Cellulitis on legs treatment

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Cellulitis

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What Is Cellulitis?

Cellulitis (pronounced: sel-yuh-LY-tus) is a skin infection that involves areas of tissue below the surface of the skin.

Cellulitis can affect any area of the body, but is most common on exposed body parts, such as the face, arms, or lower legs.

What Causes Cellulitis?

Many different types of

can cause cellulitis. The most common ones are group A streptococcus and Staphylococcus aureus.

Cellulitis usually begins in an area of broken skin, like a cut, bite, or scratch. People who have body piercings may be at risk for cellulitis because the piercing hole is a chance for bacteria to get beneath the skin’s surface.

But cellulitis can also start in areas where the skin isn’t broken, especially in people who have chronic conditions (such as diabetes) or who take medicines that affect the immune system.

Cellulitis is not contagious. It can’t spread from person to person.

What Are the Signs & Symptoms of Cellulitis?

Cellulitis begins with a small area of skin that’s:

  • tender
  • swollen
  • warm
  • red

As this area begins to spread, a person may begin to feel ill and get a fever and, sometimes, chills and sweats. Swollen lymph nodes (or swollen glands) are sometimes found near the area of infected skin.

The time it takes for symptoms to start varies, depending on which bacteria cause the cellulitis. For example, someone with cellulitis caused by Pasteurella multocida, commonly found in animal bites, can have symptoms less than 24 hours after the bite. But cellulitis caused by other types of bacteria may not cause symptoms for several days.

How Is Cellulitis Diagnosed?

A doctor can usually diagnose cellulitis by examining the area of affected skin. Sometimes the doctor may check for bacteria by taking blood samples. Positive blood cultures mean that bacteria from the skin infection have spread into the bloodstream. This can cause septicemia (blood poisoning), a serious infection.

How Is Cellulitis Treated?

If you have a mild case of cellulitis, the doctor will probably prescribe antibiotics. These can usually cure cellulitis in 7 to 10 days. Even if you feel better sooner than that, it’s important to take all the

prescribed for you. Otherwise, the infection can return.

People with severe cases of cellulitis might need treatment in a hospital with intravenous (IV) antibiotics.

Can Cellulitis Be Prevented?

To prevent cellulitis, protect skin from cuts, bruises, and scrapes. This isn’t easy, especially if someone is active or likes to play sports.

To protect yourself:

  • Use elbow and knee pads while skating.
  • Wear a bike helmet when you’re riding.
  • Wear shin guards during soccer.
  • Wear long pants and long-sleeved shirts while hiking in the woods (this can also protect you from bug bites and stings).
  • Wear sandals on the beach.

If you do get a scrape, wash the wound well with soap and water. Apply an antibiotic ointment and cover the wound with an adhesive bandage or gauze. Check wounds often for the first few days to see if any signs of cellulitis begin. Pay attention to new piercings too. If they get red, swollen, and painful to the touch, have them checked out by a doctor.

When Should I Call My Doctor?

Call your doctor whenever any area of your skin becomes red, warm, and painful — with or without fever and chills. This is especially important if the area of skin is on the hands, feet, or face (particularly ear, nose, or eyebrow piercings) or if you have an illness or condition that suppresses the immune system.

Check with your doctor if you get a large cut or a deep puncture wound. Cellulitis can happen quickly after an animal bite. So call your doctor if an animal bites you, especially if the puncture wound is deep. Not too many people get bitten by other people, of course, but human bites can cause skin infections too.

What Can I Do to Feel Better?

Take the antibiotics prescribed by the doctor exactly as directed and for the full course. Follow your doctor’s suggestions for treating the area of cellulitis, such as elevating the affected part of your body or applying heat or warm soaks to it. You can also take over-the-counter pain relievers such as acetaminophen or ibuprofen to ease pain and keep a fever down.

After you’ve taken antibiotics for 1 or 2 days, your doctor may schedule an office visit to check that the area of cellulitis has improved. This means that the antibiotics are working against the infection.

Reviewed by: Marcella A. Escoto, DO Date reviewed: February 2019

What Is It?

