Erysipelas (St. Anthony’s fire) is a skin infection that causes a painful, swollen, shiny rash. It’s often on your face or legs. You may have a fever and chills, too. Group A streptococcus bacteria usually cause it. It needs quick treatment with antibiotics to avoid serious problems.
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Erysipelas is a bacterial skin infection. It affects the top part of a deeper skin layer and nearby lymph vessels. It causes a raised, discolored, shiny and painful rash. The rash usually affects only one side of your body (unilateral). It most commonly affects your hips, thighs, knees, ankles and feet (lower extremities).
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Providers sometimes call it “Saint Anthony’s fire.” This infection can get serious if it’s not treated right away.
Erysipelas (pronounced “eh-ruh-SI-puh-luhs”) is a type of cellulitis. Cellulitis is a group of skin infections. These target your skin and the tissue under it.
Symptoms of erysipelas include:
The rash may look and feel:
Symptoms target the part of your skin you can see and touch (epidermis). The infection can also reach deeper layers called subcutaneous tissue. You can't see these layers.
You may see symptoms in these areas:
An infection causes erysipelas. Group A streptococci bacteria are the most common type. Bacteria enter your body through broken skin. This usually happens through an open wound. Bacteria can also enter through:
Erysipelas itself isn’t contagious. But the bacteria that cause it can spread from person to person. To avoid spreading germs, stay home until your symptoms go away. This helps protect others.
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Erysipelas can affect anyone, but some people have a higher risk. It happens more often in children and adults between ages 60 and 80.
You have a higher chance of getting erysipelas if you have:
You also face a higher risk if you use a dialysis access (like an arteriovenous fistula) or have had major surgery.
Erysipelas can become serious if you don’t treat it right away. The infection can spread through your blood and cause bacteremia or sepsis. These can be life-threatening.
Even with treatment, complications are still possible. These can include:
You may get erysipelas symptoms again. Repeat infections may cause scarring and long-term skin damage.
Doctors diagnose erysipelas by looking at your skin and asking about your symptoms. They often ask if you had a recent cut, bug bite or skin problem, as these can let bacteria into your body.
Your provider probably won’t need lab tests to confirm a diagnosis. But tests can help figure out what bacteria is causing the infection. They might do a blood test or a culture test to get this information.
Providers treat erysipelas with antibiotics. This is a medication that destroys bacteria. Most people take oral antibiotics at home for about five to 10 days. If the infection is more serious, your provider may give you antibiotics through an IV in a hospital or clinic.
Penicillin is the most common medicine. If you can’t take penicillin, your provider may use erythromycin or cephalexin instead.
If you get symptoms often, long-term antibiotics are available. These medicines help prevent future infections. You might take oral antibiotics every day or a shot of penicillin every few weeks.
Other helpful treatments include:
You should start to feel better soon after you take antibiotics. The infection clears up first, but your skin may take a few weeks to fully heal.
While your skin heals, avoid scratching, rubbing or injuring the area. This prevents more damage and lets your skin recover faster.
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Call your provider right away if you notice signs of erysipelas. These include pain, fever, chills or a swollen rash.
Erysipelas can be dangerous if you don’t treat it, so don’t wait to get help.
Erysipelas sounds scary, but with treatment, most people recover well. You should start to feel better in a few days.
The rash might show up on your face or other visible areas. This may make you feel embarrassed or self-conscious until the rash heals. This could take a few weeks.
Your skin might peel as it heals. This is normal and doesn’t mean something’s wrong. Most people recover without lasting damage or scarring.
Yes. Antibiotics cure erysipelas. They work by killing the bacteria that cause the infection.
You need to take all of your antibiotics exactly as your doctor tells you. If you skip doses or stop early, the infection might not go away completely. This can also make it more likely to come back.
Even after treatment, erysipelas can return if you get another skin injury or infection. Let your provider know if you’ve had erysipelas before. This way, they can help lower your risk of it happening again.
You can’t prevent all cases, but you can take steps to protect yourself by:
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Erysipelas and impetigo are both bacterial skin infections. But they look different and affect different parts of your body.
Both need treatment, so talk to a provider if you notice symptoms of either one.
A sudden, painful rash with a fever can feel scary. With erysipelas, it’s your body’s way of telling you it needs help.
The good news? Erysipelas is treatable. Most people start to feel better soon after they begin antibiotics. The rash may stick around or peel for a few weeks, but that’s part of the healing process.
If you ever wonder whether a rash is mild or something serious, don’t wait — call a healthcare provider. It’s better to get it checked and stay safe.
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Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.