Erysipelas is a bacterial infection in the upper layer of the skin. It is similar to another skin disorder known as cellulitis, which is an infection in the lower layers of the skin. Both conditions are similar in appearance and are treated in the same way.
Erysipelas is usually caused by the Group A Streptococcus bacterium, the same bacterium that causes strep throat. The infection results in large, raised red patches on the skin. This is sometimes accompanied by other symptoms, including blisters, fevers, and chills. Erysipelas most frequently occurs on the face and legs.
Erysipelas often improves with treatment. The infection can usually be treated effectively with antibiotics.
Erysipelas symptoms typically include:
- generally feeling unwell
- a red, swollen, and painful area of skin with a raised edge
- blisters on the affected area
- swollen glands
When erysipelas affects the face, the swollen area usually includes the nose and both cheeks.
Erysipelas occurs when Group A Streptococcus bacteria penetrate the outer barrier of your skin. These bacteria normally live on your skin and other surfaces without causing any harm. However, they can enter your skin through a cut or a sore and cause an infection. Conditions that cause breaks in the skin, such as athlete’s foot and eczema, can sometimes lead to erysipelas. Erysipelas may also occur when the bacteria spread to nasal passages following an infection in the nose and throat.
Other causes of erysipelas include:
- ulcers in the skin
- surgical incisions
- insect bites
- certain skin conditions, such psoriasis
- swollen legs due to health problems, such as heart failure and diabetes
- injection of illegal drugs, such as heroin
Young children (especially 2 to 6 years old) and adults over age 60 are more likely to develop erysipelas. Older adults who have weak immune systems or who have problems with fluid buildup after surgery are at the highest risk.
Your doctor can usually diagnose erysipelas by simply performing a physical exam and asking you about your symptoms. During the exam, your doctor will check for swollen, reddened, and warm areas of skin in your face and legs. Your doctor may also ask you if you’ve recently had another type of infection or experienced a minor injury, such as a cut or scrape.
Most people with erysipelas can be treated at home, but some may require treatment in a hospital. Depending on the severity of your condition, your treatment plan can include home remedies, medication, or surgery.
Usually, the affected part of the body must be raised higher than the rest of your body to reduce swelling. For example, if your leg is affected, you should try to rest as much as possible with the leg elevated above your hip. You may prop up your leg on some cushions while lying down. It’s also important to drink plenty of fluids and to get up and walk around from time to time. You may have to keep your leg elevated for several days before the swelling goes away.
Antibiotics, such as penicillin, are the most common treatment for erysipelas. You may be able to take an oral prescription at home if you have a mild case of erysipelas. You’ll likely have to take medications for about one week. More serious cases of erysipelas are generally treated at the hospital, where antibiotics can be given through a vein (IV). Young children and older adults may also require treatment in a hospital. Occasionally, the bacteria don’t respond to the antibiotic and it’s necessary to try a different type of drug.
You may also be given painkillers to reduce discomfort and treat the fever.
Antifungal medication for athlete’s foot may be required if this is the cause of your erysipelas.
Surgery is only required in rare cases of erysipelas that have progressed rapidly and caused healthy tissue to die. A surgical operation may be needed to cut away the dead tissue.
For most people, antibiotics will successfully treat erysipelas within a week. However, it can take longer than a week for the skin to return to normal, and peeling may occur in the affected areas. People who have continued episodes of erysipelas may need long-term preventive antibiotic treatment.
Without treatment, you may be at risk for various complications, including:
- an abscess
- blood clots
- gangrene, which refers to the death of body tissue
- blood poisoning, which occurs when the infection spreads throughout your bloodstream
- infected heart valves
- joint and bone infections
It’s also possible for the infection to spread to your brain if you have erysipelas near your eyes.
Although erysipelas can’t always be prevented, you can take the following steps to lower your risk:
- Always keep wounds clean.
- Treat athlete’s foot if you have it.
- Use moisturizers to prevent skin from drying and cracking.
- Try not to scratch your skin.
- Make sure any skin problems, such as eczema, are treated effectively.
You can also prevent future incidences of erysipelas by attending follow-up appointments with your doctor. They can make sure that the infection hasn’t come back or spread to other parts of the body.