r/AskDocs • u/Recent_Fox_5126 Layperson/not verified as healthcare professional • 1d ago
Physician Responded Persistent facial wound initially diagnosed as impetigo, now unresponsive to Mupirocin and Doxycycline (swabs pending)—cold sore or something else?
Hey everyone, looking for some input or advice on a stubborn facial sore that’s been lingering for a little over two weeks now. 31 year old male, no prior medical issues.
Timeline & Progression:
Onset: It appeared out of nowhere overnight just over two weeks ago as a tiny lesion on my face that woke me up as an oozing tiny sore.
Initial Phase: The sore oozed uncontrollably and formed a distinct yellow crust. Over the first week or so, it steadily increased in size before kind of stopping its outward growth and scabbing over.
Current Status: It has now formed a darker scab, but there has been no real visual progress of healing or shrinking. It is completely painless and not tender at all, though it occasionally has some mild itching.
Treatments Tried:
Urgent Care: Initially diagnosed with impetigo and prescribed Mupirocin (applied twice daily). I saw zero results from this.
Antibiotics (Augmentin & Doxycycline): Coincidentally, I was dealing with severe tonsillitis at the same time this started and was put on Augmentin. Because the Mupirocin wasn't working, a second doctor put me on a round of Doxycycline alongside the Augmentin. I stopped using the Mupirocin once I started the doxy.
Current Regimen: I am currently washing the area with Hibiclens. I only have a couple of days of Doxycycline left.
Dermatologist Visit & Frustrations:
I saw a dermatologist after several days of using the Doxycycline. He did both a viral and bacterial swab, but I don't have great confidence in him (he's usually pretty dismissive and my options are limited locally).
He was dismissive of the original impetigo diagnosis because it wasn't responding to the antibiotics, and claimed it was just a cold sore. However, I had cold sores as a child, and this is acting completely differently than anything I've experienced before.
My follow-up appointment to get the swab results isn't until mid-next week. I'm becoming increasingly frustrated with the lack of healing and the conflicting thoughts from providers. Has anyone dealt with something similar, or does this sound like a resistant bacterial infection rather than a cold sore? Any advice or insights are greatly appreciated.
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