Published: December, 2018

Cellulitis is a serious bacterial infection of the skin. Bacteria break through the skin’s protective outer layer, typically at the site of an injury, such as a cut, puncture, sore, burn or bite. Cellulitis can occur at the site of surgery, or where there is a catheter. Once beneath the skin surface, bacteria multiply and make chemicals that cause inflammation in the skin.

Cellulitis that is not caused by a wound or catheter most often occurs on the legs and feet. However, it can develop on any part of the body, including the trunk, arms and face. It often develops where there is edema (swelling), poor blood flow, or a skin rash that creates breaks in the skin, such as a fungus infection between the toes (athlete’s foot).

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What Is Cellulitis—and Is This Life-Threatening Skin Condition Contagious?

Hives, rashes, acne—when something’s up with your skin, it’s usually not a pretty (or painless) experience. You may start to run down the list of possible culprits—you ate something you were allergic to, you spent too much time in the sun, or you were super stressed last week—and shrug them off as no big deal. But cellulitis, a potentially serious infection that can cause skin to become red, painful, and swollen, is not something you want to let go untreated too long.

“Cellulitis is a bacterial infection of the skin and subcutaneous tissues,” Meghan Feely, MD, a board-certified dermatologist and spokesperson for the American Academy of Dermatology (AAD), tells Health.

Crazy enough, cellulitis is usually caused by bacteria that already live on your skin, namely streptococcus and staphylococcus bacteria, adds Noelani Gonzalez, MD, cosmetic dermatologist at Mount Sinai West in New York City.

Here’s what you need to know about cellulitis—so you can hopefully avoid ever experiencing it.

RELATED: 6 Ways Doctors Treat Celulitis

How do you get cellulitis?

Cellulitis happens when bacteria get into your skin through something like a cut, scrape, burn, or insect bite. It’s even possible for another skin condition such as athlete’s foot or eczema to compromise your skin’s barrier and allow bacteria in, Dr. Feely says. Intravenous drug users can also develop cellulitis where the drug is injected, she adds.

While cellulitis can happen to anyone, some people are more likely to develop the skin infection. “You are at increased risk if you have a weakened immune system, diabetes, chronic swelling of your legs or arms, or are an athlete who frequently injures their skin,” Dr. Gonzalez says.

Other cellulitis risk factors include chronic kidney or liver disease, peripheral artery disease, and poor circulation, adds Dr. Feely.

Is cellulitis contagious?

Thankfully, cellulitis isn’t usually spread from person to person, but if you have direct contact with someone with cellulitis, you should play it extra safe.

“Because cellulitis is caused by an infectious organism, people handling affected areas should use proper precautions when touching the area (i.e. gloves when changing bandages),” says board-certified dermatologist and AAD spokesperson Lauren Ploch, MD. “However, being in the same room with someone suffering from cellulitis does not increase your risk of cellulitis.”

RELATED: 6 Things That Increase Your Risk of Cellulitis

Cellulitis symptoms

You’ll probably notice obvious symptoms on your skin first—and they can be very painful and uncomfortable. “The skin usually feels red and swollen, tender and warm to the touch,” says Dr. Gonzalez.

Signs the infection is becoming more serious can include red streaks or a rash that’s spreading quickly, fever, chills, or swollen lymph nodes, Dr. Gonzalez adds.

Cellulitis treatment

“If not treated in time, cellulitis can be a life-threatening infection,” says Dr. Gonzalez, if it spreads to the blood. That’s why it’s crucial to get to the doctor’s office ASAP if you think you have symptoms of cellulitis. “Prompt diagnosis and treatment with antibiotics is vital,” she says.

Oral antibiotics are usually enough to stop the infection, but in severe cases, cellulitis treatment may require IV antibiotics.

Once you’re on antibiotics, your doctor will usually recommend proper wound care, rest, and elevating your legs to decrease swelling, says Dr. Feely.

RELATED: 12 Reasons Your Skin Is So Itchy—and When to Talk to a Doctor

How to prevent cellulitis

There are a few important ways you can protect yourself (and your skin) from cellulitis.

