redness. 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 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®). 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:

Quick Guide

If you have

  • itching or burning skin
  • skin redness or bumps in a small area of the skin
  • no fevers

You may have

skin rash (dermatitis)

Consider using

hydrocortisone cream, 1 topical application to affected area up to 3 times per day as needed

If you have

  • small area of skin that is red, warm to touch, painful to touch
  • no fever

You may have

minor wound infection

Consider using

mupirocin cream, 1 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

trimethoprim-sulfamethoxazole 800 mg-160 mg twice a day for 7 days

and seek emergency medical care

If trimethoprim-sulfamethoxazole is unavailable or if an allergy to sulfa drugs is present, either doxycycline OR amoxicillin-clavulanate may be considered as an alternative, although they may be less effective.

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.

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

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

GeneralMedication

Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim) is an antibiotic. It can be used to treat urinary tract infections and skin infections.

InfectionMedication

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 (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).

InfectionMedication

Cyanoacrylate (generic for Dermabond) is skin glue used to repair small lacerations.

TraumaMedication

Lidocaine/prilocaine (EMLA) gel is used to numb skin for laceration repair.

TraumaMedication

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.

InfectionMedication

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