- Diseases, Disorders & Conditions
Skin Staph Infections with Pictures
What is staph?
Staph is short for the bacterium Staphylococcus aureus, a common cause of skin infections.
Staph is highly contagious; it is usually transmitted by direct skin-to-skin contact with an infected person or by sharing towels or sport equipment.
Staph carriers have Staphylococcus bacteria on their skin, in the nose or throat, but they are healthy and have no symptoms. They can transmit bacteria to others and they can get self-infected through skin wounds.
Staph skin infections can appear as infected acne, folliculitis, stye (on the eyelid), paronychia (near the nail), furuncle, carbuncle, impetigo, cellulitis or scalded skin syndrome.
An infected wound
Who is at risk for skin staph infection?
- Staph carriers, who are often nurses, doctors, patients with diabetes and those on hemodialysis
- Breastfeeding women
- Obese people
- People living in crowded communities or hot climates
- Gymnasts who share exercise equipment
- Individuals with skin injuries, surgical wounds, piercings and fresh tattoos
- Persons with atopic dermatitis or seborrhea, impaired immune system, cancer, diabetes, blood or lung diseases, including those treated by steroids or chemotherapeutics
Are staph skin infections contagious?
Staph skin infections are fairly contagious. They can spread by:
Skin to skin contact with an infected person
Sneezing: when droplets from the nose of infected person (or staph carrier) fall on an injured skin of another person
Sharing razors, towels, clothes, bedding, sport equipment (athletes!) or toys
Walking barefoot or sitting around the swimming pools
Contact with infected pets
Auto-infection by nose picking followed by skin scratching is also possible.
Acne are collections of oil (sebum) and shed skin cells in the hair follicles. They may appear as:
- Black-heads, which appear as small black caps that cover the collection of oil beneath.
- White-heads, which appear as red bumps with a collection of white or yellow pus in the ir centers. Pus is due to an infection by staphylococci or other bacteria.
A staphylococcal infection is not the cause but a complication of acne, especially in people who pop them frequently. Acne may appear anywhere on the skin, most commonly on the face, neck, shoulders and upper back.
Folliculitis is an inflammation of the hair follicle due to:
- Infection with the bacterium Staphylococcus aureus, which can appear anywhere on the skin, often in bearded area in men (barber's itch)
- Infection with bacterium Pseudomonas aeruginosa, contracted in poorly chlorinated hot tubs or swimming pools
- Infection with fungi, such as Pityrosporum (tinea barbae)
- Autoimmune process (eosinophilic folliculitis)
- Irritating oils
Staphylococcal folliculitis may appear just like acne, but here are the differences:
- Acne are usually a long-term problem, while the red bumps in staphylococcal folliculitis usually appear and disappear within few weeks and may occur anywhere on the skin soon again.
- Folliculitis can appear practically anywhere on the skin, while acne are usually limited to the face and upper trunk.
- Red bumps in folliculitis tend to be bigger, they are usually filled with more pus and tend to be more itchy than acne.
- Folliculitis may heal on its own in 1-2 weeks.
- Superficial folliculitis can be treated by antibacterial ointments containing mupirocin.
- Deep folliculitis may need to be treated by oral antibiotics.
Furuncles and Carbuncles
A furuncle or boil is a deep inflammation and infection of the hair follicle and the surrounding tissue. It appears as a red, 0.5-1 cm big bump with pus, which may ooze out and crust over. Furuncles can develop from few nearby folliculitis bumps, especially after repeated squeezing.
A carbuncle is a group of furuncles, which may occupy several centimeters of the skin. Carbuncles usually develop on the back on the neck. Risk factors include constant friction from clothes, shaving, poor hygiene, low immunity, diabetes, or kidney or liver disease.
- Do not squeeze furuncles and carbuncles, because this may increase the risk of a systemic infection and can leave permanent scars.
- Carbuncles may drain and heal in one or two weeks on their own. Warm compresses can promote drainage.