Keep the fingernails and toenails clean and in good shape. Nails can be magnets for bacteria, and scratching yourself with dirty claws can hand-deliver bacteria into your skin. Proper nail hygiene will keep bacteria under control.

Wash and bandage any wounds to prevent bacterial infection. Open wounds and injured skin can be entryways for cellulitis-causing bacteria. Properly disinfect and treat any skin injuries as soon as possible.

Moisturize, moisturize, moisturize. “Keep your skin clean and moisturized—moisturizing will prevent cracks that might lead bacteria into your skin,” says Dr. Gonzalez.

Manage any chronic conditions. You’re more susceptible to cellulitis if you have an underlying health concern like diabetes. Managing these conditions can help prevent a possible skin infection.

“If poor circulation is a pre-existing medical condition, follow your doctor’s instructions regarding leg elevation and compression stockings,” says Dr. Ploch. Consider making an appointment with a dermatologist to treat skin conditions that could lead to cellulitis, like athlete’s foot or eczema.

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Medically reviewed by Drugs.com. Last updated on Sep 24, 2019.

  • Health Guide
  • Disease Reference
  • Care Notes

WHAT YOU NEED TO KNOW:

Cellulitis is a skin infection caused by bacteria. Cellulitis usually appears on the legs and feet, arms and hands, or face.

What increases my risk for cellulitis?

  • An injury that breaks the skin, such as a bite, scratch, or cut
  • Sores or injuries exposed to hot tub water or water in ponds, streams, or oceans
  • Shared belongings, such as towels or exercise equipment
  • Drugs that are injected
  • A weak immune system or diabetes
  • Lymphedema, chronic venous insufficiency, peripheral vascular disease, or deep vein thrombosis

What are the signs and symptoms of cellulitis?

  • A red, warm, swollen area on your skin
  • Pain when the area is touched
  • Bumps or blisters (abscess) that may drain pus
  • Bumpy, raised skin that feels like an orange peel

How is cellulitis diagnosed?

Your healthcare provider may know you have cellulitis by looking at and feeling your skin. Tell him or her how long you have had symptoms, and if anything helps decrease your symptoms. Tell your healthcare provider if you have ever had a cellulitis infection. He or she may not know which kind of bacteria caused your cellulitis. You may need any of the following tests:

  • Blood tests may show which kind of bacteria is causing your infection. Blood tests may also show if the infection is in your blood.
  • A sample of tissue or fluid from your infected skin may show what is causing your infection. The sample may also show if your infection is caused by another kind of skin disorder.
  • An x-ray, ultrasound, CT, or MRI may show if the infection has spread. You may be given contrast liquid to help the infection show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is cellulitis treated?

Treatment may decrease symptoms, stop the infection from spreading, and cure the infection. Treatment depends on how severe your cellulitis is. Cellulitis may go away on its own. You may instead need antibiotics to help treat the bacterial infection. Your healthcare provider may draw a circle around the edges of your cellulitis. If your cellulitis spreads, your healthcare provider will see it outside of the circle.

How can I manage my symptoms?

  • Elevate the area above the level of your heart as often as you can. This will help decrease swelling and pain. Prop the area on pillows or blankets to keep it elevated comfortably.
  • Clean the area daily until the wound scabs over. Gently wash the area with soap and water. Pat dry. Use dressings as directed.
  • Place cool or warm, wet cloths on the area as directed. Use clean cloths and clean water. Leave it on the area until the cloth is room temperature. Pat the area dry with a clean, dry cloth. The cloths may help decrease pain.

How can I prevent cellulitis?

  • Do not scratch bug bites or areas of injury. You increase your risk for cellulitis by scratching these areas.
  • Do not share personal items, such as towels, clothing, and razors.
  • Clean exercise equipment with germ-killing cleaner before and after you use it.
  • Wash your hands often. Use soap and water. Wash your hands after you use the bathroom, change a child’s diapers, or sneeze. Wash your hands before you prepare or eat food. Use lotion to prevent dry, cracked skin.

