Common Skin Infections: Cellulitis, Erysipelas, Impetigo Treatment

  • Treatment

    Emergency hospitalization is not normally needed in cases of uncomplicated cellulitis, erysipelas, or impetigo. Most people with these infections can be treated at home. However, follow-up with a physician is important to make sure that the infection does not come back or spread.

    If you have a severe case of cellulitis or erysipelas, you may need to go to the hospital for intravenous medication.

    Flesh-eating bacterial infections (necrotizing soft-tissue infections) are a life-threatening complication of untreated cellulitis, and require immediate hospitalization.

    These infections typically follow surgery or other invasive medical procedures, but can also appear as the result of a bug bite, cut, or scrape. Occasionally there is no obvious break in the skin. Necrotizing fasciitis (necrotic, or dead tissue, and fascia, the tissue underlying and anchoring the skin) is typical of this type of infection, and is marked by a cellulitis that rapidly becomes tense, firm, and pale. Widespread swelling may occur, and pain in the area is marked and out of proportion to the size of the skin infection. The skin may also lack sensation, or have large blisters.

    People with this type of condition tend to develop shock and organ failure quickly, both potentially lethal complications. Necrotizing infections are not responsive to standard antibiotic therapy alone, and require surgical removal of dead tissue (debridement). They tend to attack people with conditions—such as diabetes, vascular disease, malnourishment, and drug addiction—that make them more likely to suffer from infections.

    Keep skin infections, cuts, and abrasions clean with soap and water.

    If possible, keep the affected area elevated, and avoid putting weight on it. This will help to reduce swelling, and will protect the skin from further infection.

    If you have leg or arm swelling (edema) that results from surgery or problems with blood flow, your doctor may ask you to wear elastic compression sleeves or stockings to reduce the swelling.

    Treat dry skin, fungal infections (i.e., athlete's foot), and other skin disorders so they do not turn into cellulitis.

    Shower or bathe regularly, and see your doctor immediately to report any ongoing or unusual reddening of the skin. This is particularly important if symptoms such as swelling or fever occur.

    Maintain a healthy weight, as obesity can contribute to cellulitis and impetigo.

    If you have cellulitis or erysipelas, report any worsening of symptoms to your doctor right away.

    Your doctor is the best source of information on the drug treatment choices available to you.

    Hyperbaric oxygen therapy is thought by some physicians to benefit people with necrotizing infections. It is not, however, widely available. Hyperbaric oxygen therapy is a treatment in which the entire body is exposed to 100% oxygen at a high pressure. It takes place in an enclosed chamber—some suggest that it helps to heal wounds.

    Uncomplicated cellulitis, erysipelas, and impetigo do not normally require surgery.

    In cases where necrotizing infections are suspected, surgical exploration and cleaning out the wound (debridement) may be necessary.

    This will probably take place in an operating room under general anesthesia. It may be necessary to debride the infection more than once. Advanced cases, which are fortunately uncommon, may require amputation of the affected limb.

    There are no alternative treatments shown to be safe or effective for cellulitis, impetigo, and ersipelas. Moisturizing creams or aloe vera may help treat certain predisposing skin conditions.

    If you have a condition such as diabetes or HIV, you should be very alert to any changes in your skin that may suggest cellulitis or erysipelas. This holds true for those who have had repeated episodes of cellulitis as well.

    Cellulitis, erysipelas, and impetigo, when seen promptly by a physician, normally can be treated with little difficulty.

    The redness and inflammation of cellulitis and impetigo may be a little worse the day after treatment is started.

    This is because bacteria, when killed by the antibiotic, release substances that can inflame the skin.

    Necrotizing infections are serious, and can cause death if they are not treated quickly. The chance of dying from one of these infections varies widely depending on where the infection is located, what bacteria are causing the infection, and how quickly appropriate surgery takes place.

    Your doctor will treat your case in an individual manner based on the extent of the infection. Simple cases of cellulitis and erysipelas may only require that you take antibiotics and report back to your doctor if your symptoms do not improve. More complicated cases may require return visits to your doctor's office or even a brief stay in the hospital.

    Be sure to contact your doctor if your condition does not get better, or worsens. Occasionally bacteria will not respond to a particular medication, and your physician may want to switch to a different, possibly more broad-spectrum antibiotic.

    If you have problems taking a prescribed medication, let your doctor know. It is important to take antibiotics properly, as prescribed by your doctor. If for some reason you cannot take a medication as it is prescribed (for example, it makes you sick to your stomach or gives you diarrhea), let your doctor know about it so he or she can switch you over to something else.

Meet the Pharmacists

I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!

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Common Skin Infections: Cellulitis, Erysipelas, Impetigo Related Drugs

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