Can mupirocin be applied to the face?

Application of Mupirocin on the Face

Mupirocin ointment can be safely applied to the face for treatment of appropriate skin infections, but it should not be used on mucosal surfaces or near the eyes. 1

Appropriate Use of Mupirocin on the Face

Mupirocin is a topical antibiotic that is highly effective against staphylococci and streptococci, which are the predominant pathogens in most superficial skin infections 2. When considering application to the face:

• Approved indications: Primarily for impetigo and other superficial skin infections 1
• Application method: Apply a small amount to the affected area 2-3 times daily 2
• Duration: Typically 5-10 days; if impetigo has not improved in 3-5 days, contact your healthcare provider 1

Important Precautions

When applying mupirocin to facial skin, several precautions must be observed:

• Avoid mucosal surfaces: Mupirocin ointment is not formulated for use on mucosal surfaces 1
• Avoid eye contact: The product labeling specifically warns against ophthalmic use 1
• Monitor for reactions: Discontinue if sensitivity or chemical irritation occurs 1
• Limited area application: Apply only to the affected areas to minimize absorption of the polyethylene glycol vehicle 1

Clinical Evidence Supporting Facial Use

The Infectious Diseases Society of America (IDSA) guidelines support the use of topical mupirocin for impetigo, which commonly affects the face, particularly in children 3. The guidelines state:

• Mupirocin is the best topical agent for impetigo 3
• For small, localized lesions (which often occur on the face), topical mupirocin is appropriate 3

Special Considerations for Facial Application

1. Facial impetigo: Mupirocin is particularly effective for impetigo, which frequently occurs on the face 3, 4

2. MRSA colonization: For patients with recurrent skin infections, mupirocin may be used to eradicate nasal MRSA carriage, though this requires the specific nasal formulation, not the skin ointment 3

3. Efficacy: Clinical studies have shown excellent efficacy with at least 80% of patients being clinically cured or markedly improved with mupirocin treatment 2

Potential Adverse Effects

When applied to the face, be aware of these potential side effects:

• Local reactions occur in less than 3% of patients and include 2:
  • Burning sensation
  • Itching
  • Redness
  • Dryness

These reactions are typically mild and occur at rates similar to the vehicle alone 2.

Common Pitfalls to Avoid

1. Using on mucosal surfaces: The standard ointment formulation is not designed for mucosal surfaces; a specific nasal formulation exists for intranasal use 1

2. Prolonged use: Extended use may result in overgrowth of nonsusceptible organisms, including fungi 1

3. Using near eyes: Mupirocin is not for ophthalmic use 1

4. Using on large open wounds: In patients with renal impairment, the polyethylene glycol vehicle can be absorbed from open wounds and damaged skin 1

In conclusion, mupirocin ointment can be safely and effectively applied to facial skin infections, particularly impetigo, as long as it is kept away from mucosal surfaces and the eyes. The medication should be applied 2-3 times daily for 5-10 days, with discontinuation if irritation occurs.