I distinctly remember being instructed on how to identify signs of infection related to small topical cuts and wounds. We looked for increase in redness, swelling, warmth and pain. An infected wound was an automatic referral to the doctor. It still is. Don’t mess around with infection. However, for minor skin injuries that were not infected, we were usually taught to recommend a good cleaning (soap and water or possibly a saline rinse) and then applying an antibiotic ointment (like Neosporin or bacitracin).
But…as the song goes… “the times they are a changin’.”
Actually, the changing opinion on what to put on minor, topical, uninfected cuts and scrapes isn’t very new. But having just recently talked about it with my own dermatologist, I thought it would be worth writing about.
Today it would appear that many dermatologists recommend using only petroleum jelly (i.e. Vaseline) on minor skin injuries or post-surgical wound sites. Why? Well, first of all, some people have allergic reactions to the ingredients in an OTC antibiotic ointment. Such a reaction will produce even more irritation at the site of the wound and delay healing or even worsen the wound. Secondly, there is the concern about antibiotic resistance. The more frequently we expose various pathogens to antibiotic agents, the more likely they are to develop resistance.
Here is the current advice copied directly from The American Academy of Dermatology website:
Always keep your cut, scrape or other skin injury clean. Gently wash the area with mild soap and water to keep out germs and remove debris.
To help the injured skin heal, use petroleum jelly to keep the wound moist. Petroleum jelly prevents the wound from drying out and forming a scab; wounds with scabs take longer to heal. This will also help prevent a scar from getting too large, deep or itchy. As long as the wound is cleaned daily, it is not necessary to use anti-bacterial ointments.
After cleaning the wound and applying petroleum jelly or a similar ointment, cover the skin with an adhesive bandage. For large scrapes, sores, burns or persistent redness, it may be helpful to use hydrogel or silicone gel sheets.
Change your bandage daily to keep the wound clean while it heals. If you have skin that is sensitive to adhesives, try a non-adhesive gauze pad with paper tape. If using silicone gel or hydrogel sheets, follow the instructions on the package for changing the sheets.
If your injury requires stitches, follow your doctor’s advice on how to care for the wound and when to get the stitches removed. This may help minimize the appearance of a scar.
Apply sunscreen to the wound after it has healed. Sun protection may help reduce red or brown discoloration and help the scar fade faster. Always use a broad-spectrum sunscreen with an SPF or 30 or higher and reapply frequently.
So, while it remains important to keep the wound clean and moist (with petroleum) it no longer appears necessary to use triple antibiotic ointments to prevent infection or promote healing. In fact, in a JAMA study published as far back in 1996, stated that “White petrolatum is a safe, effective wound care ointment for ambulatory surgery. In comparison with bacitracin, white petrolatum possesses an equally low infection rate and minimal risk for induction of allergy.”
Am I going to throw out all my tubes of Neosporin and/or Bacitracin? Probably not. But I’ve definitely gotten into the habit of recommending petroleum for keeping uninfected, clean wounds moist to promote faster healing.
NOTE: This blog post is not to be understood as medical advice for treating your particular wound. Go get it checked out. This is for information only.
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