Erysipelas: Causes, Symptoms, Treatment & Prevention

Erysipelas is a bacterial


Erysipelas Overview

Erysipelas is a bacterial infection in the upper layer of your skin. It is similar to another skin disorder known as cellulitis, an infection in the lower layers of your skin. In practice, it is almost impossible for doctors to tell the difference between the two conditions, but this is not a problem as they are treated in the same way. Erysipelas occurs most frequently in the legs but also commonly affects the face.

Erysipelas is a superficial form of cellulitis, a potentially serious bacterial infection affecting the skin. Unlike cellulitis, almost all erysipelas is caused by Group A beta haemolytic streptococci (Streptococcus pyogenes).

Erysipelas Symptoms

  • Blisters
  • Fever, shaking, and chills
  • Painful, very red, swollen, and warm skin underneath the sore (lesion)
  • Skin lesion with a raised border
  • Sores (erysipelas lesions) on the cheeks and bridge of the nose

Erysipelas Causes

Erysipelas is usually caused by group A Streptococcus bacteria. The condition may affect both children and adults.

Risk factors include:

  • A cut in the skin
  • Problems with drainage through the veins or lymph system
  • Skin sores (ulcers)

The infection occurs on the legs most of the time. It may also occur on the face.

The list of causes includes:

  • cuts and ulcers in your skin
  • surgical incisions
  • insect bites
  • athlete’s foot
  • skin conditions such as eczema and psoriasis
  • obesity
  • swollen legs due to health problems such as heart failure
  • uncontrolled diabetes
  • injecting illegal drugs
  • anything that suppresses the immune system
  • having had a previous episode of erysipelas

Erysipelas Treatment

Most streptococcal bacteria causing erysipelas are sensitive to penicillin antibiotics. Penicillin, either orally or intravenously (if patient is very unwell), is the antibiotic of first choice. Erythromycin may be used as an alternative in patients with penicillin allergy. Treatment is usually for 10-14 days, and while signs of general illness resolve within a day or two, the skin changes may take some weeks to resolve completely. No scarring occurs.

Erysipelas recurs in up to one third of patients due to persistence of risk factors and also because erysipelas itself can cause lymphatic damage (hence impaired drainage of toxins) in involved skin which predisposes to further attacks.

If patients have recurrent attacks, long term preventive treatment with penicillin may be considered.