Drs. Wong and Borno are assistant professors of pharmacy
practice at Arnold and Marie Schwartz College of
Pharmacy and Health Sciences, Long Island University,
Brooklyn, New York.
Bacteria can cause different types of skin infections. Three
common skin infections that you and your doctor may
encounter are: (1) cellulitis, (2) folliculitis, and (3) impetigo.
Keep in mind that skin infections vary in presentation and
treatment. Therefore, it is important to talk to your doctor to
obtain an appropriate diagnosis and treatment plan.
Cellulitis
Cellulitis is an infection that involves the outer layers of the
skin. It is commonly caused by bacteria known as beta-hemolytic
streptococcus or Staphylococcus aureus. You may experience
pain, swelling, tenderness, warmth, and redness in the
infected area. If you have a severe case of cellulitis, you may
experience fever, tiredness, and a lowering of blood pressure.
If left untreated, pus may form and cells may die in the infected
skin area. Cellulitis can involve any part of the body but most
often affects the leg. It typically results from an injury to the
skin, such as scratches or animal bites—these allow bacteria
to enter the body and cause an infection. An additional cause
of cellulitis is skin breakdown around the anal area, typically
seen in children. This can lead to redness, swelling, and painful
bowel movements.
Oral antibiotics are used to treat mild cellulitis; more severe
cases must be treated with intravenous antibiotics in a hospital.
Antibiotics that may be used include cephalosporins, dicloxacillin,
clindamycin, or vancomycin. Swelling can be lessened by
elevating the affected area, such as the legs or arms. To stop
cellulitis from occurring again, it is important to keep applying
lotion to the skin and to maintain good skin cleanliness.
Folliculitis
Folliculitis is a general term used to describe an infection of
the hair follicles commonly caused by
Staphylococcus aureus,
resulting in red pimples. You may experience redness, tenderness,
or swelling of the affected area. It also can spread to the
deeper parts of the hair follicles and pus can form, also known
as furuncles or boils. Carbuncles is a term used to describe a
group of infected hair follicles. Folliculitis, furuncles, and carbuncles
can be seen on any part of the body with hair, such as
the face, scalp, thighs, underarms, and groin area. This includes
areas that are bearded or shaved.
Mild folliculitis can be treated with topical antibiotics, such
as erythromycin, clindamycin, or mupirocin. More severe infections,
such as carbuncles and larger furuncles, may require a
surgical cut and drainage of the affected area. After drainage,
it is important to clean the area with antibacterial soap; then
you should apply the antibiotic ointment to the affected area of
the skin. If needed, your doctor may prescribe oral antibiotics
such as cephalosporins or dicloxacillin. Keep in mind that your
doctor may recommend monthly treatments with mupirocin
ointment if you have folliculitis that occurs repeatedly.
Impetigo
Impetigo is a contagious skin infection commonly caused by
Staphylococcus aureus. Although this infection may occur in
adults, it is most often seen in children aged 2 to 5 years and
is usually spread through direct contact with another person
who has the infection. You may experience tenderness, itching,
sores, or blisters that can rupture and form honey-colored
crusts. It can affect different parts of the body such as the face,
arms, or legs. It also can affect moist parts of the body, such as
the armpits, neck folds, and diaper areas.
Impetigo can be treated with a topical ointment or oral
antibiotic. Mupirocin is a typical ointment that may be prescribed
by your doctor. Oral antibiotics such as penicillins or
cephalosporins are used for more severe infections. To prevent
the spread of the infection to other parts of the body, avoid
scratching the blisters or sores. Because impetigo is commonly
seen in children, it may be helpful to cut the fingernails and
cover the affected areas of the body with bandages or gauze.
It also is important to prevent the spread of infection to other
individuals in close contact by not sharing things such as blankets,
linens, toys, or clothing.
What about MRSA Infections?
MRSA stands for
methicillin-resistant Staphylococcus aureus. It
is a form of
Staphylococcus aureus or "staph" bacteria that is
resistant to certain antibiotics. It is transmitted by directly contacting
an infected person, touching contaminated surfaces, or
sharing personal items that have been in contact with infected
skin. MRSA is a large problem in hospitals or health care facilities
(like dialysis centers and nursing homes). MRSA also can
infect people in the community, however, such as children at
day care centers and children who are involved in sports that
involve close contact. This is known as
community-associated
MRSA or CA-MRSA.
MRSA infections can appear like a pimple or boil, with redness,
swelling, pain, or pus. Serious infections may spread
into the blood and cause blood infections. If you experience a
MRSA infection, your doctor may drain the infected area and
prescribe antibiotics such as linezolid, clindamycin, or doxycycline.
Do not try to drain the wound yourself! This can worsen
the infection or spread it to others.
To prevent the spread of MRSA, here are some helpful tips:
- Cover your wound with clean, dry bandages until the
affected area is completely healed.
- Maintain good hand hygiene—you and those in close
contact with you should wash hands frequently with soap
and water.
- Do not share personal items, such as linens and clothing,
with others.
General Management of Skin Infections
With antibiotic treatment, signs and symptoms of skin infections
begin to improve after approximately 2 to 3 days. If your
skin infection does not improve or gets worse (especially if you
develop a fever or the infection spreads), notify your doctor
right away. If you are prescribed topical or oral antibiotics, be
sure to finish the full course of antibiotics unless otherwise
directed. Keep in mind that the length of treatment will differ
depending on the type and severity of the infection. Lastly, as
is true among all skin infections, you should keep the affected
area or wound clean with good skin hygiene.
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