Managing Eczema-Related Skin Infections With Mupirocin

If you’ve had eczema for any length of time, you may be all too familiar with how easy it is to develop a skin infection. 

Intact skin acts as a barrier, preventing bacteria from getting under your skin and starting an infection. However, itchy, dry, and inflamed skin from eczema makes it easy for bacteria to get where they aren’t supposed to be and start complicating things.

While your medical provider may have you using other topical creams to help reduce inflammation and maintain moisture, they may also prescribe mupirocin if they feel you have an underlying infection. 

This article discusses mupirocin and how it can help with eczema. Discover recent research on its effectiveness, how to apply it, and potential side effects. 

What Is Mupirocin?

Mupirocin is a prescription antibiotic ointment. You may know it by the brand name Bactroban. The Food and Drug Administration (FDA) first approved this medication in 1997. Since then, it’s been widely used. 

Healthcare professionals prescribe mupirocin for bacterial skin infections. It doesn’t treat viral or fungal infections.

Experts have found that mupirocin 2% treats skin infections caused by Staphylococcus and Streptococcus bacteria. While some of these types of bacteria can be normal on the surface of the skin, others like Staphylococcus aureus (S. aureus), and promote skin inflammation. 

Mupirocin is especially known for being able to treat topical infections caused by methicillin-resistant Staphylococcus aureus (MRSA).

How it works

Mupirocin treats the infection by stopping the bacteria’s ability to build proteins, ultimately causing the cell to die. 

However, to work properly, mupirocin must be in an environment with the correct pH. The low pH of the skin provides the perfect environment for mupirocin. At the 2% concentration, most bacteria die within 24 hours of application.

Uses

Health professionals primarily prescribe mupirocin for skin infections such as impetigo, folliculitis, and infected wounds. 

Researchers are also looking into other ways to use mupirocin, such as treating deeper wounds and bacteria like Neisseria gonorrhoeae.

For eczema, your healthcare provider may prescribe mupirocin if you develop a bacterial infection. Treating the infection can help reduce infection-related symptoms such as redness, swelling, and discomfort. 

Dosage

Health professionals generally prescribe mupirocin 2%. They’ll direct you to apply a thin layer to the affected area two to three times a day.

The exact dose and how long you need to apply the mupirocin depends on the severity of the infection. It’s important to carefully follow your health provider’s instructions even if your symptoms improve. Completing the whole course ensures the infection is fully treated. 

On the other hand, it’s also important not to overuse mupirocin. Overuse can lead to antibiotic resistance, which is a growing problem.

How Does Mupirocin Help Eczema?

While mupirocin doesn’t directly help treat eczema, it relieves symptoms from bacterial infections that occur from your damaged skin barrier. 

Having eczema puts you at a higher risk for developing skin infections, especially from the bacteria like S. aureus. Research suggests that people with severe eczema have higher amounts of S. aureus on their skin, increasing the risk of an infection even more.

By eliminating the bacteria, mupirocin can reduce inflammation related to the infection and support the healing process.  

Effectiveness

Mupirocin is highly effective for localized skin infections, with success rates comparable to oral antibiotics in mild to moderate cases. However, it may not be sufficient for severe or systemic infections.

Many people prefer using mupirocin over oral antibiotics because they avoid the potential side effects of the oral antibiotic.

If you have a severe infection, your health provider may prescribe a combination of mupirocin with steroid creams. Studies suggest that this combination helps reduce infection, itching, and skin damage better than steroids alone. This is especially true if you use this combination in the first week of treatment. 

For example, one study found that combining mupirocin with budesonide cream reduced the rate of recurrence to just 2.67% compared with 12% when only steroids were used.

Application

Before applying mupirocin, it’s important to gently cleanse and dry the area. 

Apply a thin layer of the ointment to the infected area two to three times daily, according to your healthcare provider’s instructions. Using mupirocin more than your provider recommends can lead to the bacteria becoming resistant to the antibiotic. 

Your provider may also recommend applying a dressing, such as gauze, over the infected area after applying the mupirocin. 

Always wash your hands after applying the ointment unless the treatment area is on your hands. 

Side effects

Most people tolerate mupirocin well. Some people may have mild side effects such as:

• Burning
• Stinging
• Itching
• Rash

If you experience side effects, stop using mupirocin and let your healthcare provider know right away. 

Alternatives to Mupirocin for Eczema Treatment

Alternatives to mupirocin for eczema treatment depend on if you have a skin infection or if you are looking to treat eczema symptoms.

Antibiotic Ointments

Several other topical antibiotic ointments are available for skin infections. 

The type of organism causing the infection determines which antibiotic ointment is best. Your medical provider can take a swab of your skin to determine this. 

Topical antibiotic ointments available include:

• Gentamicin: A broad-spectrum antibiotic that’s great for treating infections from Pseudomonas, Proteus, and Escherichia coli.
• Metronidazole: A broad-spectrum antibiotic that treats most anaerobic bacteria and protozoa. It may cause burning and irritation when used topically.
• Neomycin: A bacterial ointment that treats gram-negative organisms like proteus, E. coli, serratia, and H. influenzae.

Oral Antibiotics

Oral antibiotics are also an option for treating severe skin infections. Your medical provider will take a culture of the infection to determine which antibiotic will target the infection.

Oral antibiotics available for treating skin infections include:

• Cephalexin
• Clindamycin
• Trimethoprim-sulfamethoxazole
• Linezolid
• Doxycycline

Prescription Eczema Treatments

If you need treatment for eczema symptoms, your medical provider may prescribe one or several topical medications. 

Here are some common eczema treatments:

• Moisturizing creams: These help restore your skin barrier by helping maintain moisture in your skin.
• Corticosteroid creams and ointments: These help reduce inflammation in your skin, which can bring relief from eczema symptoms.
• Phosphodiesterase-4 inhibitors: These creams help reduce inflammation when other treatments don’t help alleviate symptoms.
• Calcineurin inhibitors: These topical medications help reduce inflammation and prevent flare ups. 

Eczema Skin Care

When you have eczema, it’s important to learn how to properly care for your skin. Taking steps to support your skin’s ability to act as a barrier can help reduce your risk of developing skin infections. 

Talk with your medical provider about how often you should bathe each week. After bathing, it’s important to apply a moisturizer right away to help lock in the hydration. Your medical provider can share their moisturizing recommendations.  

Sometimes, medical providers recommend taking a diluted bleach bath. Never attempt a diluted bleach bath without first consulting your healthcare provider. They will give you specific instructions on how to take the bath if they feel it will help your eczema. Inappropriate use of bleach baths can worsen and irritate eczema. 

Phototherapy is another option available. Ultraviolet rays A and B can bring relief if your eczema is widespread or isn’t responding to other treatments. 

Conclusion

Mupirocin is a valuable tool for managing bacterial skin infections associated with eczema. Using mupirocin for an infection reduces inflammation and prevents the bacteria from spreading.

However, mupirocin is not a treatment for eczema. Medical providers also do not recommend using it long-term.

Managing eczema requires a comprehensive approach that includes moisturizing, reducing inflammation, and proper skin care. 

If you suspect an infection or need guidance on eczema treatment, contact a Zest dermatology provider for an individualized approach.