Memorial Day has passed, and as it passes, so we transition into the lazy summer months, here in NYC and beyond. Time for warm weather, long days, and…foot wounds. Ah yes, puncture wounds, nail trauma, sprains, strains, fractures, just another relaxed summer day in a NYC podiatry practice. As the hot dogs were sizzling I got to thinking: do those topical antibiotics really work? We covered Epsom Salt a few weeks ago so it seems about time to visit another potential maternal myth and see if I have to keep slathering Neosporin on my kids’ cuts and scrapes.
As I tell my patients (almost daily) in my NYC podiatry practice, the body wants to heal, we just have to help it along. Most minor cuts and scrapes, as well as lacerations and minor procedures, will heal with proper care and hygiene. More complex and larger wounds, surgical wounds and diabetic foot wounds require a more complex level of care that is beyond the scope of this short and not as sweet blog. There is a large debate in the medical community as to the role of topical antibiotics in wound healing. Most of our moms, and a few TV commercials, agree that triple antibiotic ointments will help to accelerate wound healing and minimize scarring. And there is good evidence that moist wounds heal better. There is also evidence that superficial infections can be treated with some topical antibiotics, which is good news since not only is the overuse of antibiotics contributing to the rise of multidrug resistant bacteria, but it’s also a drag to take medicine. However, an open wound that is infected beyond the most superficial skin layers will most likely respond best to an appropriate oral antibiotic taken for the prescribed and correct time frame.
Back to the most common topical antibiotic, Neosporin, or triple antibiotic ointment. The three antibiotics that comprise this most common antibiotic in a petroleum jelly base have broad activity against a wide range of pathogens. There is ample evidence that the combination can be effective for superficial skin infections. There is also evidence that it may prevent infection, and yes, may even aid in minimizing scarring. One downside is that some people are allergic to neomycin, one of the antibiotics used in the combination, and the allergic reaction can be confused for a worsening infection, leading to the occasional medical head scratching over a non-healing wound. The other downside is that the judicious use of antibiotics, in any form, for many wounds that may not need it is unnecessary and has long term consequences. But overall, there is enough evidence to justify the use of over the counter and topical antibiotics for the care of simple wounds and superficial infections.
So for your minor scrapes, scratches, and the occasional post-ingrown toenail procedure care, listen to your neighborhood NYC podiatrist and Mom, and shmear a little ointment on that boo-boo. That and a little chicken soup might just help.
See you in the office.
Ernest Isaacson
