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Skin Infection and Cellulitis Management
Skin Infection Management provides specialist dermatological care for bacterial, fungal, and viral skin infections -- accurately diagnosing the organism, prescribing the most effective targeted antimicrobial therapy, and preventing recurrence of conditions such as cellulitis, impetigo, tinea, and viral warts.
Overview
Skin infections represent one of the most common dermatological presentations and range from superficial impetigo to life-threatening necrotising fasciitis requiring emergency surgery. Accurate clinical diagnosis -- supported by bacterial swabs, fungal microscopy and culture, and viral PCR where indicated -- directs the most targeted antimicrobial therapy. Recurrent cellulitis of the lower limb -- the most common dermatological infection requiring specialist review -- requires investigation and treatment of the underlying portal of entry (tinea pedis, lymphoedema, venous disease) alongside antibiotic therapy and prophylaxis planning.
Types of Skin Infections Managed
- Cellulitis and Erysipelas (bacterial -- Streptococcus and Staphylococcus)
- Impetigo (superficial bacterial -- primary and secondary infected eczema)
- Necrotising Fasciitis (surgical emergency requiring urgent theatre)
- Tinea Corporis, Cruris, Pedis, and Capitis (dermatophyte fungal infection)
- Pityriasis Versicolor (Malassezia yeast overgrowth)
- Candidiasis (mucocutaneous candida infection)
- Viral Warts (HPV -- verruca vulgaris and plantar warts)
- Herpes Simplex and Herpes Zoster (viral -- requiring antiviral therapy)
Risk Factors for Recurrent Cellulitis
- Tinea pedis (athlete's foot) providing portal of entry for streptococcal cellulitis
- Lymphoedema causing impaired lymphatic clearance of bacteria
- Chronic venous insufficiency and leg ulceration
- Obesity reducing lymphatic efficiency
- Peripheral arterial disease impairing tissue defences
- Immunosuppression -- diabetes, immunosuppressive medications
- Previous deep vein thrombosis causing lymphatic damage
- Disrupted skin barrier from eczema or psoriasis
Skin Infection Symptoms Requiring Specialist Assessment
- Recurrent cellulitis (two or more episodes per year)
- Cellulitis not responding to first-line oral antibiotic therapy
- Spreading cellulitis with systemic features (fever, tachycardia)
- Rapidly spreading infection with severe pain suggesting necrotising fasciitis
- Fungal infection resistant to over-the-counter antifungal treatment
- Extensive or recurrent viral warts requiring specialist treatment
- Skin infection in an immunocompromised patient
- Atypical infection morphology requiring microbiological confirmation
Key Benefits
Discover the advantages of choosing our skin infection and cellulitis management services.
Appropriate empirical antibiotic selection prevents complications of inadequately treated skin infection
Portal of entry treatment is the single most impactful intervention for recurrent cellulitis
Oral terbinafine achieves 90% cure rates for fungal skin infections at standard dosing
Antibiotic prophylaxis provides sustained protection for patients with frequent recurrent cellulitis
Early recognition of necrotising fasciitis and immediate surgical referral is life-saving
Clinical Features
The technology, techniques and clinical approach behind our skin infection and cellulitis management.
Clinical severity assessment determines antibiotic route and admission threshold
Blood cultures taken before antibiotic changes in hospitalised patients
Portal of entry identification and treatment is the most effective recurrent cellulitis prevention
Tinea pedis treatment is mandatory in all patients with recurrent leg cellulitis
Antibiotic prophylaxis for 2 or more annual cellulitis episodes reduces recurrence by 45%
Preparation Instructions
Complete the full antibiotic course even when the skin appears to have improved. Treat any identified tinea pedis between the toes every day with antifungal cream to prevent recurrent cellulitis. Attend all follow-up appointments. Contact your dermatologist or emergency services immediately for rapidly spreading redness, severe pain out of proportion to appearance, tissue blistering or darkening, or fever with rigors as these may indicate necrotising fasciitis requiring emergency surgery.
The Procedure
Step-by-step guide to what you can expect during your skin infection and cellulitis management procedure.
Infection Type and Severity Assessment
The infection is classified as superficial (impetigo tinea) or deep (cellulitis erysipelas fasciitis) and its severity assessed -- erythema extent systemic features elevation of WBC and CRP guide antibiotic route and urgency.
Wound Swab and Culture
Swabs are taken from the wound surface or blister fluid where accessible. Blood cultures are taken for systemic features. Culture results guide antibiotic rationalisation from empirical broad-spectrum to targeted narrow-spectrum therapy.
Antibiotic Selection and Route
Superficial bacterial infections receive topical antibiotics. Mild cellulitis receives oral flucloxacillin. Severe cellulitis with systemic features requires IV benzylpenicillin and flucloxacillin. MRSA screen guides empirical therapy.
Portal of Entry Treatment
The portal of entry for recurrent cellulitis is identified and treated -- tinea pedis with topical terbinafine leg ulcers with optimal wound care lymphoedema with compression therapy.
Fungal Infection Management
Tinea corporis pedis or cruris is confirmed clinically. First-line treatment is topical terbinafine cream for 1 to 2 weeks. Extensive or resistant tinea or tinea capitis requires oral terbinafine 250mg daily.
Antibiotic Prophylaxis for Recurrent Cellulitis
Patients with 2 or more cellulitis episodes per year are prescribed prophylactic phenoxymethylpenicillin 500mg twice daily for 6 to 12 months -- reducing recurrence by 45% in randomised controlled trials.
What to Expect
Your dermatologist examines the infection, takes targeted swabs or skin scrapings for microscopy and culture, and prescribes the most appropriate antimicrobial therapy. For recurrent cellulitis, the portal of entry is identified and treated (tinea pedis with antifungal) and prophylactic antibiotic therapy is prescribed. Compression therapy is arranged for lymphoedema contributing to recurrence.
Frequently Asked Questions
Common questions about skin infection and cellulitis management.
Related Services
Explore other services in our Dermatology department.
Psoriasis Management
Eczema and Atopic Dermatitis
Skin Lesion Assessment and Biopsy
Ready to Get Started?
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