  • Wear pressure stockings as directed. You may be told to wear the stockings if you have peripheral edema. Peripheral edema is swelling in your legs. The stockings improve blood flow and decrease swelling.
  • Treat athlete’s foot. This can help prevent the spread of a bacterial skin infection.

Call 911 if:

  • You have sudden trouble breathing or chest pain.

When should I seek immediate care?

  • Your wound gets larger and more painful.
  • You feel a crackling under your skin when you touch it.
  • You have purple dots or bumps on your skin, or you see bleeding under your skin.
  • You have new swelling and pain in your legs.
  • The red, warm, swollen area gets larger.
  • You see red streaks coming from the infected area.

When should I contact my healthcare provider?

  • You have a fever.
  • Your fever or pain does not go away or gets worse.
  • The area does not get smaller after 2 days of antibiotics.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2019 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Learn more about Cellulitis

Associated drugs

  • Infection

IBM Watson Micromedex

  • Abscess
  • Cellulitis in Children
  • Impetigo
  • Lymphangitis
  • Periorbital Cellulitis in Children
  • Umbilical Granuloma

Symptoms and treatments

  • Cellulitis

Mayo Clinic Reference

  • Cellulitis

Treatment


Abscess

Skin abscesses

Some small skin abscesses may drain naturally and get better without the need for treatment. Applying heat in the form of a warm compress, such as a warm flannel, may help reduce any swelling and speed up healing.

However, the flannel should be thoroughly washed afterwards and not used by other people, to avoid spreading the infection.

For larger or persistent skin abscesses, your GP may prescribe a course of antibiotics to help clear the infection and prevent it from spreading.

Sometimes, especially with recurrent infections, you may need to wash off all the bacteria from your body to prevent re-infection (decolonisation). This can be done using antiseptic soap for most of your body and an antibiotic cream for the inside of your nose.

However, antibiotics alone may not be enough to clear a skin abscess, and the pus may need to be drained to clear the infection. If a skin abscess is not drained, it may continue to grow and fill with pus until it bursts, which can be painful and can cause the infection to spread or come back.

Incision and drainage

If your skin abscess needs draining, you’ll probably have a small operation carried out under anaesthetic – usually a local anaesthetic, where you remain awake and the area around the abscess is numbed.

During the procedure, the surgeon cuts into the abscess, to allow the pus to drain out. They may also take a sample of pus for testing.

Once all of the pus has been removed, the surgeon will clean the hole that is left by the abscess using sterile saline (a salt solution).

The abscess will be left open but covered with a wound dressing, so if any more pus is produced it can drain away easily. If the abscess is deep, an antiseptic dressing (gauze wick) may be placed inside the wound to keep it open.

The procedure may leave a small scar.

Rashes, Poison Ivy, Shingles, Lyme Disease & Cellulitis

Sure, you can scratch that itch or just hope it goes away. However, only when you find the cause of the rash can you start on the path to feeling better. Here are a few things that may be bothering you:

Rashes
Rashes can be caused by anything from allergies to eczema. Symptoms can include, but aren’t limited to redness, itching and small bumps or hives that appear on the skin.

Poison Ivy
If you’ve come in contact with poison ivy, poison oak or poison sumac recently, wash your skin within 1-2 hours with lots of soap and warm water. If you develop symptoms of redness, itching, swelling or blisters, then talk to a medical professional about treatment.

Shingles
If you’ve had chicken pox as a kid, the virus may still be inside you, putting you at risk for developing shingles. Shingles is just your chicken pox virus coming back out when you’re an adult. It usually returns in one area of the body because it’s supplied by the one nerve where the virus has been hiding for years.

The risk of getting shingles is greater if you’re age 50 or older, though they’re possible to get at any age. Symptoms of shingles include a burning pain, rash, tingling, itching, and generalized symptoms of fatigue and headache.

Lyme Disease
If you’ve come in contact with a black-legged or deer tick and weren’t able to remove it within 36 hours, you should talk to a medical professional about Lyme Disease diagnosis and treatment. Early symptoms of Lyme Disease include rash, fever, chills, headaches, neck stiffness muscle pain, joint pain and swollen lymph nodes. Symptoms of advanced Lyme Disease include, drooping of the face, arthritis and heart arrhythmia

Cellulitis
Cellulitis is a local skin infection that occurs when bacteria get under the skin. It’s different from an abscess because it does not include a collection of pus. Symptoms include redness, warmth, pain and occasionally mild swelling.

