17694 Cellulite

Overview

Cellulitis is a common bacterial skin infection that affects the deeper layers of the skin and the tissue just beneath it. It usually starts as a red, swollen, tender area that spreads over time. It is not the same as 'cellulite', which is the harmless dimpled skin often seen on thighs and buttocks.

Yes, cellulitis is fairly common. It can affect anyone, at any age.

Cellulitis can affect people of all ages, but it is more common in people with weakened immune systems, poor circulation, diabetes, or skin conditions like eczema. It also often happens after a cut, insect bite, burn, or surgical wound.

Symptoms

Common symptoms

• A warm, red, swollen, and tender area of skin that grows over time
• Skin that looks tight, shiny, or pitted like an orange peel
• Pain or tenderness in the affected area
• Sometimes a fever, chills, or feeling unwell

Symptoms in children

• Children may show the same signs as adults, but they might also be irritable, cry, or have a fever. Check for red, warm, or swollen skin, especially near a cut or sore.

Symptoms in older adults

• Older adults may notice confusion, drowsiness, or a sudden worsening of a skin wound. The red area can be harder to see on darker skin, so look for warmth, swelling, or tenderness.

Causes

Main causes

• Cellulitis happens when bacteria (usually streptococcus or staphylococcus) enter the skin through a crack, cut, puncture, insect bite, burn, or surgical incision.
• Rarely, bacteria can enter through skin that is dry and cracked, such as with athlete's foot.

Risk factors

• A break in the skin, such as a cut, bite, burn, or ulcer
• Skin conditions that cause cracks, like eczema or athlete's foot
• Poor circulation in the arms or legs (for example, from varicose veins or obesity)
• A weakened immune system due to diabetes, chemotherapy, or other health conditions
• Taking certain medicines that suppress the immune system
• Older age

When to see a doctor

See a doctor urgently if:

• If you have a red, painful, swollen area and a fever, see a doctor the same day.
• If a wound is increasing in size or redness quickly, seek medical care promptly.

Book a routine appointment if:

• If you have a skin wound that is not healing, or any unusual redness, swelling, or pain, make an appointment with your GP.

Diagnosis

A doctor will examine the affected area and ask about your symptoms, recent injuries, and medical history. In most cases, this is enough to diagnose cellulitis.

Tests that may be done

• No tests are needed for mild cases.
• Sometimes a doctor may order a blood test, or take a swab or sample from the wound if it is oozing.

What to expect at your appointment

The doctor may mark the edges of the red area with a pen to see if it is growing. This helps track whether treatment is working.

Treatment

Cellulitis is treated with antibiotics, usually taken by mouth. In more serious cases, you may need intravenous antibiotics (given through a drip) in the hospital. Always finish the full course of antibiotics, even if you feel better.

Self-care at home

• Rest the affected limb and raise it to reduce swelling.
• Ask your pharmacist about safe pain relief options if you are uncomfortable.
• Keep the skin clean and dry, and cover any open wound with a sterile dressing.
• Drink plenty of fluids.
• Watch the area daily for spreading redness or worsening symptoms.

Medical treatments

Antibiotics are the main treatment. Your doctor will choose the type of antibiotic that matches the likely bacteria. If the infection is extensive, deep, or you have severe symptoms, you may need intravenous antibiotics in the hospital. If an abscess (a pocket of pus) forms, a doctor may need to drain it. Never share antibiotics or take leftover medicine.

When is surgery considered?

Surgery is only rarely needed. If an abscess forms, a doctor or surgeon may make a small cut to drain the pus.

Living with this condition

While you are being treated, rest and keep the affected area raised. Follow your doctor's instructions and finish all antibiotics. If the infection does not improve within 48 hours, contact your doctor.

Lifestyle tips

• Manage underlying conditions like diabetes or poor circulation.
• Keep your skin well-moisturised to prevent cracking.
• Wear supportive footwear to avoid blisters and cuts.
• Treat athlete's foot promptly because it can let bacteria into the skin.

Diet and exercise

A balanced diet and regular physical activity can help you maintain a healthy immune system and good circulation. Both support healing and overall health.

Mental health and emotional wellbeing

Dealing with an infection can be uncomfortable and worrying. It is normal to feel anxious. Talk to your doctor if you are feeling overwhelmed or need extra support.

Prevention

You can lower your chances of cellulitis by protecting your skin and treating any breaks or infections quickly.

Vaccines

Keeping your tetanus vaccination up to date is a good idea if you have a skin wound. There is no vaccine that prevents cellulitis directly, but staying up to date on recommended vaccines can help keep your immune system strong.

Screening programmes

There is no routine screening for cellulitis in healthy people. Early attention to skin wounds is the best way to avoid problems.

Complications

If left untreated

• The infection may spread into deeper tissues, the bloodstream, or lymph nodes.
• A pocket of pus (abscess) can develop that needs draining.
• Rarely, the infection can lead to sepsis, a life-threatening emergency.

Long-term outlook

With prompt diagnosis and antibiotic treatment, cellulitis usually improves within 7 to 10 days. Most people recover completely without lasting problems. Serious complications are rare when treatment starts early.

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