Nasal sores are a common, painful nuisance. They frequently come and go, and often are accompanied by blemishes on the face and scalp that typically have white, pus-filled tops (see picture).
These sores are most commonly due to staph bacteria. The majority of people carry staph in their nose, and a number of them will develop sores and pustules sometime during their life. The bacteria is transmitted by direct contact. It is therefore critically important to practice good hand-washing techniques, and to limit blowing and picking one’s nose as much as possible.
Medical care should be sought if nasal sores and/or pustules develop. Sometimes, a serious, full-blown skin and soft tissue infection (cellulitis) can result if treatment is not begun. A physician will often culture the nose to determine what strain of staph is causing the sores. The appropriate antibiotic combination is then given, usually a shorter course of oral antibiotics with a 1 to 3 month trial of a nasal antibiotic ointment. Washing with an antibacterial soap such as Hibiclens can also be recommended, often for up to 3 months. All bedding, towels and clothing should be washed in hot water and bleach should be used whenever possible. Sharing personal items such as hairbrushes and razor-blades is discouraged. With these aggressive measures, staph carriage can be eradicated, at least temporarily from the nose and skin. Unfortunately, it is very likely that the patient will be colonized by the bacteria again sooner or later.
If you have developed any of the above symptoms and are a member of our Direct Primary Care program, contact our office to schedule an appointment for evaluation.