15071 Cellulitis

Overview

Cellulitis is a common skin infection caused by bacteria. It affects the deeper layers of the skin and the tissue just beneath it, causing the area to become red, swollen, warm, and painful. It usually starts when a crack or break in the skin lets bacteria in.

Yes, cellulitis is one of the most common skin infections treated in primary care and hospitals.

Cellulitis can affect anyone, but you are more likely to get it if you have diabetes, circulation problems, a weakened immune system, or a skin wound such as a cut, ulcer, or insect bite.

Symptoms

Common symptoms

• Redness and swelling that spreads
• Warmth and tenderness in the area
• Pain or ache in the skin
• Fever or chills (sometimes)
• Tight, glossy, stretched-looking skin

Symptoms in children

• The same redness and swelling, often on the face or around a wound
• Fussiness, low energy, or a high temperature
• A swollen, tender area that may feel hot

Symptoms in older adults

• Redness may be harder to see on darker or thinner skin
• Confusion or feeling unusually sleepy can be a sign of infection
• The skin may break down into a blister or sore

Causes

Main causes

• Bacteria called Streptococcus or Staphylococcus
• Bacteria entering through any break in the skin: cuts, scrapes, insect bites, surgical wounds, ulcers, or cracked skin

Risk factors

• Diabetes, especially if blood sugar is poorly controlled
• Peripheral artery disease or poor leg circulation
• A weakened immune system (for example, from medicines or illness)
• Obesity
• Tight swelling in the legs (lymphoedema)
• Previous cellulitis
• Athlete's foot, eczema, or other skin conditions that cause cracked skin

When to see a doctor

See a doctor urgently if:

• Read the emergency and urgent lists above. If you have any of those symptoms, call your local emergency number or get urgent same-day medical help.

Book a routine appointment if:

• Make a doctor's appointment if you notice a red, warm, painful patch of skin that seems to be growing, especially if you have diabetes or a weak immune system.

Diagnosis

Your doctor will look at the affected skin and ask about your symptoms and medical history. Usually that is enough for a diagnosis.

Tests that may be done

• Sometimes blood tests to check for infection
• Sometimes a swab of the area if there is fluid or an open wound
• If the infection is severe or not getting better, imaging tests like an ultrasound can help see deeper problems

What to expect at your appointment

Your doctor will likely prescribe antibiotics and ask you to draw a line around the edge of the red area with a pen. That helps you both see if the infection is spreading or improving. They may also ask you to recheck the area daily and come back if it worsens.

Treatment

Cellulitis is treated with antibiotics, usually as a tablet or liquid you take by mouth. For more severe cases, you may need antibiotics through a drip in the hospital. It is very important to finish the full course of antibiotics, even if you feel better.

Self-care at home

• Keep the area raised if possible, for example rest a leg on a footstool
• Use simple pain relief only if your pharmacist or doctor recommends it
• Drink plenty of fluids
• Keep the area clean and dry
• Do not massage the area

Medical treatments

Your doctor will prescribe an antibiotic. The type and how you take it depend on how severe the infection is and other factors. Always take the full course as prescribed, even when the skin starts to look better. If there is an abscess (a pocket of pus), it may need to be drained by a doctor.

When is surgery considered?

In rare cases, if an abscess forms or dead tissue develops, a small surgical procedure may be needed to remove it. Most people with cellulitis do not need surgery.

Living with this condition

While you are recovering, rest and keep the area raised. Watch the area for any change. If the redness continues to spread beyond the line you marked, call your doctor promptly.

Lifestyle tips

• Keep your skin moisturized to prevent cracks
• Wear protective footwear, especially outdoors
• Manage long-term conditions like diabetes under your doctor's guidance
• If you have athlete's foot, treat it promptly

Diet and exercise

A balanced diet and gentle movement, as you feel able, help support your immune system. Follow your doctor's advice about resting the affected limb until the infection clears.

Mental health and emotional wellbeing

A visible skin infection can feel worrying or embarrassing. It's normal to feel anxious about treatment and recovery. Talk to your doctor if you are feeling overwhelmed.

Prevention

You can lower your risk by caring for your skin and treating breaks quickly. Keep wounds clean, use protective dressings, and wash your hands often.

Vaccines

There is no vaccine for cellulitis itself, but staying up to date with recommended vaccines helps prevent other infections that could lead to skin breaks or complications.

Complications

If left untreated

• Sepsis (a life-threatening reaction to infection)
• Abscess (a pocket of pus)
• Necrotizing fasciitis (a severe deep tissue infection, rare)
• Permanent swelling in the limb
• Returning episodes of cellulitis

Long-term outlook

With antibiotics, nearly everyone with cellulitis gets better within 7 to 14 days. Some people need a short hospital stay if the infection is severe. The outlook is very good when treatment starts early. Follow your doctor's instructions and do not skip doses.

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