Skin Infections

Skin infections are caused by bacteria, viruses, fungi or parasites that get into or onto the skin. They range from minor problems such as impetigo, warts, ringworm and athlete's foot to deeper infections such as cellulitis and abscesses that need prompt medical treatment.

Most clear fully with the right treatment. The main difficulty is getting the diagnosis right, because fungal rashes, eczema and bacterial infection can look alike and the wrong cream, particularly a steroid on a fungal rash, makes things worse.

Symptoms

• A hot, red, swollen, tender area of skin that spreads over hours or days
• A painful lump that comes to a head and discharges pus
• Honey-coloured crusts around the nose and mouth, typical of impetigo
• A ring-shaped scaly patch with a clearer centre, typical of ringworm
• Grouped painful blisters in a band on one side of the body, typical of shingles
• Rough warty lumps or small pearly bumps with a central dimple
• Intense itching worse at night with burrows between the fingers, typical of scabies

Causes and risk factors

Bacterial infections are mostly due to Staphylococcus aureus and streptococci entering through cuts, insect bites, eczema or athlete's foot. Fungi thrive in warm moist folds and are spread by gyms, pets and shared towels. Viruses cause warts, molluscum, cold sores and shingles, the last being a reactivation of chickenpox virus. Scabies and lice pass by close contact. Diabetes, obesity, leg swelling, poor circulation, a weakened immune system and broken skin all make infection more likely and recurrence more common.

How it is diagnosed

• Clinical examination: Most skin infections are recognised by appearance and distribution. The margin of redness may be marked with a pen to track spread.
• Swabs and pus culture: Identify the bacterium and which antibiotics work, including resistant staphylococci in recurrent boils.
• Skin scrapings and hair samples: Microscopy and culture to confirm a fungus before weeks of antifungal treatment.
• Blood tests: Inflammatory markers, blood count and glucose when cellulitis is significant or infections keep returning.
• Ultrasound: Shows whether a deep collection of pus is present that needs drainage.

Treatment options

• Oral or intravenous antibiotics: For cellulitis and widespread impetigo, chosen for the likely organism and adjusted by culture. Most courses last 5 to 10 days.
• Incision and drainage: The definitive treatment for an abscess, done under local anaesthetic. Antibiotics alone rarely clear a collection.
• Antifungal creams and tablets: Creams for limited body and foot infection, tablets for scalp, nail or extensive infection.
• Antiviral medicines: Aciclovir or valaciclovir for shingles, ideally started within 72 hours of the rash, and for severe cold sores.
• Wart and molluscum treatments: Salicylic acid, cryotherapy or curettage. Many resolve on their own, especially in children.
• Scabies treatment: Permethrin cream or ivermectin tablets for the patient and all close contacts at the same time, with bedding washed hot.

When it is urgent

Go to an emergency department locally for rapidly spreading redness with fever or shivering, severe pain out of proportion to what you can see, skin turning dusky, purple or blistered, infection around the eye or on the central face, shingles involving the eye or tip of the nose, or any skin infection in someone with diabetes, a transplant or chemotherapy who feels unwell.

Travelling to Türkiye for treatment

Acute skin infections must be treated where you are and are never a reason to fly. Travel is reasonable only for a specialist opinion on infections that keep coming back or will not clear, where cultures, scrapings, a biopsy and a search for an underlying cause can be completed in a few days. Do not travel with untreated scabies or open discharging wounds.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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