9 Infections That Cause a Bacterial Skin Rash

Pictures and How to Identify Them

Bacterial skin infections are fairly common and can range in severity from mild to life-threatening. Most are caused by Staphylococcus aureus (often referred to as a staph infection) or Streptococcus pyogenes (the same bacteria responsible for strep throat).

Bacterial skin infections can take many different forms from localized boils to whole-body infections like septicemia (in which the infection moves from the skin into the bloodstream). The infection generally starts when the skin is irritated or disrupted, such as by a cut, scrape, puncture, or rash.

The causes and treatment of a bacterial skin infection can vary by location—such as on the face, genitals, scalp, or hands—and whether the infection occurs in a baby, toddler, adolescent, or adult.

Here is a rundown of the nine most common bacterial skin infections, including their causes, how to identify them, and when to seek medical help.

Cellulitis

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Cellulitis

Richard Wareham / Getty Images

Cellulitis affects the two deepest layers of the skin called the dermis and subcutaneous tissue. It often appears as a swollen, red area of skin and feels tender and hot when touched.

Cellulitis usually occurs when the skin is broken, such as near ulcers, bruises, burns, or recent surgical wounds. While many types of bacteria can cause cellulitis, Staphylococcus aureus and Streptococcus pyogenes are the most common culprits.

If the cellulitis spreads to your bloodstream, it can be deadly, causing high fever, chills, rapid heart rate, vomiting, and other symptoms of septicemia. Seek emergency care if symptoms like these develop.

Erysipelas

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Erysipelas

 DermNet / CC BY-NC-ND

Erysipelas is an infection of the top two layers of the skin—the dermis and epidermis—by Streptococcus aureus. It is commonly known as "St. Anthony's Fire" because of the intense, burning sensation that it causes.

Symptoms include areas of extreme redness and swelling with a sharply defined border. It is common on the face and legs but can also affect the arms and trunk.

Erysipelas is similar in appearance to cellulitis. However, cellulitis occurs in the lower layers of the skin.

Minor skin disruption like athlete's foot or eczema can lead to erysipelas by allowing bacteria into tiny breaks in the skin. It can also occur when bacteria spread to the nasal passages following a nose or throat infection.

Bacterial Folliculitis

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Bacterial Folliculitis

Jodi Jacobson / Getty Images

Bacterial folliculitis is a relatively common infection of the hair follicles. It is usually caused when the pores are blocked by ingrown hairs, oils, or skin care products, trapping in bacteria and allowing them to proliferate.

Shaving or plucking hairs can increase the risk by providing bacteria easier access to disrupted pores.

Symptoms include tiny, red bumps and/or white-headed pimples filled with pus. Folliculitis tends to affect people with acne more than those with clearer skin.

While bacterial folliculitis usually heals on its own, more severe cases may require topical or oral antibiotics. Left untreated, folliculitis can cause permanent hair loss.

Fungal and Viral Folliculitis

Folliculitis can also be caused by fungi like Pityrosporum or Malassezia or viruses like herpes simplex virus (HSV). It is for this reason that folliculitis should be seen by a healthcare provider to ensure that the right treatment is dispensed.

Hot Tub Folliculitis

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Hot Tub Folliculitis

 Joel Carillet / Getty Images

Hot tub folliculitis is a skin infection by a bacteria called Pseudomonas aeruginosa. Symptoms include pus-filled bumps and an itchy, red rash that can develop several hours or days after exposure to the bacteria. The bacteria can survive even in chlorinated water, making it tougher to kill.

The condition is sometimes called "jacuzzi folliculitis" because it is contracted through contaminated whirlpools and hot tubs (especially wooden ones). People can also become infected through water slides, physiotherapy pools, or even loofah sponges.

Hot tub folliculitis typically affects the chest or groin. The risk is higher in people with acne or eczema as their skin barrier has already been disrupted.

Hot tub folliculitis tends to resolve on its own but may benefit from topical silver sulfadiazine cream. Severe cases may require oral antibiotics.

Hot Tub Folliculitis in Kids

Not surprisingly, children are more prone to hot tub folliculitis because their skin is thinner and they tend to stay in the water longer than adults.

Furuncles

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Furuncles

Mahdouch / Wikimedia Commons / CC BY 1.0 

A furuncle, commonly known as a boil, is a painful infection involving a hair follicle. It starts as a red, tender lump that rapidly fills with pus as it gets bigger. If left untreated, a furuncle can become a pus-filled pocket known as an abscess.

Unlike folliculitis, which also involves a hair follicle, a furuncle is an infection of the entire pilosebaceous unit (which includes the follicle, hair shaft, and sebaceous gland).

Furuncles are common on the face, neck, armpits, buttocks, and thighs. Applying warm compresses can help drain pus.

But, in severe cases, your healthcare provider may need to lance (cut open) the boil to drain it, followed by a course of oral antibiotics.

Carbuncles

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Carbuncles

Drvgaikwad/Wikimedia Commons / CC BY 3.0 

A carbuncle is a cluster of furuncles closely packed together. It can be as large as four inches across and usually has one or more openings where pus can ooze out. The infection may also cause a fever, fatigue, and a general feeling of unwellness.

Carbuncles usually develop on the back, thighs, or back of the neck. The infection tends to be deeper and more severe than that caused by furuncles. The most common cause is Staphylococcus aureus.

Carbuncles are more difficult to treat and can take longer to resolve than boils. The risk of scarring is high as is the spread of infection to other parts of the body. For this reason, carbuncles generally require medical treatment.