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Cellulitis and its Mimickers

by Andrew W. Choi BA, and Steve Xu MD, MSc

Cellulitis refers to a bacterial infection of the deep layers of the skin as well as the tissue below the skin. In the United States alone, there are about 14.5 million cases of cellulitis, which cost $3.7 billion yearly in annual health care costs. Ten percent of the hospitalizations in the United States related to an infection were due to cellulitis.

What Does Cellulitis Look Like?

It usually presents initially as red, swollen skin that feels warm and is tender. This infection can occur anywhere on the skin, but it most commonly happens on the lower legs in adults and on the face or neck in children. If cellulitis is caught early and treated, it usually clears completely without any long-term issues. When it is seen early, oral antibiotics can be given, improving the cellulitis within 24-48 hours. However, without treatment, the infection can spread quickly, even into the bloodstream. If the infection becomes severe enough, hospitalization and IV antibiotics may be required.

The Diagnostic Challenge of Cellulitis

There are many other skin conditions that can look like cellulitis, making it difficult to distinguish from benign conditions, such as a fungal infection or redness from poor circulation. Some common things physicians look for to diagnose cellulitis include red streaking around the area, which would mean the lymph vessels are inflamed, a condition more likely to be seen in cellulitis. Also, physicians may look for a wound or cut where bacteria could have entered the skin. Usually, the patient feels sick and may have fevers and chills. In addition, cellulitis typically only affects one area. Bilateral lower leg cellulitis has been reported, but redness on both legs usually suggests a different condition.

But even these signs are not perfect indicators. Benign skin rashes can look very similar to cellulitis, so it can be difficult sometimes to differentiate cellulitis accurately from other conditions. Below are some common red rashes that can be confused with cellulitis. These benign red rashes tend to have certain characteristics that can be helpful in differentiating them from cellulitis.

Venous stasis dermatitis, also known as gravitational dermatitis, is a very common condition that can cause redness in the legs. This rash usually happens in people who have poor circulation in their legs. The leg veins have one-way valves that help push blood up from the leg back to the heart. As we get older, these valves can weaken and stop working properly, allowing blood to leak out and pool in the legs, causing swelling and redness. Unlike cellulitis, which usually affects one area, venous stasis dermatitis affects both legs. Also, it does not cause patients to feel sick or have a fever since it is benign. Patients typically complain about itchiness rather than pain.

Another skin condition that can occur on the leg and look like cellulitis is gout. Gout happens when crystals form in a joint, usually the big toe, which causes inflammation that leads to redness near the joint. The area is tender, swollen, and warm, like cellulitis. However, these symptoms are not caused by infection. The redness from gout is usually much more localized around the joint where the crystals are located, and the skin around the redness is clearly normal, as opposed to in cellulitis, where the skin around the redness is hard.

Erythema nodosum, another benign cause of redness in the legs, can be confused with cellulitis. In erythema nodosum, there is inflammation of the fat under the skin, which causes tender knots under the skin that are bright red at first. Unlike cellulitis that usually affects one leg, erythema nodosum affects both legs, usually around the shin. It can be triggered by an infection somewhere else, so the patient may have fevers or feel sick, like in cellulitis.

Similar to erythema nodosum, lipodermatosclerosis is another benign skin condition that causes inflammation of fat under the skin. Lipodermatosclerosis causes a painful red rash on the legs, usually as a result of chronic venous insufficiency, which also causes venous stasis dermatitis. It most commonly happens on the legs, like cellulitis. Often, it can involve both legs, like venous stasis dermatitis and unlike cellulitis. Unlike cellulitis, patients usually do not have fevers or feel sick.

