What is this skin sore on DS’s face? Pics attached

[hippohector]

DS (14) has had a sore/rough piece of skin on his face for over two months.
He has seen two different doctors now - had two lots of oral antibiotics plus antibiotic cream. When that didn’t work the doctor prescribed anti fungal cream that he has been using for the last three weeks, but so far there has been no improvement.
It isn’t sore but it sometimes itches. He hasn’t been too bothered about it until now as we haven’t really been going out much, but he is now getting quite conscious of the fact he is back at school in a couple of weeks.
I will take him back to the doctors but I haven’t got much faith in them to be honest as they just keep saying ‘skin infection’ and giving him tablets and creams that don’t work.
Any advice please mumsnetters?

Could it be a cold sore? I don't know much about them as never had them myself, but my friend used to get them like that in her face occasionally before antivirals were commonly available. I'd assume that would occur to a GP though...

Hi OP, judging by its circular shape I think it looks like impetigo which my teen son had on his scalp during lockdown. It turned pretty nasty but we eventually zapped it with more antibiotics and a steroid cream. Sorry can't remember what you said you'd had but push for those and perhaps a swab too for certainty. Once we had more antibiotics plus cream it cleared up pretty quickly but I sympathise as I think I'd have struggled to get my son to school if it hadn't been lockdown

He has already had two courses of oral antibiotics and an antibiotic steroid cream - maybe I’ll push for a skin swab

I think it could well be impetigo

Query ringworm?

Google ring worm rash face - there are some similar spots. It’s fungal so would only get worse with antibiotics, not better.

I also think impetigo is possible. When DS had impetigo he needed antibiotics, antibiotic cream and bleach baths (google it) to get rid.

I would ask the GP to send a photo to dermatology to get their advice. My ds had really itchy palms of his hands with a rash for months and GP prescribed lots of different creams but it cleared up quickly when the dermatologist prescribed something.

Ringworm would go away with antifungals though. Impetigo can be very resistant which makes me think that as it hasn't gone away with lots of treatment. DS impetigo was horrible and very crusty but every time it was swabbed it was negative, dermatologist was very disbelieving of results as it was clearly very infected (think he thought the swabs weren't handled correctly).

Yes agree dermatology opinion would be good.

Can you get a referral to a dermatologist? I had a skin lesion on my face that my gp couldn't identify or get rid of. A dermatologist identified it immediately (after I had had it for years) and treated it. It was gone within a few weeks.

You need to get some chlorhexidine wash (hibiscrub). You could also try something like optrex infected eyes (although ask for the generic 'chloramphenicol' as it's cheaper). It's really effective for some skin infections.

Thanks all

If it's impetigo it'll be bacterial and it depends on which bacterium is causing it as to which antibiotic will kill it. You should get a swab done for MC+S (Microscopy, Culture and Sensitivities - this should also pick up a yeast infection).

If it's fungal you'll need to get a skin scraping (they will scrape across the surface to get flakes of skin for culture) - get them to look for dermatophytes (which cause ringworm and other superficial fungal infections)

If something grows in one of those your GP will be better placed to suggest how to treat it. Otherwise it's just guesswork.