MMRSA Guide
Microscopic illustration of MRSA (Staphylococcus aureus) bacteria
Reference · Symptoms

MRSA in the nose

The front of the nostrils is where MRSA most often lives. Usually it causes nothing at all — but it can also cause a stubborn nasal sore, and it is the main reservoir from which MRSA spreads to skin and to other people.

Written by David Roberts, editor · Updated

Checked against current CDC and IDSA guidance. Not medically reviewed. How we source this

The short answer

MRSA in the nose is most often colonisation, not infection: the bacteria live harmlessly inside the nostrils and cause no symptoms. Around 2% of the general population carries MRSA, most commonly in the nose. Carriage matters because it raises the risk of a later skin or surgical-site infection and because it spreads to others on the hands.

When nasal MRSA does become an infection, the usual picture is a persistent, tender, crusted sore or a small boil just inside one nostril that does not clear with ordinary care.

MRSA in nose symptoms

  • Persistent soreness, burning, or stinging inside one nostril
  • Redness and swelling at the nostril rim
  • Crusting or a scab that keeps returning after it is picked off
  • A small painful pimple, pustule, or boil at the edge of the nostril
  • Thick yellow or green discharge lasting more than a week or two
  • Occasional nosebleeds from cracked, inflamed skin
  • Boils or spots appearing elsewhere on the skin at the same time
  • Rarely, facial pain or fever if the infection reaches the sinuses

Skin lesions that appear alongside nasal symptoms are covered on MRSA skin infection and MRSA boil.

Carriage vs infection vs a cold

 Silent carriageNasal MRSA infectionCommon cold
DurationIndefinite — weeks to yearsPersistent sore that worsens over days to weeksImproves within 7–10 days
PainNoneTender, burning, often one nostril onlyGeneral stuffiness, no localised tenderness
AppearanceNormal-looking nostrilsRedness, crusting, scabs, pimples or a boil at the rimRed, chapped skin from wiping
DischargeNormalThick yellow-green, sometimes blood-streakedClear then thicker, then clears up
Other symptomsNoneSometimes skin boils elsewhere; rarely feverSneezing, sore throat, cough
DiagnosisScreening nasal swabNasal swab culture with susceptibility testingClinical — no swab needed
TreatmentDecolonisation if high-risk or recurrentMupirocin nasal ointment; oral antibiotics if spreadingRest and fluids only

MRSA and ordinary staph look identical in the nose; only laboratory testing separates them. See MSSA vs MRSA.

How nasal MRSA is diagnosed

A clinician rotates a sterile swab just inside both nostrils — the anterior nares — for a few seconds. The sample is either cultured for 24–48 hours or run through a PCR test that returns a result in a few hours. If MRSA grows, the laboratory also reports which antibiotics will work.

Full detail on swabs, culture, and susceptibility reporting is on the MRSA test page.

Treatment and clearing nasal carriage

The standard decolonisation regimen is a pea-sized amount of mupirocin (Bactroban) nasal ointment in each nostril twice daily for five days, usually combined with chlorhexidine body washing. Where mupirocin resistance is a concern, alternatives such as nasal povidone-iodine are used instead.

If there is active infection rather than carriage, an oral antibiotic that covers MRSA may be added — see decolonisation and treating MRSA skin infection.

Stopping it spreading from your nose

  • Wash or sanitise hands every time you touch or blow your nose
  • Use disposable tissues once and bin them immediately
  • Avoid picking or rubbing the inside of the nostril
  • Do not share towels, flannels, razors, or bedding
  • Wash bedding and towels on the hottest cycle the fabric allows
  • Keep any skin lesions covered with a clean dry dressing

More on household spread is on MRSA at home and is MRSA contagious?

See a doctor if

  • A nasal sore or crust lasts more than two weeks
  • There is a painful lump inside or at the edge of the nostril
  • You develop fever, facial pain, or swelling around the nose or eye
  • Boils keep coming back on your skin
  • You are due surgery, on dialysis, or immunosuppressed

Infection spreading beyond the skin is covered on invasive MRSA.

Frequently asked questions

What are the symptoms of MRSA in the nose?
Most nasal MRSA has no symptoms at all — it simply lives in the nostrils as colonisation. When it does cause infection, the usual signs are persistent nasal soreness or a burning feeling, redness and crusting just inside the nostril, small painful pimples or boils at the nostril rim, thick yellow or green discharge that does not settle, a scab that keeps returning, and occasional nosebleeds from cracked, inflamed skin.
How do I know if I have MRSA in my nose or just a cold?
A cold produces sneezing, a runny nose, and a sore throat that improve within a week or so. Nasal MRSA infection is usually one-sided, does not follow a viral pattern, and involves a tender lump, crusting, or a sore that persists for weeks. Only a nasal swab sent for culture or PCR can confirm MRSA — see the MRSA test page.
Is MRSA in the nose contagious?
Yes. Nasal carriage is one of the main reservoirs for spread. The bacteria transfer to your hands when you touch or blow your nose, and from there to other people, shared towels, bedding, and surfaces. Hand hygiene after touching your face is the single most effective step.
How is MRSA in the nose treated?
Nasal MRSA is usually cleared with mupirocin (Bactroban) nasal ointment applied to both nostrils twice daily for five days, often combined with chlorhexidine body washing. This is called decolonisation. Oral antibiotics are only used if there is an active infection beyond simple carriage.
Can MRSA in the nose go away on its own?
Carriage often comes and goes without treatment — some people clear it within weeks, others carry it persistently for months or years. Because carriage raises the risk of skin and surgical-site infection, doctors treat it before operations or after recurrent boils rather than waiting.
Why do doctors swab the nose for MRSA?
The front of the nostrils (the anterior nares) is the favourite site for Staphylococcus aureus, so a nasal swab is the most reliable single screen. Hospitals swab before surgery or on admission to high-risk wards so carriers can be decolonised and isolated appropriately.
Can nasal MRSA cause a sinus infection?
It can, though it is uncommon. MRSA sinusitis is mostly seen after nasal surgery, in people with nasal packing or tubes, or in those who are immunosuppressed. Facial pain, fever, and thick one-sided discharge that fails standard antibiotics should prompt a culture.
Should the rest of my household be treated?
Household treatment is considered when MRSA infections keep recurring in more than one person. Your clinician may swab close contacts and decolonise everyone at once, alongside washing towels and bedding at high temperature and stopping the sharing of razors and flannels.
References
  1. CDC. MRSA: people at risk and healthcare settings (2024)
  2. NHS. MRSA — Overview and screening (2023)
  3. IDSA. Clinical practice guidelines for the treatment of MRSA infections in adults and children (2011)
  4. Clinical Microbiology Reviews. Nasal carriage of Staphylococcus aureus: epidemiology and clinical relevance (1997)

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