Infections of the Skin

Infections of the skin are fairly common throughout life and can affect almost anyone. Some infections may be self-limited and can resolve on their own, while others may require medical attention. Skin infections may be caused by bacteria, viruses, fungi or parasites. Common viral infections include warts, molluscum, or herpes simplex which can affect any part of the skin. Fungal infections can affect the skin and nails, with a slow progressive course. Bacterial infections can be rapidly progressive and present with pain, tenderness, and drainage. Parasitic infections often present with inflammation, itching, and irritation of the skin. Common bacterial and parasitic infections include:

Furuncle: Also referred to as a “boil”, a furuncle is a bacterial infection which involves the hair follicles and corresponding oil glands. Commonly presents as a tender and painful red nodule which may drain. A furuncle can present anywhere on the body but is most common in warm and moist areas such as the underarms and groin area. Staph aureus is the most common cause of furuncles, although other types of bacteria may be implicated. Treatment often consists of oral antibiotics and/or drainage depending on the size of the lesion.

Abscess: Bacterial infection of the skin that commonly presents as a painful red nodule which may drain. An abscess may be considered an advanced furuncle or boil. It’s usually caused by Staph aureus, although other types of bacteria may also be implicated. Treatment usually consists of incision and drainage along with oral antibiotics.

Impetigo: Common superficial bacterial infection that can present with draining blisters or honey-crusted lesions with a red base. Usually affects children and athletes. Commonly caused by Staph aureus or streptococcus bacteria. Treatment usually consists of antibiotic creams and/or oral antibiotics. Patients are highly contagious and should avoid physical contact with others until all lesions are healed.

Erysipelas: Superficial bacterial infection which may also involve the lymphatic system. Commonly presents as a red hot swollen patch which usually involves the face or lower extremities. Patients may also experience fever, chills and fatigue. Erysipelas is commonly caused by Group A Streptococcus bacteria, but other types of bacteria may also be implicated. Treatment often consists of oral antibiotics, although hospitalization and IV antibiotics may be necessary for severe cases.

Cellulitis: Infection of the skin and subcutaneous tissue which commonly presents with swelling, redness, pain and warmth of the affected area. Patients may also experience fever, chills and fatigue. Usually caused by trauma to the skin with a secondary bacterial infection. Although Staph aureus is the most common cause, other bacteria can also be implicated. Patients with a compromised circulatory or immune system are most susceptible to skin infections including cellulitis. Early and aggressive treatment is essential to prevent progression and complications. Early cellulitis may respond to oral antibiotics, although most cases may require hospitalization and IV antibiotics.

Scabies: Common parasitic infection of the skin caused by the mite, Sacroptes scabiei. Usually presents with a sudden onset of itchy bumps that can affect any part of the body, but favors the web-spaces of the fingers, wrists, and groin area. The scabies mite is a tiny bug which is not visible to the eye and tends to burrow under the skin. Symptoms include inflammation, itching and irritation of the skin. Itching tends to be worse at night and can be very intense. Scabies is a contagious condition and can be transmitted by direct skin-to-skin contact as well as through clothing, bed sheets and close contact in general. Treatment consists of topical creams and/or oral medications. Close contacts may also need to be treated to prevent re-infection.

Lice: Small parasitic insects that can infest the skin. There are three different types of human lice which can be found on the head, body or pubic area. Symptoms include intense itching with small red bumps at the affected area. Lice infestations are contagious and commonly caused by close person-to-person contact. Head lice are very common in school children and can present with severe itching of the scalp along with small red bumps on the scalp, neck, and shoulders. Tiny eggs on the hair can look like flakes of dandruff that are stuck to the hair. It’s important to never share any hair brushes, combs, hats, clothing, bedding, or towels with someone who has head lice. There are both over-the-counter and prescription medications available for the treatment of lice. Close contacts may also need to be treated if they share similar symptoms.