Health NW: Bacterial skin infections

<center>Kathryn B. Brown, FNP</center>

Impetigo, boils and cellulitis are three common types of skin infections. These often require medical treatment, but all are curable. They all happen when a break in the skin becomes infected with certain types of bacteria.

Our skin is the largest organ of the body, and is incredibly important. Its main function is to protect us from the outside world by helping to regulate our body temperature and acting as a barrier to germs in the environment.

Several types of beneficial bacteria live on our skin naturally. They help prevent disease-causing bacteria from creating problems on our intact skin. If there is a break in the skin - because of a puncture wound, scratch, laceration or even tiny cracks from athlete's foot - then disease-causing bacteria can invade the skin and multiply. People with diabetes or immune-system problems are most prone to bacterial skin infections.

Most of the time, our immune system can deal with small invasions of bacteria in our wounds. The redness and swelling around a wound tell us that our infection-fighting cells are working hard to kill off bacteria. Wounds should get better each day.

If you have a wound that is getting worse each day - more red, more swollen or more painful - then you know that your immune system is not able to fight off the bacteria on its own. This is when you need to see a health care provider for some help.

Impetigo is a skin infection that usually affects children. It causes patches of pus-filled blisters that ooze and form a honey-colored crust. It is usually seen on the face, but it can spread from one part of the body to another. It is very contagious from person to person. It is treated with antibiotic ointment or oral antibiotics.

Boils (also known as furuncles) start as small infections around hair follicles. They can become very large as pus forms under the skin. They look like firm, swollen lumps and are tender to the touch. They are most commonly found on the face, neck, armpits, buttocks and groin.

Warm compresses (a warm washcloth applied for 20 minutes at a time, at least four times a day) can bring a boil to a head and allow the pus to drain. If this is ineffective after several days of treatment, a health care provider may need to lance the boil with a sterile scalpel to allow the pus to escape. Antibiotics may be needed in some cases.

Cellulitis is a bacterial infection that spreads in the deeper layers of the skin. Affected areas of skin will appear red and inflamed, and can appear shiny and stretched. Sometimes, small blisters are seen. The area of red, warm, tender skin can spread quickly. If the infection spreads to the bloodstream, it can cause fever and chills; these are signs of a serious infection and medical care is needed immediately.

The treatment for cellulitis is antibiotics. They may be given orally for mild cases, but severe cases may require hospitalization and intravenous (IV) antibiotics.

If you are prone to any of these bacterial skin infections, ask your health care provider for advice on how to prevent them in the future.

Some people are carriers of a certain type of infection-causing Staphylococcus bacteria. They may benefit from treatment with an ointment called mupirocin, which is applied in the nostrils for five days each month.

Good hygiene is always important to keep bacteria under control. Plain old soap and water is just fine for most people, but for those troubled by recurrent skin infections, an antibacterial soap might be helpful.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to

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