Methods to prevent staph infection / rash?

I might have had a canker sore once due to rapamycin, but I’m noticing that skin issues that seem like staph infections have become more common when I take it.

What are the best ways to avoid getting a staph infection? Do any of you have a protocol for this?

I’d imagine that some additional attention to hygiene might help. A bit of googling suggests that tea tree oil, active manuka honey, and coconut oil all have anti-microbial activities. So I’m looking for a lotion which has these.

Any other ideas or suggestions here?


Actually, would finding a way to populate my skin with good bacteria be a better option? I’ve seen some products that I’d never thought much of till now.

And maybe anti-microbials may be best to use if I get an infection, rather than to prevent an infection?

I think the rash (at least that i get) is just contact dermatitis. I use cortisone /cortisol cream on it and it goes away.

Where and how large is your rash?

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IMO you shouldn’t just assume it’s a recurrent staph infection and go down that rabbit hole when it could very likely be something completely different. It’s very easy to get a skin swab culture (primary care or urgent care provider can do that) to rule out a staph infection.


@shc I recommend you read this thread about another rash a person had with rapamycin.

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I’ve had rashes before and I just let it recover on its own.

What I recently got a little concerned about are what I presumed were staph infections — these basically look like small bubbles that forms on my skin that can be very easily be popped — there’s no pus but there’s a transparent watery liquid underneath. These can vary in size from the diameter of a ball point pen nib to that of a highlighter.


I have added vitamin A, 10,000 units per day. This seems to have helped. BTW, I am not convinced that they are infectious.


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You’ll likely know a soft-tissue skin infection if you have one. Any staphylococcus infected lesion will usually form a golden crust w/o healing each morning (Doesn’t the word Staphylococcus have something to do with “a gold rim”- or maybe I am nuts (or know it) :slight_smile: ? My infections (have not had one in a while on Rapamycin but fielded a few in the past) usually start with one lesion (which may look a large papule but over the next few days, despite an exploits of a mass amounts of clear fluid but are just as inflamed the next morning and look just “off.” The infection can come on very subtle, one small uninflected blemish on the skin because so over the next few days- my spreading leaves small gaps in parts of my faces than groups of not normal sized pustules that appear almost in patches. Almost always, my infected lesions will burn just from the hot water so it’s obvious. A culture is always nice to all back on but typical treatment for suspected uncomplicated methicillin susceptible staph or strep- something like Cephalexin (Klex) and a topical anti starch/strep prescription ointment.
If it’s Staph or Strep, despite fears of MRSA now everywhere in our community, this combo will work 73-75% of time. Now, you may have MRSA, community-acquired, which is why you are glad you got an infected lesion cultured earlier :), something like Bactrim or Tetracycline as well as newer Rx anti-bacterial MRSA effective ointment. Once I had a Paeudomonas infection, a gram negative bacterium not nearly as common as Staph. In that situation 5 days of Oral Ciproflaxcin or Levoflaxcin (Cipro or Levaquin) will do it.

How to prevent? Great question. Huge fan of general hygiene :), think broad spectrum daily Probiotic, obviously not touching a lesion, no matter what. Use of double or triple antibiotic creams or ointments (OTC- Neo or Polysporin) when used if injury occurs, used until lesion as healed, shows a dramatic reduction in skin infections.


The infections I have gotten are very similar to the ones you report getting. Do you know what this is, if not staph?

Thanks for the heads up on cehpalexin, and tetracycline.

Probiotics shouldn’t touch the lesion even though they’re “good bacteria”? I thought this would mean they’re relatively harmless, and potentially help mitigate the spread of the “bad” ones

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I think Probiotics may in general just improve overall immune response and help balance the delicate millions upon millions of organisms that
reside on the human skin in balance. Certainly, different strains of probiotics have other properties but conventionally I do not think Probiotics work like Antibiotics. A good probiotic should help with preventative portion of even getting an infection but once infected, antibiotics are usually required.

The only reason I mentioned Tetracycline or
Bactrim are for skin infections which are highly suspected of being a MRSA strain, due to failed response of antibiotics already, past experience, or a culture. These 2 antibiotics are neither a 1st line skin ineffective, targeted for MRSA in particular.

If something like Keflex and Bactroban Ointment don’t cure it, usually a more serious infection or strain is the issue. Either you’ll need to graduate to MRSA covered Bactrim, Tetra, or Levaquin or you have a gram negative skin infection (Pseudomonas, E. Coli) - more rare but require Gram Negative covered antibiotics (Cipro, Levaquin, etc).

I highly recommend a culture at first suspecting of infection of the skin but if reoccurring (even just a 2nd time for sure). You can find out if you have a bacterial infection, fungal infection, etc. or no infection at all! Could be a bad rash requiring some corticosteroid cream or something other.

It’s good to know more info about these reoccurring issues so you may help prevent them, know what works, and to be careful on the Rapamycin.

My infections will start with one lesion. Usually after 3 days of not going the way I want, if it looks and feels odd at 44, it likely is. When the spreading starts it’s an easy read.

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Tea tree oil is some thing that I’ve used for years with great success. Probably the reason that I don’t get skin irritations even though I’m on a high dose 22 mg of Rapamycin every 15 days. What makes tea tree oil so good is that you can put it everywhere including the scalp and it will rejuvenate your skin also.

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Many skin infections are due to dysbiosis of the skin microbiome. Many soaps and cleansers tend to harm and/or destroy your skin microbiome. Dr. Ohhira’s skincare products contain ingredients that actually protect and promote a healthy skin microbiome. For more information, give me a call at (541) 601-1492 Ross

I have been taking 5mg Rapa once a week. I upped it to 6mg yesterday, and noticed two small sores on the lower part of my legs. (ankle and shin). I am now also wondering if it could be staph from the Rapa. I have never had these before.

