Help identify my skin issues, please? Picture included.
June 23, 2013 7:09 PM   Subscribe

I've been getting open sores on my chest area that start as pimples for about five years. A few days ago, I got an especially bad one. Dermatologist says it's a "staph abscess", but I'm not so confident. Any ideas?

YANMD, and I've seen a dermatologist about this, but I'm curious if any of you might be able to give me some insight as to what the heck is going on with my freaky skin as of late.

This open sore is located underneath my right breast. I've had previous sores like this but they were always on top of my chest and healed up with application of SSD (silver sulfa) cream, which was prescribed by a previous family doctor. They start out looking like pimples, never come to a head (I don't squeeze them), and then the skin just sort of comes off. They don't ooze pus, but weep clear fluid only and then open up to this ulcer-like state. Then they typically get infected and once cleaned out, heal from the outside borders, with new tissue developing inwards and take weeks to completely heal over. A scar is left afterwards. This one was in an unusually awkward spot and was very puffy around it - there was a circle of puffy skin in about a 3" circle around the sore, like edema under the skin. In fact, the clear fluid was leaking not only from the sore itself, but from the pores surrounding it.

I've experienced these sores for about five years now and I went to the dermatologist a few days ago since this one was bigger and worse than usual, and the whole puffiness thing was new. Derm took a swab and sent it off to the lab, and is guessing (until she has official results) that it's an "abscess" or staph infection. In general I didn't feel great about the doctor's bedside manner, and it was my first visit there. In any event, I was prescribed a Z-pack (Zithromax antibiotic) of which I now have 1 pill left. I am also doing 2x daily warm compresses to the area and fresh bandaging with Mupirocin afterwards as directed by the dermatologist.

As a cautionary move, I've also washed all my towels and clothing (especially bras) in hot water. I'm only using single use disposable razors now, and only using my towels once after I shower. I've also switched to using washcloths in the shower, again only once. I use antibacterial body wash in the shower and am careful when I dry to touch the area last and not use the towel on my body after making contact with the area. I do the warm compresses with clean washcloths only and they are also single use only. All this stuff then gets washed on hot before being re-used, until the infection is completely gone. I'm also washing my hands after every bandage change/warm compress/accidental contact with the area and just in general, always with anti-bacterial soap.

It's cleared up a bit since I had the appointment but until I hear back from the lab, I'm just curious if anyone might have any insight as to what this might actually be. I've contacted a new dermatologist about setting up a follow-up appointment to help determine how the sore is healing and for future appointments, but since it's the weekend I won't hear back from them until the coming week arrives.

Here is the rather gross picture - mildly NSFW, picture of underside of my right breast. Sorry for the bad quality phone picture.

Thanks for any insight!
posted by anonymous to Health & Fitness (14 answers total) 3 users marked this as a favorite
I am not a doctor, but your picture looks like a very mild version of what I see in a Google image search for "staph abscess". (Not for the faint of heart).
posted by colin_l at 7:52 PM on June 23, 2013

Staph abscess.
posted by batmonkey at 7:53 PM on June 23, 2013

The description at Mayo clinic's website describes pretty much exactly what you have. Even the picture is similar.
posted by annsunny at 7:54 PM on June 23, 2013

The description you give of the weepy not-quite-pimples reminds me of some skin troubles I had several years ago. It cropped up after I'd been dating a guy who had a staph infection on his foot, and manifested in these strange tiny open sore things on my legs.

It took me months to connect the two, but I finally realized what was going on. I began a regime of immune system strengthening stuff, including adequate sleep, reducing stress, some antioxidants, etc, and it went away.

Anyway, I think what you've got is a low-grade staph infection, and this particular sore got a toehold.
posted by Specklet at 8:07 PM on June 23, 2013

I had a staph abscess that looked exactly like that.
posted by deadmessenger at 8:07 PM on June 23, 2013

It does sound like staph- I'm not brave enough to look at the picture. :)

My middle child had it twice. The second time, the doctor prescribed antibiotic creme for the sore and for her nostrils. My pharmacist confirmed it. Staph lives in your nose. If you treat your nose with antibiotic cream then you are less likely to have it come back.

I think that it is time for you to stick a medicated q-tip into your nose. Don't go up far, don't use too much, but do it once or twice a day for 5 days. You may also need something stronger than a z-pack.
posted by myselfasme at 8:37 PM on June 23, 2013

That is most emphatically a staph infection. I had tons of those growing up, mainly from coral cuts. There was a black, tar-like ointment we used Back in the Day to remedy such things, whose name I cannot recall - but a poultice of Epsom salts mixed with glycerine worked to resolve them as well.

Unless staph infections have changed a lot in the intervening time (30 yr), symptom management is enough to get them to resolve.

I bet you live in an area where you are exposed to sea-water routinely.
posted by jet_silver at 9:06 PM on June 23, 2013

black, tar-like ointment

Maybe drawing salve (not to be confused with black salve).
posted by Dansaman at 9:48 PM on June 23, 2013 [1 favorite]

I associate high sugar in my diet with this sort of thing, try cutting out sugar and hfcs as much as possible after you are done with the antibiotics (perversely, studies have shown that since staph love sugar, adding it to an antibiotic regimen prevents reinfection from staph hibernating and therefore missing out on the antibiotic).
posted by 445supermag at 9:55 PM on June 23, 2013

A good friend of mine regularly gets staph infections - she (and the docs) believe its related to her autoimmune disorder. It might be something to think about in the future.
posted by florencetnoa at 6:19 AM on June 24, 2013

it does sound like staph. i think your treatment sounds like you're on the right track. from personal experience, i may also suggest putting some of the ointment on a gauze and putting it in your bra all day. not taping it down or anything, just kind of resting in there with the pressure of your bra holding it in. that way you're not getting staph goo in your bra and spreading it all around. this is what i do. it may help the healing it may just be for peace of mind, i dunno. but at least then i don't have staph goo stains in my bra either. i hope it heals soon for you i know how uncomfortable staph sores can be.
posted by misanthropicsarah at 6:54 AM on June 24, 2013

The black stuff is definitely drawing salve, which CVS has sometimes. It's ichthammol and green soap, smells like gasoline but makes the pain/pressure stop. It's good for getting them to come to a head and drain.

After that, use neosporin on gauze - like misanthropicsarah says, it'll limit the amount of drainage you get in your bra. Don't touch it except with just-washed hands (and then don't touch anything else until you've washed your hands).

I find that washing the areas where I am most prone to them (armpits, in my case) with facial acne wash (I like the drugstore version of Olay's 7-in-1 cleanser), and periodic light exfoliation keeps things better under control.
posted by Lyn Never at 9:04 AM on June 24, 2013

Staph infection is non-trivial. I'd be using extra precautions like not sharing towels and washing towels often, but IANAD
posted by theora55 at 9:47 AM on June 24, 2013

I just wanted to say thank you for asking this question. I have been getting these weird little sores all over my chest and face for months now but they'd disappear before I could ever see a dermatologist about them. Once I read this post and saw the picture though it all clicked and I finally got a dermatologist and an allergist to confirm and help me treat my staph infection (which I was previously unaware of until seeing your picture and realizing what was going on). Now I'm applying a triple antibiotic to each sore as they appear and it's making a big difference. Don't discount the staph diagnosis!
posted by These Birds of a Feather at 7:43 PM on July 14, 2013

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