Should I Use A Topical Antibiotic on My Wound?
Patients often ask if they should use over-the-counter topical antibiotics (such as Neosporin, Polysporin, or Bacitracin) on surgical wounds or other cuts or injuries. While many people use such medications to try prevent wound infections, several recent studies have shown that these over-the-counter topical antibiotics often do more harm than good. In most cases, the rates of allergic reactions to topical antibiotics are higher than the rate of postoperative wound infections. Rates of allergic reactions to these medications can be as high as 4-5% whereas most dermatologic surgery practices have infection rates of only 1-2%. Neomycin is the most common topical antibiotic to cause allergic contact dermatitis (allergic skin reactions). There is a risk of co-reactivity between Neomycin and Bacitracin. Allergic contact dermatitis associated with topical antimicrobial agents is an increasing problem for postoperative wounds. Even patients who have used a particular antibiotic ointment previously without problems may develop a sensitivity or allergy over time. In addition to the redness, itching, and discomfort associated with an allergic skin reaction, sometimes such an allergic reaction can mask a true skin infection or be mistaken for an infection.
For these reasons, we continue to recommend only white petrolatum (Vaseline) for most wounds.
Should I Cover My Wound or Leave It Open to the Air?
There is good evidence to show that moist wound healing reduces healing time and improves the quality of the final scar. When the wound is moist, the epithelial cells can glide across the granulating base with greater ease. If a scab is allowed to form, the epithelial cells are required to migrate beneath the hard crust which both delays healing and is more likely to cause a depressed scar. In order to maintain moist healing, one must use both a product like Vaseline and an airtight dressing.