Skin Infections in Canada: Facts, Care and Research

A skin infection means an organism has taken hold in the skin. Three kinds cause them: bacteria, fungi and viruses. Treatment aimed at one does nothing for another.

By the numbers in Canada

9thmost common reason people come to an emergency department in Canada is cellulitis, a bacterial infection of the skin, according to the Canadian Association of Emergency Physicians' best practices checklist for skin and soft tissue infections.

Source: Canadian Association of Emergency Physicians, best practices checklist for skin and soft tissue infections, 2023

Shingles is the viral skin infection with the clearest Canadian numbers. Canada's National Advisory Committee on Immunization reported that 130,000 cases of herpes zoster, 17,000 cases of the lasting nerve pain that can follow it, and 20 deaths were estimated to occur in Canada each year, that nearly one in three Canadians developed shingles during their lifetime, and that approximately 2 to 4 percent of Canadian cases were hospitalised. Source: National Advisory Committee on Immunization, 2018
Impetigo, the crusted bacterial infection most common in young children, is poorly counted in Canada. The National Collaborating Centre for Infectious Diseases states that population-based statistics relating to impetigo in Canada are difficult to find. It reports that children aged 2 to 5 are most affected, that Staphylococcus aureus is the dominant cause in temperate climates such as Canada's, and that it spreads by skin-to-skin contact and through shared items such as towels and clothing. Source: National Collaborating Centre for Infectious Diseases, disease debrief: impetigo, 2026
Fungal infection is common enough to account for much of what people notice about their nails. The Canadian Dermatology Association states that nail fungus causes about half of all nail abnormalities, that it comes from the same fungi that cause athlete's foot, jock itch and ringworm, and that common sources include public swimming pools and gym locker rooms and showers. Source: Canadian Dermatology Association, 2026

Worldwide616.5 million people worldwide were living with a fungal skin disease in 2021 according to the Global Burden of Disease study, with 1.73 billion new cases that year. This is an international figure rather than a Canadian one.Source: Global Burden of Disease Study 2021, Frontiers in Epidemiology, 2024

What a skin infection is, and what it is not

Bacterial infections include cellulitis, which spreads through the deeper layers, impetigo, which crusts on the surface, and abscesses. Fungal infections include ringworm, athlete’s foot and nail infections. Viral ones include shingles, cold sores and warts.

Not every red, itchy or scaly patch is infected. Eczema, psoriasis and insect bites can look similar, and the Canadian Association of Emergency Physicians notes several non-infectious conditions are mistaken for cellulitis.

Signs and symptoms

Skin that is red or darker, warm, swollen, tender and spreading: cellulitis
Honey-coloured crusted sores, often around a child’s nose: impetigo
Itchy, scaly, ring-shaped patches, or cracking between the toes
Nails that thicken, crumble or streak yellow
A painful band of blisters on one side of the body or face: shingles

Fever or chills with any of these suggests the infection is not staying local.

An adult applying moisturiser to the skin of the upper arm. — Bacterial, fungal and viral skin infections look different and need different treatment. Illustrative photograph.

What raises the risk

Some risk factors cannot be changed:

Age: impetigo is commonest in children aged 2 to 5; shingles rises sharply with age
Having had chickenpox, since shingles is that virus reactivating years later
A previous episode of cellulitis, long-standing limb swelling, or a weakened immune system

Others can often be worked on, usually with support from a health care team:

Any break in the skin: a cut, scratch, bite, cracked heel or eczema flare
Bare feet in pools, locker rooms and showers, named by the Canadian Dermatology Association
Shared towels or razors, and crowded housing, which NCCID links to more impetigo

How skin infections are diagnosed in Canada

Most are diagnosed by looking at the skin and asking how fast it is changing. For cellulitis the Canadian Association of Emergency Physicians states that diagnosis rests on clinical judgement rather than decision tools or biomarkers, and clinicians often mark the edge to see whether it advances. Fungal infection is where the laboratory matters: the Canadian Dermatology Association states the only accurate way to confirm a fungal nail infection is a clipping or scraping sent for microscopy and culture.

