Bacterial Skin Infections: What to Know

Impetigo

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Impetigo is a bacterial skin infection of the epidermis. It is highly contagious and more commonly seen in children than adults. Impetigo is caused by both Streptococcus aureus and Staphylococcus pyogenes.

Symptoms

Impetigo causes an oozing skin rash covered by a honey-colored crust. It usually occurs around the nose and mouth but can spread to other parts of the body through skin-to-skin contact or contaminated clothing or towels.

Treatment

Impetigo is usually treated with topical antibiotics.

MRSA Infections

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Methicillin-resistant Staphylococcus aureus (MRSA) is a serious bacterial infection that is resistant to standard antibiotic treatment.

Laboratory tests are usually required to diagnose MRSA. If left untreated, MRSA can easily spread from person to person, particularly in hospital settings.

Symptoms

The symptoms of MRSA can vary by the location of the infection. They typically include redness, swelling, pain, pus, and fever. Some MRSA infections look like other bacterial infections and can even be confused with a spider bite.

Treatment

MRSA can't be treated with the same antibiotics used to treat other bacterial skin infections. If your infection is caused by MRSA, your healthcare provider may try draining the abscess first. This might be the only treatment required.

If the infection is more serious, there are a few antibiotics that may work. These include:

• Vancocin (vancomycin)
• Bactrim (trimethoprim-sulfamethoxazole)
• Zyvox (linezolid)
  

Furuncles

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A furuncle, commonly known as a boil, is a painful bacterial skin infection of the entire pilosebaceous unit (which includes the hair follicle, hair shaft, and sebaceous gland).

If left untreated, a furuncle can become a pus-filled pocket known as an abscess.

Symptoms

A furuncle starts as a tender, red or purple lump that rapidly fills with pus. As it grows, it will develop a white head and eventually burst and drain. Furuncles are common on the face, neck, armpits, buttocks, and thighs.

Treatment

Applying warm compresses can help drain pus. In severe cases, your healthcare provider may need to lance (cut open) the boil to drain it, followed by a course of oral antibiotics.

Carbuncles

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A carbuncle is a cluster of furuncles closely packed together. The infection tends to be deeper and more severe than that caused by furuncles. The most common cause is Staphylococcus aureus.

Symptoms

A carbuncle can be as large as 4 inches across and usually has one or more openings where pus can ooze out. The infection may also cause a fever, fatigue, and malaise (a general feeling of unwellness).

Carbuncles usually develop on the back, thighs, or back of the neck.

Treatment

Carbuncles are more difficult to treat and can take longer to resolve than boils. The risk of scarring is high as is the spread of infection to other parts of the body. For this reason, carbuncles generally require medical treatment.

Ecthyma

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Ecthyma is similar to impetigo, but it occurs in the deeper layers of skin. It is sometimes called "deep impetigo."

Ecthyma is usually caused by streptococcus bacteria, but staphylococcus can also be involved. People with a compromised immune system are more likely to develop this type of infection.

Symptoms

Echtyma often occurs on the legs and may begin as a superficial scratch or insect bite. Symptoms include impetigo-like blisters that turn into a deep ulcer that crusts over.

Treatment

Echtyma is usually treated with oral antibiotics, though early cases may only need topical antibiotics.

Erythrasma

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Erythrasma is a superficial bacterial skin infection caused by Corynebacterium minutissimum. It develops where skin surfaces rub against each other.

It is most common in warm, humid climates. Other risk factors include poor hygiene, obesity, diabetes, and older age.

Symptoms

The infection usually starts with a well-defined pink patch of skin covered with fine scales. The rash can then turn a reddish or brownish color with flaking and wrinkling. The most common parts of the body to be affected include the armpits, groin, and between the toes.

In addition to skin discoloration and flaking, mild itching or burning may occur, especially in groin area infections.

Treatment

Topical or oral antibiotics may be used depending on the severity of the rash. Gentle scrubbing can help remove some of the scales.

Bacterial Folliculitis

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Bacterial folliculitis is a relatively common infection of the hair follicles. It is usually caused when follicles are blocked by ingrown hairs, oils, or skin care products, trapping bacteria in pores and allowing them to multiply and spread.

Shaving or plucking hairs can increase the risk of bacterial folliculitis by providing bacteria easier access to disrupted pores. Folliculitis tends to affect people with acne more than those with clearer skin.

Symptoms

Symptoms include tiny, red bumps and/or white-headed pimples filled with pus.

Treatment

While bacterial folliculitis usually heals on its own, severe cases may require topical or oral antibiotics. Left untreated, folliculitis can cause permanent hair loss.

Hot Tub Folliculitis

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Hot tub folliculitis is a bacterial skin infection caused by Pseudomonas aeruginosa. The bacteria can survive even in chlorinated water, making it tougher to kill.

The condition is sometimes called "jacuzzi folliculitis" because it can be contracted through contaminated whirlpools and hot tubs (especially wooden ones). People can also become infected through water slides, physiotherapy pools, or even loofah sponges.

The risk is higher in people with acne or eczema as their skin barrier has already been disrupted.

Symptoms

Symptoms of hot tub folliculitis include pus-filled bumps and an itchy, red rash that can develop several hours or days after exposure to the bacteria. Hot tub folliculitis typically affects the chest or groin.

Treatment

Hot tub folliculitis tends to resolve on its own but may benefit from topical silver sulfadiazine cream. Severe cases may require oral antibiotics.

Erysipelas

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Erysipelas is a bacterial skin infection of the dermis and epidermis—the top two layers of the skin. It is caused by Streptococcus aureus.

Minor skin disruptions like athlete's foot or eczema can lead to erysipelas by allowing bacteria into tiny breaks in the skin. It can also occur when bacteria spread to the nasal passages following a nose or throat infection.

Symptoms

Erysipelas is commonly known as "St. Anthony's Fire" because of the intense, burning sensation it causes.

Other symptoms include areas of extreme redness and swelling with a sharply defined border. It is common on the face and legs but can also affect the arms and trunk.

Treatment

Erysipelas can be treated with antibiotics. In severe cases, the medication may need to be delivered intravenously. The antibiotics you receive will depend on the type of bacteria that is causing your infection. You may also need anti-inflammatory pain medication to reduce pain and fever.

Cellulitis

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Cellulitis affects the two deepest layers of the skin called the dermis and subcutaneous tissue.

Cellulitis usually occurs when the skin is broken, such as near ulcers, bruises, burns, or recent surgical wounds. While many types of bacteria can cause cellulitis, Staphylococcus aureus and Streptococcus pyogenes are the most common culprits.

Symptoms

Cellulitis often appears as a swollen, red area of skin and feels tender and hot when touched.

Necrotizing cellulitis is a more severe form of this infection that causes the death of tissue. Necrotizing cellulitis causes severe pain, gray discharge, and high fever.

If the cellulitis spreads to your bloodstream, it can be deadly, causing high fever, chills, rapid heart rate, vomiting, and other symptoms of septicemia ("blood poisoning"). Seek emergency care if symptoms like these develop.

Treatment

Cellulitis is usually treated with intravenous antibiotics. You may also need pain medication such as ibuprofen to treat pain and fever.

Necrotizing cellulitis requires emergency medical care.