Another infection of the skin, tinea pedis, also known as athlete’s foot, can cause redness like cellulitis, especially in patients with suppressed immune systems. Tinea pedis is caused by a superficial infection of the skin by fungi that likes humidity, so it typically occurs in patients who use communal pools or showers. Like cellulitis, tinea pedis usually affects only one foot and can be bright red. Unlike cellulitis, the rash is usually itchy and has scales, and is typically in between the toes. Also, tinea pedis does not cause fevers and the patient does not feel sick, unless cellulitis develops because the tinea pedis has allowed bacteria to enter the skin.

Contact dermatitis can also look very similar to cellulitis. Contact dermatitis happens when out skin touches something that can cause a rash. It happens in everyone at least once in our lives. This includes allergic contact dermatitis, which can be caused by touching poison ivy or nickel (in jewelry or belt buckles), and irritant contact dermatitis, which is caused when something irritates our skin enough, such as certain soaps. The rash from contact dermatitis is red, like cellulitis, and can happen within hours to days of the exposure. The rash can be tender and stinging. Unlike cellulitis, the rash does not cause fevers or make the patient sick. Also, the rash from contact dermatitis is usually very distinct from the rest of the skin around it because it only develops where the skin touched the substance; in cellulitis, there is less of a clear distinction between the infected skin and the rest of the skin.

Conclusion

Right now, there isn’t a single laboratory test or imaging modality that can confidently diagnose cellulitis. Typically, a dermatologist must put together the patient’s physical appearance, blood work, and medical history to come to a diagnosis.

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At MedExpress, we understand that sometimes an annoying itch can’t wait for an appointment. That’s why we have convenient hours to try to ease your discomfort.

There are a number of skin conditions that can cause dry, painful, itchy skin, and blisters, rashes, or sores. Some common conditions we treat include cellulitis, eczema, impetigo, poison ivy/oak/sumac, ringworm, and shingles.

What is Cellulitis?

A common bacterial skin infection, cellulitis occurs when bacteria enters a break in the skin and spreads. Cellulitis can manifest anywhere on your body, but it’s most common on exposed parts of the skin like the lower legs, hands, arms, and face.

Symptoms of Cellulitis

  • Redness in the skin that expands or streaks
  • Swollen skin that can be tender or even painful
  • Areas of the skin that are warm to the touch
  • Red, blotchy skin that may blister or dimple

You should seek immediate emergency care if you have a:

  • A rash that’s changing rapidly, or is swollen and painful
  • Fever

Diagnosing Cellulitis

To diagnose cellulitis, your MedExpress medical team will, among other things, examine the affected area. They may perform a blood test or take a sample of the area to test for bacteria that caused the condition.

Treating Cellulitis

A healthcare professional can consider the severity of your symptoms when determining treatment, which may include an oral antibiotic. Stay in touch with your healthcare professional as the infection heals and responds to medication to determine if a course correction is required. If the infection doesn’t respond well to the initial antibiotic choice, alterations to the antibiotic regimen may be necessary, which could include a change to IV medications.

At home, you can ease the symptoms of cellulitis by:

  • Elevating the affected area to reduce swelling
  • Applying a cold, damp cloth to the area to reduce pain

What is Eczema?

Eczema, derived from a Greek word meaning “to boil over,” refers to a group of noncontagious conditions that cause the skin to become red, itchy and inflamed.1 There are several types, including:

  • Atopic dermatitis
  • Contact dermatitis
  • Dyshidrotic eczema
  • Nummular eczema
  • Seborrheic dermatitis
  • Stasis dermatitis

It is possible to have more than one type at a time, but each type of eczema causes itching and redness. Some may also cause the skin to blister, “weep,” or peel.2

While eczema is a very common skin aliment – more than 30 million Americans have some form of eczema, it is also highly manageable.1

Symptoms of Eczema

  • Itchy skin.
  • Dry red areas.
  • Red to brownish-grey patches on the skin.
  • Small, raised bumps that can leak fluid and crust when scratched.
  • Raw, sensitive, swollen skin – mostly from scratching.

Diagnosing Eczema

If appropriate, our medical team may, among other things, check your skin, ask about your medical history, and any family history of eczema, allergies, hay fever, or asthma.