Treatment and day-to-day management

Treatment follows the organism. A clinician may discuss:

For limited impetigo, topical antibiotics such as mupirocin or fusidic acid, plus wound care
For spreading infection, oral antibiotics: Canadian Family Physician names cephalexin and cloxacillin, or trimethoprim-sulfamethoxazole and doxycycline where MRSA is a concern
Incision and drainage for an abscess, with intravenous antibiotics and hospital care where someone is systemically unwell or has not improved after 48 to 72 hours
For fungal infection, topical antifungals, and oral ones where nails or a wide area are involved
For shingles, prompt assessment, antiviral medicine and pain treatment; for warts, freezing or topical treatment

NACI also publishes shingles vaccine advice. These are decisions for you and your own clinician.

When to talk to a doctor

Call 911 or go to an emergency department if pain is far worse than the skin looks, the area is spreading fast, the skin turns dusky, purple or black, blisters or bruising appear, there is a crackling feel under the skin, or you become confused or very unwell. The Canadian Association of Emergency Physicians lists these as red flags for a necrotising soft tissue infection, which needs urgent surgical assessment.
Get care the same day if a warm, tender area is spreading, red streaks run up a limb, you have fever or chills, or the infection is on the face or near an eye.
Go back for review if a skin infection has not improved after two to three days of antibiotics.
Book an appointment for an itchy scaly rash or a changing nail.

Why clinical research matters for skin infections

Antibiotic resistance is the central problem: Canadian Family Physician already advises against clindamycin here because of resistance and the risk of Clostridioides difficile. Canadian emergency physicians built a national checklist because of high rates of intravenous antibiotic use, hospitalisation and treatment failure. Studies are testing shorter antibiotic courses, oral rather than intravenous routes, outpatient pathways, faster identification of the organism, and new antifungals and antivirals.

Taking part is voluntary, informed consent comes first, you can stop at any time without affecting your regular care, and no one can say in advance whether a study will help you.

Learn more from Canadian sources

Where this information comes from (6 sources)

This page is written in plain language for people considering clinical research. It is general health information, not medical advice, and it does not replace a conversation with your own doctor or nurse practitioner.

Common questions

How do I know whether a rash is infected or something else?

Often you cannot tell at home, and that is a genuine difficulty rather than a failure to look properly. Eczema, psoriasis, insect bites, contact reactions and problems with the veins in the legs can all look like a skin infection, and the Canadian Association of Emergency Physicians notes that several conditions are commonly mistaken for cellulitis. The features that point towards infection are spreading over hours to days, warmth, increasing tenderness, and feeling unwell or feverish with it. A clinician looking at the skin, sometimes marking the edge to see whether it advances, is what settles it.

Why will an antibiotic cream not fix my itchy scaly rash?

Because if the cause is a fungus, an antibacterial treatment has nothing to act on. Bacteria, fungi and viruses are different organisms and need different medicines. This is why identifying the group matters, and why the Canadian Dermatology Association states that the only accurate way to confirm a fungal nail infection is for a doctor to take a clipping or scraping and send it for microscopy and culture. Steroid creams can also make a fungal infection look better briefly while it spreads underneath.

Why would someone with a skin infection join a clinical trial?

Because antibiotic resistance is narrowing the options, and because Canadian emergency physicians documented high rates of intravenous antibiotic use, hospitalisation and treatment failure for these infections. Studies are testing shorter antibiotic courses, oral rather than intravenous treatment, outpatient pathways, faster ways to identify the organism, and new antifungal and antiviral agents. Taking part is voluntary, you give informed consent before anything begins, you can withdraw at any time without affecting your regular care, and no one can say in advance whether a study will help you personally.

What to do next

Talk to your doctor. This guide is information, not medical advice.
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Skin Infections

What a skin infection is, and what it is not

Signs and symptoms

What raises the risk

How skin infections are diagnosed in Canada

Treatment and day-to-day management

When to talk to a doctor

Why clinical research matters for skin infections

Learn more from Canadian sources

Common questions

Learn more about Skin Infections

Find a study

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