Erysipelas

Medically reviewed by:

Dr Dan Bunstone - Medical Officer

Updated: Aug 18, 2021

Next review: Aug 18, 2022

Erysipelas is a bacterial infection that affects the layers of skin near the surface. It’s similar to cellulitis, and sometimes it’s difficult to tell the difference between the two, but cellulitis affects the deeper layers of skin, as well as the layers of fat and tissues under the skin. However, because they’re very similar, they’re usually treated in the same way.

It causes red patches to develop on your skin, which grow quickly. They are raised, smooth and are warm to the touch. It will usually be painful to touch too.

If you notice these symptoms, speak to a doctor as soon as possible, as if it is erysipelas, it needs to be treated quickly to prevent complications. You may also have other symptoms, such as a fever, which we’ll discuss later on.

The infection is most often caused by the Streptococcus aureus bacteria and commonly affects the lower legs or face. Most cases of erysipelas are found in the elderly or very young, though it can affect anyone.

It’s usually treated with antibiotics and responds well to treatment, but it is important to get treatment as soon as possible so that the infection doesn’t spread throughout your body, which can be life threatening.

The bacterial infection usually gets into the body through breaks in the skin. Skin conditions such as eczema or athlete’s foot put you more at risk, but even scratches or an insect bite in the top layer of the skin can cause erysipelas to develop.

The symptoms of erysipelas include:

Small red patches on the skin that enlarge quickly. These can blister and will be tender and warm to the touch.
Shiny skin
Headache
A high fever and chills
Swollen glands
Generally feeling unwell

The condition occurs when the streptococcus bacteria infects the skin. The bacteria can live on your skin without causing a problem. However, if the skin is damaged or broken then the bacteria can infect the tissues underneath the surface (subcutaneous tissue).

You skin can be damaged or broken by:

Insect bites
Skin ulcers
Open wounds, such as after an operation
Psoriasis
Eczema
Another condition which damages the skin

You are also more likely to develop the condition if you:

Have swollen legs, which could be because of another condition, or if you’re overweight
Have had cellulitis before
Have high blood sugar levels because of poorly managed diabetes
Are pregnant
Use intravenous drugs
Are elderly or very young
Have a weakened immune system

If you think that you have erysipelas, then you should speak to a doctor as soon as possible. A skin infection can be serious and needs to be treated to prevent complications.

One of our doctors can diagnose your skin condition during a video consultation. The doctor will ask to see the affected area and about your symptoms.

The doctor will be looking for swollen, reddened areas of skin. They will also want to ask about other recent infections or minor injuries such as scrapes or insect bites, that you may have had.

In some cases, you may be referred for further investigation or tests.

Erysipelas is treated with oral antibiotics, and if it is caught early enough, should start to improve within a matter of days. If it’s a more serious case, or if a course of oral antibiotics does not help, hospital treatment may be needed, and can include an intravenous antibiotic drip.

Most people are treated with penicillin, so it is important to let the doctor know if you are allergic to it.

In addition to antibiotics, you can take painkillers to help with the pain and discomfort. If your erysipelas does not respond to antibiotics, then other medicines may be prescribed. You should also try to keep the affected area raised above the rest of your body. If for example the leg has been affected, then keeping the leg elevated will help to reduce swelling. You may need to do this for several days before the swelling goes down. You can also use moisturiser on the affected area to help the skin heal and to prevent it drying out.

If you have repeated occurrences of erysipelas, then you may require long term antibiotic treatment to help prevent it returning in the future. Likewise, if the bacteria have got into your skin because of another condition, such as athlete’s foot, you will need to treat this too, to help prevent further infections. The treatment will depend on the condition.

Antibiotics usually treat the bacterial infection successfully. However, the visual effects may not heal as quickly, but the area of skin will return to normal eventually.

Without treatment, erysipelas can lead to serious consequences, such as:

Abscesses can form in the infected area
Joint and bones can become infected
Infected heart valves if the bacteria gets into the bloodstream
Gangrene
Blood poisoning (septicaemia – when the infection spreads through bloodstream), which can be life threatening

At Push Doctor, you can see an online doctor on any device, from work, home or even when you are on the go. They can look at your skin over video consultation, listen to your symptoms and suggest the right treatment to get you back up on your feet as quickly as possible.

You can see a doctor about your skin condition at a time that suits you. Our doctors are available 7 days a week and can offer you the advice, diagnosis and treatment you may need. They can also refer you to a skin specialist for further investigation or treatment, if needed.

Dr Dan Bunstone - Medical Officer

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