Rashes and Skin Infections in Southlake, TX

Skin problems are one of the most common reasons people come in and one of the easiest things to get wrong, because a great many conditions look similar and the treatments are completely different. The work of the visit is putting the rash in the right category.

What we treat here

• Cellulitis, the spreading bacterial skin infection that causes warmth, redness and tenderness. We treat uncomplicated cases and mark the border so we can tell whether it is improving.
• Abscesses and boils, drained in the office when they are small and straightforward.
• Shingles, which is time-sensitive and covered below.
• Contact dermatitis from plants, metals, soaps and adhesives.
• Eczema and seborrheic dermatitis.
• Fungal infections, including ringworm, athlete’s foot, jock itch and yeast in skin folds.
• Hives, including working out whether there is a trigger and whether it is acute or chronic.
• Impetigo, folliculitis and infected hair follicles.
• Insect bites and reactions, including tick bites and the decision about prophylaxis.
• Drug eruptions, which means going through everything you have started recently.

Shingles is a clock

A painful, burning, one-sided rash in a band that does not cross the midline is shingles until proven otherwise, and the pain often starts days before the rash appears.

Antivirals work best within 72 hours of the rash appearing. They shorten the illness and reduce the chance of postherpetic neuralgia, the lingering nerve pain that can persist for months and is genuinely difficult to treat.

Shingles involving the tip of the nose or around the eye can threaten vision and needs same-day ophthalmology involvement.

If you have had shingles, you should still have the vaccine. It reduces the chance of recurrence, and we can discuss timing.

Cellulitis, and what mimics it

Cellulitis is red, warm, tender and spreading, usually on one leg, often with a break in the skin somewhere as the entry point.

The most common mimic is stasis dermatitis, which affects both legs, is chronic, and does not respond to antibiotics. Two red legs are almost never bilateral cellulitis. Getting this right avoids repeated antibiotic courses for a condition that needs compression instead.

We mark the border with a pen and ask you to watch it. Spreading beyond the mark, fever, or worsening pain after 48 hours on antibiotics means come back the same day.

If you have diabetes, any foot infection gets taken more seriously and looked at sooner.

When we refer

Uncertain diagnosis, anything that could be a skin cancer, chronic conditions such as psoriasis or severe eczema needing systemic therapy, and any rash that has not responded to reasonable treatment.

We would rather send you to dermatology with a clear question than treat something for six weeks on a guess.

Red flags

Fever with a spreading rash. Blistering or skin peeling. Involvement of the mouth, eyes or genitals. Pain far out of proportion to appearance, which can signal a deep infection. Facial swelling or breathing difficulty.

Any of those means emergency care, not an appointment.

Same-day appointments are covered on our sick visits page. See our primary care Southlake practice overview.