This is a 4-week series focused on bacteria found on our skin, in particular Staphylococcus aureus, a bacterium that can lead to infection and complications in eczema patients. I’m honored to have Dr. Clay Cockerell, the clinical professor of dermatology and pathology and the director of the Division of Dermatopatholgy at University of Texas Southwestern Medical Center in Dallas, Texas, to help in this series.
More on Dr. Cockerell – Dr. Clay Cockerell was the president of the American Academy of Dermatology in 2005. He is a renowned medical educator having overseen an educational program designed to train the next generation of dermatologists and dermatopathologists and the author of numerous papers and textbooks. He is a board-certified dermatologist and dermatopathologist licensed in many states throughout the U.S. His clinical expertise is in skin disorders and his passion has led him to co-found TopMD Skin Care, the company behind CLn® BodyWash.
How Staph Bacteria Passes From One To Another
Staph bacteria, including MRSA, are spread from skin-to-skin or by contact with surfaces and objects. Staph bacteria present in mucous lining of the nose can be passed to another if the other person touches the mucus from the former’s sneezes (and kindly not dig your nose!). Measures such as hand washing, disinfecting, particularly on surfaces such as doorknobs, mobile phone and keyboards, kill the Staph bacteria.
Marcie Mom: Dr. Clay, here are a series of practical questions on regular cleaning and hygiene!
1. For cleaning of door knobs/mobile phones – how regular should the cleaning be? And is any disinfectant effective against Staph bacteria?
Dr. Clay: The common household antiseptics that contain bleach and other products, such as Lysol, are very effective at killing Staph. There is no “right” answer to how frequently to clean these areas, but if there is a person at high risk of getting an infection or becoming colonized with MRSA, such as a child with eczema, perhaps as often as once or more per day might be a good idea.
2. A hospital setting or being in a confined area with a patient with infected wounds, is a venue with a higher rate of MRSA. Should a child not be brought to a hospital at all, especially a child with eczema skin?
Dr. Clay: Yes, if the eczema is flared, it would probably be wise to avoid such settings. If for some reason the child must be in those areas, I would strongly recommend that he or she wear protective clothing, such as a gown, and consider taking a bleach bath or shower afterward.
3. Towels should not be shared but washed with detergent and preferably warm water. What is the temperature a washing machine ought to be set to kill Staph bacteria?
Dr. Clay: The temperature is not the most important aspect of killing the bacteria, but rather the presence of the detergent – especially if it contains bleach is very important. Even if the clothing is washed in cool water, if it contains bacteria-killing detergent, that will be effective. Most washing machines have a hot/warm cycle, but the temperature of the water is not hot enough alone to kill bacteria.
4. Pets can also be infected with Staph bacteria and pass to humans through contact. Should regular checking of the pet be conducted for Staph bacteria?
Dr. Clay: Yes, especially if there is a child at home with eczema. Most pets that are infected with Staph have some sort of skin compromise like crusting and oozing, and a veterinarian should evaluate those. Just as with humans, washes with bleach-containing products coupled with antibiotics are quite effective.
5. For someone who had a prior Staph infection, is he/she more prone to a repeat case?
Dr. Clay: Yes. Unfortunately, this indicates that the person is prone to get Staph and that their body chemistry is conducive to Staph colonization.
Prevention via Bleach Bath & Alternative Preventive Measures
Bleach bath has been shown to be effective in reducing Staph bacteria, more in this post. How does the bleach act against the bacteria on the skin? Kill it and it’s drained with the water?
Dr. Clay: Bleach differs from antibiotics in its killing mechanism as it acts to physically destroy the bacterial cell wall and proteins. Antibiotics interact with the proteins and nucleic acids to cause the bacteria to make abnormal cell structures. As such, they can develop resistance. Once the bacteria are killed with bleach, the residual cell structures are no longer viable, and yes, they will degenerate and be washed away.
For parents who are resistant to bleach bath (like me), I use chlorhexidine. How much chlorhexidine to put on the cotton pad (soaking wet or squeezed dry wet) and how many ‘swipes’ are required to kill the bacteria?
Dr. Clay: Chlorhexidine is also effective at killing bacteria and basically, all one needs is to coat the area and rinse with water. There is no “right” amount to use, just use enough to cover the area and wash it off. Different products come with different instructions, so follow those as it may be necessary to leave it on a bit longer before washing. Chlorhexidine is not supposed to be used on the head and neck or in the groin area, however, and unfortunately, these are areas where Staph thrives. For this reason, bleach-containing products like CLn® BodyWash, which can be used in those areas, is a very good alternative. It’s much easier to use than a traditional bleach bath and is much more cosmetically elegant.
Are there other alternatives? Especially for a child with eczema who ought to avoid frequent hand washing with soap?
Dr. Clay: As noted above, a bleach-containing product such as CLn® BodyWash could help to decrease the use of harsher products because of their efficacy in killing bacteria such as Staph and MRSA, which would lessen the risk of causing irritation. For general cleansing, mild cleansers like Cetaphil can be used instead of soap and water, which also lessens the risk of irritation – although, this has no antibacterial effect.
MarcieMom: Thank you so much Dr Clay Cockerell for teaching us lots on how to manage the bacteria on our child’s skin. I’ve learned much in this series and I’m sure many parents do and appreciate your advice!