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Erysipelas: Causes, Risk Factors, Signs, Symptoms, Treatment, Prevention, Prognosis

Erysipelas is a bacterial skin infection affecting the top most layer of the skin. Erysipelas resembles another skin condition, which is known as cellulitis, but cellulitis affects the lower layers of the skin. Upon inspection, it is difficult to distinguish between the two. Treatment for both of them is almost similar. Erysipelas commonly affects the legs and face.

If erysipelas condition is ignored and treatment is not sought, then it can result in complications like abscess, blood clots, blood poisoning, gangrene, infection of the heart valves, bone and joint infection. If the erysipelas affects the region near the eyes, then the infection can spread to the brain.


Treatment comprises of antibiotics and pain killers.

Causes of Erysipelas

The common bacterium which causes erysipelas is streptococci. They generally live on the skin without causing any harm; but when they enter the skin through any injury, cut, scratch or sore, they cause infection. Other medical conditions which cause any breakage of the skin, such as eczema or athlete’s foot, can also lead to erysipelas. Conditions which prevent any fluid or blood draining from a region also increase the risk of erysipelas. Face is affected when the bacteria from the nasal passages after an ENT infection spread to the face.

Conditions Which Can Lead To Erysipelas Are:

  • Ulcers and cuts in the skin.
  • Insect bites.
  • Surgical incisions.
  • Skin conditions like athlete’s foot, eczema and psoriasis.
  • Obesity.
  • Uncontrolled diabetes.
  • Use of I.V. illegal drugs.
  • Previous history of erysipelas.

Risk Factors for Erysipelas

  • Taking immunosuppressants.
  • Having a previous history of erysipelas.
  • Individuals aged above 60.
  • Weak immune system.
  • Very young and very old individuals.

Signs & Symptoms of Erysipelas

  • Fever and chills.
  • Malaise.
  • The affected area of the skin is red, warm, swollen and painful with raised edges.
  • Development of blisters in the affected region.
  • Swelling of the glands.
  • If the face is affected, then red swollen region of erysipelas commonly covers both the cheeks and nose.

Investigations for Erysipelas

Physical examination is sufficient for diagnosis. The skin can be scraped and the sample can be sent for testing and further confirmation of the diagnosis.

Treatment for Erysipelas

  • Conservative measures, such as keeping the affected body part elevated than the rest of the body will help in reduction of the swelling.
  • Patient should get up and walk around periodically to keep the blood circulation going.
  • It is important to keep the fluid intake adequate.
  • Medications given include antibiotics, such as penicillin, for treating the infection of the erysipelas. Oral antibiotics are given for mild cases.
  • For severe cases, patient may require hospitalization where the antibiotics are given intravenously.
  • Painkillers or NSAIDs are given to alleviate pain, discomfort and fever.
  • Antifungal medication is given if the patient has athlete’s foot.
  • Surgery is required in extremely severe cases where the infection of erysipelas has spread extensively causing necrosis. Surgery is done to remove the dead tissue.

Prognosis for Erysipelas

With proper treatment, the prognosis of Erysipelas is very good. With antibiotics, erysipelas can resolve within a week. It takes another week for the skin to return to its normal state and the skin may also peel. There is a small chance of recurrence of infection.

Prevention of Erysipelas

  • Skin conditions, like athlete’s foot and eczema, should not be ignored and treated first.
  • Always keep any cut, sore or wounds clean.
  • Always use moisturizers or lubrication to prevent skin dryness and cracking.
  • Avoid scratching your skin.


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 4, 2023

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