Treating Eczema

For mild eczema, treatment consists of:

  • Washing with mild soap and using moisturizer to keep your skin from drying out.
  • Avoiding long, hot showers or baths, which dries out skin.
  • Managing your stress.
  • Using a humidifier to keep air moist.

For more severe eczema, treatment consists of a variety of therapies:

  • Antihistamines
  • Prescription topical medications, commonly corticosteroid cream
  • Systemic corticosteroids

What is Impetigo?

Impetigo is a contagious infection that is caused by one of two kinds of bacteria: strep (streptococcus) or staph (staphylococcus). It creates red sores that can break open, which then get a yellow-brown crust. The sores are not typically painful, but they can be itchy.

Although impetigo is one of the most common skin infections in children, adults can contract the ailment since skin sores are often prone to bacterial infection.

Symptoms of Impetigo

  • Small red spots that change to blisters.
  • Commonly found around the nose, mouth, hands, and forearms (and diaper areas for infants and toddlers).
  • Blisters break open and leak fluid and/or looked crusted.
  • Sores that get bigger and spread.

Diagnosing Impetigo

To diagnose impetigo, our medical team may, among other things, examine your skin and take a thorough medical history. Sometimes, a culture may be taken by swabbing a sore that will be sent to a lab to test for the bacteria that caused the condition.

Treating Impetigo

Since it is bacteria-based, impetigo is treated with antibiotics. A prescription topical cream or pills/liquid to take internally may be recommended.

Children can usually return to school 24 hours after treatment has begun.

At home, you can ease the symptoms of impetigo by:

  • Gently washing the sores with soap and water and patting dry.
  • Not scratching the sores.

After applying cream or washing the rash, be sure to always thoroughly wash your hands to prevent the sores from spreading.

Poison Ivy, Oak, and Sumac: Is There a Difference?

Poison ivy and poison sumac are typically found in the Midwest and Eastern states, while poison oak is usually found in the Western states.

The three plants have different characteristics, but they all have one thing in common: urushiol. It’s the oil in the plants that causes that itchy rash you expect to develop if you come in contact with poison ivy, oak, or sumac.

Often, the itchy rash, which can turn into painful blisters, doesn’t start to develop until one to two days after encountering the plant. Typically, the rash lasts one to two weeks and is not contagious. However, the oil can stick to clothing and objects, potentially causing another rash if these items are not washed properly after exposure.

Symptoms of Poison Ivy, Oak, and Sumac

  • Itchy skin.
  • Redness or red streaks.
  • Hives.
  • Swelling.
  • An outbreak of small or large blisters, often forming streaks or lines.
  • Crusting skin (after blisters burst) – usually from scratching.

If you experience any of the following symptoms, go to an emergency room right away:

  • Trouble breathing or swallowing.
  • Rash covers most of your body.
  • Many rashes or blisters.
  • Swelling, especially if an eyelid swells shut.
  • Rash develops anywhere on your face or genitals.
  • Much of your skin itches, or nothing seems to ease the itch.

Diagnosing Poison Ivy, Oak, and Sumac

By examining the rash, among other things, our medical team can diagnose poison ivy, oak, or sumac. Typically, no laboratory testing is needed to make the diagnosis.

Treating Poison Ivy, Oak, and Sumac

Most rashes from poison ivy, oak, or sumac go away without treatment within one to three weeks. However, if the reaction is serious, you will likely need prescription medication, such as a topical or systemic steroid depending upon severity.

If an infection develops as a result of the rash, an antibiotic may also be prescribed. A fever, pus, pain, swelling, and warmth around the rash are all indicators that you likely have an infection.

To help stop the itch while healing, consider these tips:

  • If possible, immediately rinse your skin with lukewarm, soapy water after coming into contact with poison ivy, oak, or sumac.
  • Wash everything that may have the plant’s oil on its surface, including your clothing.
  • Take short, lukewarm baths in a colloidal oatmeal preparation or add one cup of baking soda to the running water. Short, cool showers may also provide some relief.
  • Consider calamine lotion or hydrocortisone cream.
  • Apply cool compresses to the itchy skin.

What is Ringworm?

