Medically reviewed by Dr. A.M. van Coevorden, dermatologist
ErysipelasA skin infection that needs treatment fast.
Erysipelas, in Dutch known as wondroos, is a bacterial infection of the skin. A warm, thick, shiny and painful red patch appears suddenly and grows within hours, usually on a lower leg or the face. You often feel ill and feverish as well. Erysipelas is always treated with antibiotics: if you suspect it, call your GP the same day.
What is erysipelas?
Erysipelas starts acutely: a sharply demarcated, bright red or dark patch that feels warm, looks shiny and tense, and hurts. The patch visibly expands within hours. Erysipelas usually sits on one side of the body, often on a lower leg or on the nose or cheek. Many people feel ill with it, with fever, chills or nausea. Blisters can sometimes form on the patch.
Erysipelas and shingles are sometimes confused, but they are completely different: erysipelas is a bacterial infection with one warm, red, painful patch; shingles is a viral infection with blisters in a band on the skin.
How does erysipelas develop?
Erysipelas is caused by bacteria, usually streptococci and sometimes staphylococci, entering the skin through a small wound. That can be anything: a crack, a graze, a pimple, eczema or fungus between the toes. With erysipelas on the face, the bacteria can also come from the nose, ears or sinuses. Erysipelas is not contagious through touch. Those who have had erysipelas before, retain fluid in the legs or have a weakened immune system are at higher risk.
What can you do yourself?
Erysipelas does not heal by itself and always requires antibiotics; self-care comes alongside the treatment, not instead of it. Finish the entire course of antibiotics, even if the patch looks better sooner. Rest, and with erysipelas on the leg, keep the leg elevated. After the acute phase, it helps to remove the cause: care for small wounds and cracks, treat fungus between the toes and keep the skin supple with a neutral cream. With fluid in the legs, compression bandages or an elastic stocking can help and prevent recurrence.
When to see a doctor?
If you suspect erysipelas, call your GP the same day, and outside office hours the out-of-hours GP service. Rapid treatment with antibiotics prevents complications. An online consultation is not the right channel here: with erysipelas speed matters, and treatment sometimes requires physical examination or an IV. During the course, contact your doctor again if the redness spreads, the fever rises or the pain worsens, or if you cannot keep the tablets down. If erysipelas keeps coming back, discuss with your doctor how to prevent recurrence.
Please note
A rapidly growing, warm, painful red patch, especially with fever or chills? Don't wait: call your GP or the out-of-hours service immediately.
Frequently asked questions
Is erysipelas contagious?
No, not through ordinary contact. The bacteria that cause erysipelas live on many people's skin without doing harm; they only cause an infection once they enter the skin through a small wound.
How do I recognise erysipelas?
By a suddenly appearing, sharply demarcated, warm, thick and painful red patch that grows within hours, usually on a lower leg or the face, often with fever or feeling ill. With this picture, call your GP the same day.
Does erysipelas clear by itself?
No. Erysipelas is always treated with antibiotics, usually tablets. With fever or a weakened immune system, admission with IV antibiotics can be needed. Untreated, the infection can spread.
Why does erysipelas keep coming back in some people?
Because the entry point remains: a crack, fungus between the toes or fluid in the legs. Treating that cause, caring for the skin and wearing an elastic stocking if needed makes recurrence much less likely. With frequent recurrences, the doctor can consider long-term antibiotics.
Can I start an online consultation for erysipelas?
No, erysipelas is too acute for that: you need antibiotics the same day and sometimes physical examination. Call your GP or the out-of-hours service. For questions afterwards, such as skin care to prevent recurrence, a dermatologist can review online.
Sources and more information
- Wondroos (nvdv.nl)
- Ik heb wondroos (thuisarts.nl)