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Erysipelas Causes, Symptoms and Treatment

Erysipelas refers to a skin infection caused by a bacterium of the streptococcus type or more rarely of the staphylococcus or pseudomonas type. This infection can affect various parts of the body, especially the legs and face. It is mainly characterized by red skin, shiny, swollen and hot, often accompanied by severe pain. Although erysipelas can occur at any age, the risk of infection is higher after 40 years. The antibiotics are the basic treatment.

Description of erysipelas

Erysipelas is an infection of the skin that causes a strong defense of the body. This inflammatory process concerns the dermis and the hypodermis ( the two layers of the skin which are just under the epidermis), which is why we sometimes speak of acute dermo-hypodermitis. This infection of bacterial origin is caused most often by a streptococcus. In general, the bacterium enters the body through a “gateway”, for example a sore between the toes or an ulcer.


Erysipelas: at-risk populations and risk factors

Erysipelas affects both children and adults. That said, the incidence of the disease increases with age, people over 40 are more exposed, with a peak frequency around 60 years.

Risk factors for erysipelas

Due to the passage of the bacterium through a “gateway”, any skin lesion increases the risk of infection:

  • cut
  • Ulcer
  • Edema of the lower limbs
  • Postoperative wound
  • Mycosis with cracks between the toes
  • Cutaneous disease (dermatosis), especially intertrigo
  • Insect bite
  • Gardening

Other more general risk factors:

  • Alcoholism
  • Smoking
  • Diabetes
  • Immunodepression ( weakening of the immune system)

Symptoms of erysipelas

The disease is brutally manifested by a significant rise in temperature (39 ° or 40 °) and chills. Skin lesions may appear shortly before or shortly after these first signs. They take the form of red and shiny patches on the skin, swollen by inflammation. The subject feels sharp pain, the affected area becomes hot. Sometimes there is an increase in the size of lymph nodes ( lymphadenopathy) located nearby, where the erysipelas is drained: for example in the groin, if the erysipelas is located on one leg. One can sometimes observe a red trail between the “sick” area, and the “satellite” ganglion towards which this diseased area is drained, so-called lymphangitis.

Note: Cases of erysipelas without fever have been reported but are very rare.

The extent and severity of erysipelas varies from person to person. Well-prescribed and followed antibiotic treatment, avoids the extension of erysipelas and sometimes serious complications: general or face.

Diagnosis of erysipelas

The lesions being characteristic, the doctor makes his diagnosis of erysipelas simply by examining the sick person. The presence of fever, the red, swollen and shiny appearance of the affected area and the enlargement of the lymph nodes can be appreciated during the consultation.

In about 3 out of 4 cases, the doctor manages to identify the “gateway” of the infection, that is, the place where the bacteria entered the body.

Further examinations are then useless.

Treatments of erysipelas

Antibiotic therapy (= administration of antibiotics) is the treatment of choice for erysipelas. The doctor generally prescribes a penicillin (see intravenous in hospitalization in case of severe erysipelas: Penicillin G at the dose of 10 to 20 million units per day, or orally in case of erysipelas without signs of seriousness amoxicillin), or in case of allergy, may recommend pristinamycin and recommend rest until healing. When the erysipelas recurs, other treatments can be put in place.
Treatment should also include care of the area through which the bacteria entered the body.

The doctor always checks that the tetanus vaccination is up to date.


In case of erysipelas, taking anti-inflammatories is totally against indicated. On the other hand, anti-pain treatments can provide relief before the effect of antibiotics.

The fever must drop in 72 hours, otherwise it is that the antibiotic treatment is poorly adapted and needs to be changed. Then the area gradually regains its normal appearance, healing becomes complete after 10-15 days.

Erysipelas: complications

If the erysipelas is not treated with antibiotics, the risk is a spread of the bacteria in the deep tissues under the skin (necrotizing fasciitis) or even in the body, with sepsis. Thanks to antibiotics, these situations only occur in 5% of cases for erysipelas of the lower limbs.
Impairment of the kidneys can be observed because of the effect of streptococci.
Recurrence is common among at-risk individuals.
The need for care in hospitals is rare, it only occurs in case of complications.

Prevention of erysipelas

The prevention is to avoid the entrance doors. In other words, we must disinfect all wounds and preserve the integrity of the skin, especially since there is a risk of recurrence. To avoid the appearance of skin lesions such as mycosis (intertrigo), good body hygiene is essential, especially in the feet and legs. We must therefore carefully dry the folds, moisturize the skin, wear comfortable socks and prevent the appearance of ulcers by the management of venous and lymphatic insufficiency. Wearing compression stockings reduces the risk of erysipelas in case of chronic venous insufficiency.

Complementary approaches to treat erysipelas

Although antibiotic treatment is systematically recommended, it may be useful to accompany it with natural care that will prevent recurrences that are common.



Erysipelas can be combated with a combination of Niaouli essential oil ( Melaleuca quinquenervia ) and Eucalyptus globulus . Mix them with respectively 8 ml and 4 ml in 60 ml of vegetable oil of your choice (for example argan oil or hemp).

Apply the preparation in compress, 3 times a day, directly on the zone to be treated.

Note that Oregano essential oil can also be used for its antibacterial properties.

Natural anti-infective remedies

You can use various natural anti-infectives such as:

  • the mother tincture of Echinacea Angustifolia , at a rate of 25 drops twice a day, for 3 weeks, then twice a week until the disappearance of the erysipelas;
  • propolis at a rate of 5 capsules, dosed at 250 mg per day;
  • Magnesium chloride, one glass, four times a day.


Immerse the affected areas in a two-liter bath of water, consisting of a handful of each of the following plants: artichoke leaves, celandine, fern and nettle.

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