What Is Erysipelas?

Medically Reviewed by Stephanie S. Gardner, MD on February 21, 2024
Written by Jeffrey Weishaupt
3 min read

Erysipelas is a common bacterial infection of the skin. It affects the upper dermis (upper layer of the skin) and the lymphatic vessels within the skin. The condition begins with the breaking of the skin, followed by bacterial invasion. 

Erysipelas face occurs when the bacteria causes tender and bright red rashes to appear on the facial skin. Erysipelas infections usually affect the face and the legs but can occur anywhere on the skin. 

Although erysipelas is a common bacterial infection - and tends to recur -- it may become serious if left untreated. 

One of the strains of group A Streptococcus bacteria (“strep”) causes erysipelas. This condition affects children as well as adults. Although it affects any age group, people with these conditions are at higher risk of getting erysipelas:

  • Venous diseases (for example, eczema)
  • Diabetes
  • Pregnancy 
  • Obesity
  • Alcoholism
  • Prior injuries 
  • Prior episodes of erysipelas
  • Surgical wounds
  • Radiotherapy
  • Skin sores

Erysipelas causes raised rashes on the skin. The bacteria releases toxins, which play a role in causing skin inflammation. The legs, face, and arms are the main sites of infection.

Besides skin rashes, other common erysipelas symptoms include:

  • Fevers
  • Chills
  • Shivering 
  • Fatigue
  • Headaches
  • Vomiting

People with erysipelas begin to notice red swollen patches on the skin. The condition also forms blisters and sores (erysipelas lesions). If the infection affects other parts of the skin, you will notice redness and painful skin lesions with raised borders. 

Doctors diagnose erysipelas by examining visible symptoms such as sores, blisters, or raised skin rashes.

Your doctor will also take your medical history, asking about injuries or surgeries, and order a blood test to look for signs of infection. The blood test may show:

  • High levels of white blood cells (indicating tissue damage or bacterial infection)
  • High levels of C-reactive protein (indicating inflammation)
  • Presence of bacteria

Oral antibiotics (taken by mouth) are prescribed if your doctor diagnoses erysipelas. If the condition is severe, they may recommend intravenous (through the vein) antibiotics.

Antibiotics used to treat erysipelas include:

  • Oral therapy: penicillin
  • Intravenous penicillin
  • Vancomycin for facial erysipelas caused by MRSA  
  • Alternative to penicillin: erythromycin (for people allergic to penicillin)

If you have repeated episodes of the infection, your doctor will give you long-term antibiotics to prevent future infection. Antiallergic drugs, mineral complexes, and vitamins are sometimes added to the antibiotics to increase their effectiveness. 

General treatment of erysipelas includes:

  • Applying cold packs to relieve discomfort
  • Elevating your legs to reduce swelling
  • Dressing the wound

Doctors also recommend physical therapy in the late stages of recovery. It is also recommended that people with erysipelas should get bed rest with their legs elevated.

If the individual shows signs of recurrence, doctors may recommend antibacterial therapy for an extended period.

‌The severity of the infection will determine the duration of the treatment. ‌

The treatment of erysipelas is the same for all infected sites. It includes taking antibiotics. But sometimes, additional care is required for severe cases.

For example, if someone has painful swelling in the legs, they should keep them elevated.

Complications are rare in people who are infected by erysipelas. But sometimes, complications can occur.

For example, if the bacteria infects the blood, it will spread to the heart valves, bones, and joints. As a result, a condition called bacteremia will occur.

Other complications include:

There are some ways to prevent erysipelas. These include keeping your skin healthy by moisturizing it. In addition, you should avoid dry skin, cuts, and scrapes to reduce the risk of infection.

To prevent the recurrence of the infection, long-term antibiotics such as penicillin might be recommended. ‌

Since erysipelas is prone to recurrence, you should follow these measures to avoid contracting the bacterial infection.

  • Wash your hands frequently. 
  • Use alcohol-based sanitizers. 
  • Moisturize your body to prevent dryness.  
  • Take antibiotics as prescribed by your doctor. 
  • Avoid scratching your skin. ‌

These measures will help prevent the infection. The signs of illness generally go away in a day or two. However, your skin will take a few weeks to return to its normal state. Fortunately, there is no scarring as you recover from the condition. 

Your doctor may prescribe penicillin for long-term preventive care to reduce the risk of recurrent infection.