- A doctor can cut and drain carbuncles and prescribe antibiotics to prevent their recurrence.
A stye or hordeolum is a staph infection of the hair follicle on the inside or outside of the eyelid. It is a small abscess (a pus collection).
Touching the eyes frequently with the hands, or coloring the eyelashes can increase the risk of a stye.
A stye should not be confused with a chalazion, which is a non-infected, painless small lump in the eyelid without reddened skin.
Styes usually do not need any treatment. They can persist for several days or weeks until they burst and heal spontaneously. Hot compresses for several times a day can help drain a stye.
Impetigo (from the Latin impetere: "to attack") is a skin infection with large, flat liquid-filled blisters. It mainly occurs in children, usually on their faces, trunks and arms. When the blisters burst, they leave a red oozing skin surface, which then crusts over and give the appearance of honey or brown sugar. The causing bacteria include Staphylococcus aureus and Streptococcus A.
Treatment is by topical or oral antibiotics.
Cellulitis is the inflammation of the under-skin tissues, mostly due to an infection with Staphylococcus aureus or Streptococcus A. It appears as a red, warm, tender and swollen skin patch of the varying size. Other symptoms may include fever, chills and fatigue. The lymph nodes near the affected part of the body can be swollen and tender; for example, in cellulitis of the lower leg, the lymph nodes behind the knee could be enlarged.
Risk factors for cellulitis:
- A skin wound due to injury or surgery
- Insect or human bites
- Hardening of the arteries (atherosclerosis) in the limbs
- Ulcers due to the inflammation of the arteries (vasculitis), for example, in poorly managed diabetes
- Long-term treatment with steroids
Treatment of cellulitis usually includes antibiotics by mouth for one or two weeks.
Paronychia is an infection of the skin around the nail; it appears as a painful, red swelling or as a cluster of red bumps or blisters around the nail.
An infection may result from nail biting, finger sucking, wearing artificial nails or an ingrown toenail. People who constantly have wet hands, for example, bartenders, cooks, dentists or gardeners, are at greater risk to develop paronychia.
Paronychia usually heals on its own; if not, a skin cut and pus drainage may be needed. Soaking the affected finger in warm water few times a day may help relieve pain.
Staphylococcal Scalded Skin Syndrome
Staphylococcal Scalded Skin Syndrome (SSSS)
SSSS usually occurs in children under five years of age, especially in newborns and those with impaired immunity or kidney failure. Red, painful blisters looking like a burn or scald appear over extended areas of the body. SSSS is caused by toxins released by the Staphylococcus aureus bacteria. Rarely, SSSS may appear in adult with impaired immunity or renal failure.
Treatment is by intravenous antibiotics.
Diagnosis of Staph Skin Infections
A diagnosis of staph skin infection is usually made by physical examination. In doubtful cases, a doctor can take a swab from the rash and send it to a microbiological laboratory, where they can determine the exact type of bacteria.
Treatment of Staph Skin Infections
Staph skin infections usually resolve on their own in few days or weeks. Antibacterial soaps or over the counter antibacterial ointments may speed up healing. In resistant cases, oral or intravenous antibiotics are needed.
When antibiotics do not help, you can ask your doctor to check if the infection you have is maybe caused by MRSA (Methycillin Resistant Staphylococcus Aureus). Infections by MRSA need treatment with special antibiotics, such as vancomycin.
Draining a staph boil on the leg
Prevention of Staph Skin Infections
Effective prevention of staph infections include:
- Hand washing, regular showers
- Wearing comfortable clothes
- Not sharing towels and razors
- Cleaning athletic equipment before use
- Avoiding contact with infected persons
- Avoiding nose picking and subsequent skin scratching
- Wearing slippers in public showers and around the swimming pools
- Wearing gloves when touching infected individuals
An over-the-counter cream containing the antibiotic mupirocin can help in minor skin staph infections, such as folliculitis or stye.
Prescribed oral or even intravenous antibiotics are needed for severe infections, such as cellulitis or scalded skin syndrome.