Did you ever get a diagnosis? Have you continued to get them?

This is not medical advice.

“Staph infection” is way too simplistic, and I wonder if it even is Staph. A rash is extremely nonspecific - could mean anything. “Health gurus” that game the SEO system on Google rankings tend to interpret literature in a very superficial way that can cause harm. Gullible sites parrot claims. “Natural” is not inherently good - plenty of dangerous possibilities.

For example, coconut oil may affect the lipid coating of some bacteria. But why would you think is “good”? Because some “health guru” from a Google search said so and told you “natural” good “antibiotics” bad? If that’s really true, it’s simple - the primary effect would be to reduce normal flora as a “natural antibiotic” for routine use - which may be bad! They are contradicting the so-called evils of antibiotics and they flip their own logic when convenient. That’s how you know you should stay far away from that BS. Either they don’t work or they don’t work the way you think such that you don’t want them to work!

Please avoid sloppy thinking from Google-ranked “gurus” and follow scientists/infectious disease physicians who are meticulous and systematic with evidence-based medicine, preferably with research experience. The antimicrobial choice should be tailored to each individual. That’s why every single time physicians consult infectious disease physicians if it is unclear!

I’ll share my infection prevention mainstays, based on my geography, meds, genetics, individual situation, risk factors, etc. It has no application to anyone else due to the complexities of how bacterial infection, how empirical antibiotics work, as well as antibiotic stewardship, etc.

I also found Dr. Green’s abx potentially dangerous - explained in depth elsewhere - trying to figure out his rationale but nowhere to be found. I primarily use doxy when indicated instead of Zpak which I can’t wrap my head around.

You must consult an infectious disease physician expert for yourself:

For prevention, oral hygiene (inc electronic toothbrush, guava leaves, constant flow of green tea, bamboo floss, dental visits q2yrs), custom topical synbiotics for skin, for MRSA nares decolonization CAP, I use topical mupirocin as needed, wear mask (cheap filter for air pollution - indoor and outdoor), avoid injury (all kinds), avoid any skin disorders with derm, don’t rub eyes, nose breathing except exercise/eating, exercise (circulation), wash hands after patient room using regular soap and water, shower every other day with soap limited to genital, armpits, mild salicylic acid cleanser USP every day, feet cleaned with urea USP cream once in a while, anti-fungal powder in shoes, Picaridin if at risk of insect bites, 2% ketoconazole shampoo USP, tretinoin USP at night, tazarotene 0.1% USP foam cleanser for the back. I have a wide range of vaccines and experimental vaccines that have already been done (ie GBS) and always get everything on schedule (ie get your shingles shot! You can lose eyesight with herpes zoster ophthalmicus s/o with bacterial infection)

For limited impetigo, I use topical mupirocin bid x 5d

For abscess, extensive systemic assuming neutropenia/immunosuppression from Rapa: I&D with concierge physician asap + doxy 100 mg po bid 7-14d

Erysipelas/uncomplicated, non-purulent, lymphangitis: Cefazolin 1g IV q8h

Nec Fasc with water or if I might have vibrio with raw seafood: doxy 100 mg po bid 7-14d

MRSA bacteremia/pre-septic: Go to ED ASAP while calling my concierge physician to coordinate and get to a hospital bed where there is availability, tell them my procalc baseline if >=0.25 then tell them to get the right abx and forward any early STAT swabs/culturesx2 from concierge as applicable just in case, if already done much earlier, so I get to the right antibiotics based on susceptibilities sooner than any other similar patient by 24 hrs+ and have quick proof of severity so they take it seriously.

Not comprehensive. I have a much longer list for every single possible infection. These are just the basic skin-related ones.

Again, not medical advice. There is nonapplicability for individuals based on too many factors. This is for my own use and for my SO to give to my physician if I’m incapacitated or have too much confusion from say sepsis. Antibiotics aren’t a simple subject and you should never try to treat sepsis or something that can become sepsis on your own without a physician! Can be deadly.

You should consult your physician for advice if you have any medical issues.

Beware urgent care clinics often look as if they are staffed by physicians, but many aren’t. The easy-in for private equity firms by using the cheapest lowest quality labor possible, high profits, and high demand is why they own a large chunk of the market. Most of the rest is hospital owned and they tend to use the same max profit, minimal patient safety formula.

I’ve literally seen enough deaths by skin infection (ie cellulitis by MRSA) to sepsis (including younger patients btw) to know a concierge physician with labs who can run suspicious things STAT and prescribe everything right before they become an issue, fight on my behalf with medical records and previous abx use while providing extremely accurate medical information (including pharmacogenetics information to warn them to avoid certain antibiotics due to risks of possible severe side effects and get better predicted dosing) and avoid cognitive errors in the ED, access to my chart on the EHR to re-read imaging and EKGs, while saving on stupid hospital chargemaster prices while my insurance company dukes it out and charges me big copay, charge me the exact same amount for far better quality with cheaper “copay” on in-house labs, and get me a hospital bed when needed ASAP with my SO is just golden - even if I’m suffering confusion. I also have a few experimental emergency options available (ie whole blood exchange, esmolol, and iloprost/eptifibatide) in specific cases.

Think about this - do you really want to roll the dice on increased mortality because of things like a lack of ICU beds, mistakes in triaging, or misdiagnosis in urgent care when say it’s something like cellulitis that can be treated far earlier for much cheaper?

Prevention is clearly way cheaper than the ED.

Just see how the private equity firms work in healthcare and what type of lobbying they support. It’s pretty easy to work it out.

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What exactly do you have on your skin? Pls describe.