• Early diagnosis key, reducing complexity of spread and management
• Antibiotics; follow local guidelines for those used with acute skin infections and abscess
• UK fist line; flucloxacillin 500mg for 7 days or clarithromycin 2x daily if penicillin allergy
• UK second line; addition to the above with amoxycillin or co-amoxiclav, clindamycin if penicillin allergy 300mg 4x daily
• Topical antibiotic: fusidic acid to be used for superficial skin infections
• Mild Erysipelas should be treated with oral antibiotics, however you shouldn’t wait to refer to hospital if spreading rapidly while on antibiotics already or systemic symptoms such as fever occur.
• Surgical incision and drainage should be adopted for abscess formation as well as systemic antibiotics

What about Reversal?

This is a viable and reasonable option when considering the treatment of infection, mainly due to potential risk of biofilm formation and the adequacy in which hyalase will break down dermal filler. The impact that the hyalase can also have in breaking down the external protective shell which biofilms characterise with is also promising in the treatment and resolution of infection. Antibiotics are therefore able to access the bacteria and clear the infection or negate build a biofilm in the first instance with the removal of the filler causing the infection rapidly.