Skin Infection Treatment Online

What is a bacterial skin infection?

A bacterial skin infection occurs when bacteria — most commonly Staphylococcus aureus (golden staph) or Streptococcus pyogenes (Group A strep) — enter through a break in the skin and multiply. Common types include:

• Cellulitis — diffuse infection of the deeper layers of skin and underlying tissue, presenting as a hot, red, tender, often expanding area, sometimes with fever
• Boil (furuncle) — tender, pus-filled lump from infection of a hair follicle
• Abscess — collection of pus deeper in the skin or soft tissue
• Impetigo (school sores) — superficial infection with honey-coloured crusts, mostly in children
• Folliculitis — inflammation and infection of multiple hair follicles
• Paronychia — infection of the skin around a fingernail or toenail
• Infected wound — including infected cuts, surgical wounds, insect bites, or burns

Skin and soft tissue infections are among the most common reasons for primary-care antibiotic prescribing in Australia. Cellulitis alone accounts for around 10,000 to 15,000 hospital admissions per year, while milder infections are usually managed in primary care. Telehealth is well suited to the initial assessment of many of these because the GP can observe the affected area by video and decide whether antibiotics, in-person review, or urgent care is needed.

Symptoms of a skin infection

Typical features of a bacterial skin infection include:

• Localised redness, warmth, swelling, and tenderness
• Pus or yellow-green discharge
• A tender lump that may come to a head (boil or abscess)
• Honey-coloured crusts (impetigo)
• Fever, chills, or feeling generally unwell (suggests a more significant infection)
• Swollen, tender lymph nodes near the affected area

Marking the edge of the redness with a pen and timing how quickly it expands is a useful way to help your GP assess severity. Rapid spread, red streaks tracking towards a lymph node, or significant change over a few hours is a red-flag feature.

When to go straight to an emergency department

Skin infections can occasionally be life-threatening. Go to an emergency department, or call 000, for any of the following — do not delay by booking telehealth:

• Redness that is rapidly spreading or expanding visibly over hours
• Red streaks tracking up the limb from the affected area
• High fever, shaking chills, or feeling severely unwell
• Severe pain out of proportion to the appearance (possible necrotising infection)
• Blistering, skin breakdown, or skin turning dark or dusky
• Facial infection, particularly around the eye or near the nose
• Hand or genital infections that are progressing
• Confusion, drowsiness, low blood pressure, or signs of sepsis
• Infection in a person with poorly controlled diabetes or significant immunocompromise

For everything else, telehealth or in-person GP review is reasonable. Your GP will tell you if at any point in your treatment you need to be seen in person, and arrange follow-up to review progress.

How a telehealth GP can help with a skin infection

A NewDoc telehealth GP can take a focused history, examine the affected area by video, and decide on the right level of care. You will be asked to hold the camera close to the area in good lighting, mark the edge of any redness, and sometimes send before-and-after photos.

During the consult, your GP can:

• Send an eScript for an appropriate oral antibiotic (for cellulitis, larger boils, or widespread impetigo) or a topical antibiotic ointment (for small areas of impetigo) per current Australian Therapeutic Guidelines
• Issue a pathology referral for a wound swab if the infection is recurrent, atypical, or you are at risk of MRSA
• Refer you to a dermatologist or infectious diseases specialist for recurrent or unusual cases
• Direct you to in-person care or an urgent care clinic for incision and drainage of larger abscesses
• Issue a medical certificate for time off work, or a school exclusion certificate for impetigo (typically 24 hours after starting effective treatment)
• Arrange follow-up to make sure the infection is settling on treatment

For eligible Medicare cardholders, the consultation and all of the above are bulk billed with no out-of-pocket cost. Antibiotics themselves are usually subsidised under the PBS at your pharmacy.

Treatment options for skin infections

Treatment depends on the type and severity of the infection. Small uncomplicated boils often settle with warm compresses applied for 10 to 15 minutes several times daily until the boil drains. Localised impetigo can usually be treated with a topical antibiotic ointment and good wound hygiene.

Cellulitis, larger or recurrent boils, widespread impetigo, and infected wounds with surrounding redness usually need oral antibiotics. Your GP will select a first-line oral antibiotic per current Australian Therapeutic Guidelines, with alternatives where you have a penicillin allergy, where MRSA (golden staph) is suspected or confirmed, or where first-line treatment has not worked. The choice is made based on your history, allergies, and any prior swab results.

Larger abscesses typically need incision and drainage, which is an in-person procedure. Severe cellulitis or any systemic features (fever, low blood pressure, confusion) need hospital review and may require intravenous antibiotics. Your telehealth GP will direct you to the right level of care.

Recurrent skin infections and MRSA

Recurrent boils or skin infections may indicate ongoing carriage of staphylococcus on the skin or in the nose, or methicillin-resistant Staphylococcus aureus (MRSA, also known as golden staph). MRSA is more common in remote Aboriginal and Torres Strait Islander communities, in people with prior healthcare exposure, in contact-sport settings, and in some occupational contexts.

A GP can organise a wound swab to identify the bacteria and its antibiotic sensitivities, and discuss a decolonisation plan — including antiseptic body washes, a nasal antibiotic ointment, regular laundering at hot temperatures, and household-contact measures. Recurrent infections in the same area, particularly in the groin or armpits, may indicate hidradenitis suppurativa, which needs a dermatology referral.