Impetigo

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Impetigo

 CFCF / Wikimedia Commons / CC BY 4.0

Impetigo is a bacterial infection of the epidermis. It is highly contagious and more commonly seen in children than adults. Caused by both Streptococcus aureus and Staphylococcus pyogenes, impetigo causes an oozing skin rash covered by a honey-colored crust.

Impetigo usually occurs around the nose and mouth but can spread to other parts of the body through skin-to-skin contact or contaminated clothing or towels. Impetigo is usually treated with topical antibiotics.

Erythrasma

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Erythrasma

 DermNet / CC BY-NC-ND

Erythrasma is a superficial skin infection caused by a bacteria known as Corynebacterium minutissimum. The infection usually starts with a well-defined pink patch of skin covered with fine scales. The rash can then turn a reddish or brownish color with flaking and wrinkling.

Erythrasma develops where skin surfaces rub against each other, such as the armpits, groin, or between the toes. In addition skin discoloration and flaking, mild itching or burning may occur, especially in the groin area.

Erythrasma is most common in warm, humid climates. Other risk factors include poor hygiene, obesity, diabetes, and older age.

Topical or oral antibiotics may be used depending on the severity. Gentle scrubbing can help remove some of the scales.

Erythrasma or Not?

Due to its location and appearance, erythrasma is often confused with fungal infections like athlete's foot or jock itch.

MRSA Infections

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MRSA Skin Infection

CDC / Bruno Coignard, M.D.; Jeff Hageman, M.H.S. / Wikimedia Commons / Public Domain 

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious bacterial infection that is resistant to standard antibiotic treatment.

The symptoms of MRSA can vary by the location of the infection. They typically include redness, swelling, pain, pus, and fever. Some MRSA infections look like other common bacterial infections and can even be confused with a spider bite.

Untreated MRSA

If left untreated, MRSA can spread through the bloodstream, causing septicemia and sepsis (an immune system overreaction to a whole-body infection). One of five people hospitalized for sepsis die as a result of complications.

Laboratory tests are usually required to diagnose MRSA. If left untreated, MRSA can easily spread from person to person, particularly in hospital settings.

Summary

A bacterial infection can be caused by any number of different bacteria. Staphylococcus aureus and Streptococcus pyogenes are the two most common.

A bacterial infection may cause localized symptoms (such as with furuncles, carbuncles, erythrasma, and impetigo) or affect larger portions of the body (such as with hot tub folliculitis and erysipelas). Some like MRSA and cellulitis can also spread into the bloodstream and cause septicemia and sepsis.

A Word From Verywell

Bacterial skin infections are common, and they can be hard to tell apart. While most aren't dangerous, they generally need treatment and can quickly become serious if left untreated.

If in doubt about a skin infection, do not hesitate to speak with your healthcare provider or a skin specialist known as a dermatologist. You can also contact a telehealth provider who may be able to offer advice based on a visual exam using your cell phone camera.

Frequently Asked Questions

  • Is a rash a symptom of COVID-19?

    In some cases, people with COVID-19 do develop a rash, but it’s less common than cough, fever, and shortness of breath. When rashes do appear, they may be patchy, itchy, and blister-like or cause raised bumps that last two to 12 days.

  • What is the best antibiotic for skin infections?

    It depends on the type of infection you have and its severity. For uncomplicated cellulitis, abscesses, or furuncles, beta-lactams such as penicillin may be used. Complicated infections may require broad-spectrum antibiotics able to treat many different bacteria types.

  • How can you tell if a rash is fungal or bacterial?

    It is often impossible to tell a fungal skin infection from a bacterial skin infection by looks alone. With that said, certain fungal infections can cause a round or circular rash with flaking. In the end, the only surefire way to tell is with lab cultures and/or a microscopic examination of skin scrapings.

  • Can you get a yeast infection on the skin?

    Yes. Sometimes, a type of yeast called Candida albicans can overgrow on the skin and cause an infection. Symptoms include a red, scaly, moist patch with itchiness. This common fungal infection is mostly seen in skin folds, such as under the breasts or in the belly area.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Ogunbiyi A. Pseudofolliculitis barbae; current treatment optionsClin Cosmet Investig Dermatol. 2019;12:241–7. doi:10.2147/CCID.S149250

  5. Bennett J, Blaser M. Chapter 221 - Pseudomonas aeruginosa and ther Pseudomonas species. In: Mandell, Douglas, And Bennett's Principles And Practice Of Infectious Diseases. 8th ed. Philadelphia: Saunders; 2015. doi:10.1016/B978-1-4557-4801-3.00221-6

  6. National Center for Biotechnology Information, U.S. National Library of Medicine. Boils and carbuncles: How are boils treated?

  7. MedlinePlus. Carbuncle.

  8. MedlinePlus. Impetigo.

  9. MedlinePlus. Erysthrasma.

  10. Kaur D, Chate S. Study of antibiotic resistance pattern in methicillin resistant Staphylococcus aureus with special reference to newer antibioticJ Glob Infect Dis. 2015;7(2):78. doi:10.4103/0974-777x.157245

  11. Bhattacharya S, Pal K, Jain S, Chatterjee SS, Konar J. Surgical site infection by methicillin resistant Staphylococcus aureus- on decline? J Clin Diagn Res. 2016;10(9):DC32–DC36. doi:10.7860/JCDR/2016/21664.8587

  12. American Academy of Dermatology. COVID toes, rashes: how the coronavirus can affect your skin

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By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.