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Erysipelas is an infection of the upper layers of the skin.


Erysipelas is caused by specific bacteria. In most cases, it is Group A streptococci. These bacteria normally live on the skin or come from sources outside of the body. It can enter the skin through a cut or injury to the skin. Once inside the skin, the bacteria can grow and spreads into the surrounding skin layers.

Puncture Wound

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Risk Factors

The most common factors that increase the chance of erysipelas:

  • Infancy or older age, though any age group can be affected
  • Diabetes
  • Obesity
  • IV drug use

Any damage to the skin, such as a cut, scratch, blister, burn, puncture, ulcer, or bite can increase the risk of erysipelas. Skin damage may also be caused by certain skin conditions such as:

The risk of skin infection can also be increased by conditions that cause pooling of blood or fluids in the skin such as:


Erysipelas can occur on skin anywhere, but most often affects the face, arms, or legs.

Symptoms may include:

  • Skin that is warm, red, firm, and swollen
  • Blisters
  • Pain or tenderness
  • Swollen glands or lymph nodes
  • Fever or chills


You will be asked about your symptoms and medical history. A physical exam will be done. The doctor can diagnose erysipelas based on the appearance of the skin.

Further testing may be done if the infection does not respond to treatment as expected, for certain infection source, or if there is a compromised immune system. Information about the infectious agent and the body’s response can be found through:

  • Blood tests
  • Cultures of blisters
  • Skin biopsy —a sample of the affected area is removed and cultured or examined under a microscope


Antibiotics are used to treat bacterial infection. The medication may be delivered by IV, or by pills or liquids by mouth.


To help reduce your chance of erysipelas:

  • Your doctor may give you preventive low-dose antibiotics if you have had many infections.
  • Keep your skin clean.
  • Moisturize dry skin with lotion.
  • Treat fungal skin infections if present
  • Avoid injury to the skin:
    • Wear protective gear in sports.
    • Wear long pants and long-sleeved shirts when hiking.
    • Wear sandals when at the beach, rather than going barefoot.
    • Be careful around animals. Treat pets with respect to avoid bites.
  • If a small cut, bite, or other injury occurs, carefully treat the wound:
    • Clean cuts or scrapes with soap and water.
    • Apply antibiotic ointment.
    • Cover wounds with a bandage or dressing.
    • Do not scratch wounds.
    • Call the doctor right away if the area becomes red or inflamed.
  • Seek prompt medical care for larger wounds or bites.
  • If your legs tend to swell, elevate them several times a day and wear support stockings.
  • Follow treatment plans for chronic health conditions.

American Academy of Dermatology

National Institute of Allergy and Infectious Diseases


Canadian Dermatology Association

Health Canada


Cellulitis and erysipelas. Patient website. Available at: Updated April 11, 2015. Accessed August 17, 2017.

Erysipelas. DermNet New Zealand website. Available at: Updated February 2016. Accessed August 17, 2017.

Erysipelas. EBSCO DynaMed Plus website. Available at: Updated August 14, 2017. Accessed August 17, 2017.

Management of erysipelas and cellulitis. The International Foundation for Dermatology website. Available at: Accessed August 17, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 8/17/2017