Ringworm (tinea corporis or tinea manuum) does not involve worms despite its name. It is a contagious skin infection caused by fungus, and its name likely comes from the raised, ring-shaped rash that forms as a result. It can appear on just about any part of the body, but it tends to lack the ring-shaped pattern on the palms, soles, groin, and nails.

Athlete’s foot (tinea pedis) is among the most common form of ringworm, putting athletes at a higher risk than others. However, the fungi that cause ringworm thrive in tropical areas and during hot, humid summers. The fungi also flourish in warm, moist locker rooms and indoor pools, putting anyone in those environments at an increased risk as well.

Skin-to-skin contact with an infected person can transmit ringworm. The fungi that cause ringworm can also live on any infected object, including clothing, brushes, and sports equipment, for long periods of time.

Symptoms of Ringworm

  • Ring-shaped, flat patches on the skin that have a raised, scaly border.
  • A red rash on light skin or a brown/gray rash on dark skin – with swelling.
  • Infected skin can be intensely itchy and painful — but not always.
  • Skin can flake, peel, and crack.
  • Itching, burning, and stinging on soles of feet and between toes.
  • Foul foot odor if specifically suffering from athlete’s foot.
  • Discoloration and thickening of toenails or fingernails.

Diagnosing Ringworm

To diagnose ringworm, our medical team may, among other things, examine the affected area and potentially other areas of your body, as it’s common for the infection to spread. Sometimes, a sample of the infected skin, hair, or nail may be collected and sent to a lab to confirm whether it contains any fungi that caused the ringworm.

Treating Ringworm

Ringworm is treated with antifungal medicine that comes in a variety of forms, such as creams, ointments, and pills. The type of medication will depend on the area of your body that needs treatment.

If applying medication directly to the affected area, be sure to wash your hands immediately afterward to prevent ringworm from spreading to other areas of your body.

It’s also important to use your antifungal medicine for as long as prescribed. Otherwise, the infection may fail to clear and could make ringworm harder to treat.

What is Shingles?

Shingles (herpes zoster) is a viral infection that causes a painful rash, which most commonly appears on your torso as a strip of blisters that will extend around your right or left sides. However, the rash can happen anywhere on the body. While it is typically a benign self-limiting rash, some sites may indicate a more urgent condition, particularly the tip of the nose, which can indicate involvement of the nerves of the eye.

Anyone who has had chicken pox can get shingles, since it is caused by the same virus – varicella-zoster. After you’ve had chicken pox, this virus lies dormant in your body until a potential trigger, such as stress or certain medication, reactivates the virus. In many instances, it is unknown what causes the varicella-zoster virus to reactivate.

You can’t catch shingles from someone who has shingles. However, if you have shingles, you can infect someone who has never had chicken pox (or the chicken pox vaccine) with the varicella-zoster virus.

Shingles is most common in adults and with those who have weakened immune systems.

Symptoms of Shingles

  • Pain, burning, or numbness (usually the first symptoms).
  • Usually only one side of the body is affected.
  • A red, itchy rash that begins a few days after the pain.
  • Rash becomes fluid-filled blisters that can break open and crust over.

Diagnosing Shingles

To diagnose shingles, your MedExpress medical team will, among other things, perform a thorough medical history and physical exam. The symptoms of shingles, especially the rash on one side, are distinctive enough that providers usually do not need to perform laboratory tests to diagnose the cause.

Treating Shingles

If you suspect you may have shingles, medical care should be sought as soon as possible. The treatment of shingles is most effective when caught early.

Shingles can be treated through a combination of medication and home care. Prescription antiviral medications can help the rash heal sooner and reduce the chance of developing chronic pain (post-herpetic neuralgia). In addition, if you have shingles, you can lessen the discomfort by taking over-the-counter pain relievers.

While you’re healing, try to:

  • Avoid scratching the rash.
  • Use cool, moist compresses on the blisters.
  • Apply baking soda to the sores to help them dry and heal faster.

1 National Eczema Association: What is Eczema? Accessed: April 17, 2018.

2 National Eczema Association: Overview of the Different Types of Eczema. Accessed: April 17, 2018.

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