Cellulitis of the leg

Overview

Cellulitis is a bacterial infection of the deeper layers of the skin. It is not the same as ‘cellulite’. It often affects one leg, causing the skin to become red, swollen, warm and painful.

Yes, cellulitis is a common infection, especially in adults.

Anyone can get cellulitis, but it is more common in people who have poor circulation, diabetes, leg swelling (lymphoedema), or a weakened immune system.

Symptoms

Common symptoms

• A red, swollen area on the leg that feels warm and tender to touch.
• The red area may spread quickly.
• Pain or discomfort in the affected leg.
• Feeling generally unwell, with fever or chills.

Symptoms in children

• Irritability or crying more than usual.
• Fever and feeling unwell.
• Limping or not using the leg normally.

Symptoms in older adults

• The typical redness and swelling may be less obvious.
• Confusion or drowsiness can be a sign of serious infection.
• Fever may be absent, but the leg is still red and painful.

Causes

Main causes

• Bacteria (most often Streptococcus or Staphylococcus) enter the skin through a break, such as a cut, scratch, insect bite, or area of athlete's foot.

Risk factors

• Having a skin condition like eczema or athlete's foot that causes cracks in the skin.
• Poor circulation in the legs (for example, from varicose veins or diabetes).
• Leg swelling (lymphoedema) or fluid buildup.
• A weakened immune system due to illness or medicine.
• Obesity.
• Previous cellulitis in the same leg.

When to see a doctor

See a doctor urgently if:

• If you have a red, swollen, painful area on your leg that is spreading quickly.
• If you have a fever and feel unwell along with the leg symptoms.
• If you have a condition that weakens your immune system and develop leg redness.
• If the infection is not improving after 48 hours of antibiotic treatment.

Book a routine appointment if:

• If you notice a red, warm, tender patch on your leg that is not improving with rest and basic care.
• If you have recurrent episodes of leg redness or swelling.
• If you have diabetes or poor circulation and develop any skin change on your leg.

Diagnosis

A doctor will examine your leg and ask about your symptoms and medical history. They will look for redness, swelling, warmth and tenderness.

Tests that may be done

• Often no tests are needed – the appearance of the leg is enough to diagnose cellulitis.
• Sometimes a blood test may be done to check for signs of infection.
• A swab of any open wound may be taken to identify the bacteria.

What to expect at your appointment

The doctor may draw a line around the red area to monitor if it spreads. They will usually prescribe antibiotics and explain how to care for your leg at home. If the infection is severe, they may recommend treatment in hospital.

Treatment

Cellulitis is treated with antibiotics. Mild cases can be managed at home, while severe infections may need hospital care and antibiotics given through a drip into a vein.

Self-care at home

• Rest the affected leg and keep it elevated (for example, on a stool or pillows) to reduce swelling.
• Keep the skin clean and dry.
• Apply a cool, damp cloth to the area to soothe discomfort.
• Take pain relief such as paracetamol or ibuprofen if you are able – always follow the medicine's instructions and ask a pharmacist if unsure.
• Drink plenty of fluids and eat well to help your body fight the infection.

Medical treatments

Antibiotics are the main treatment. For mild to moderate cellulitis, you will be given a course of oral (by mouth) antibiotics. For more serious infections, you may need to go to hospital and receive antibiotics through a drip (intravenously). Treatment usually lasts 5 to 10 days, but may be longer if needed. It is very important to finish the full course of antibiotics, even if you start feeling better.

When is surgery considered?

Surgery is rarely needed for cellulitis. However, if an abscess (a collection of pus) forms under the skin, a doctor may need to drain it. This is a simple procedure.

Living with this condition

During treatment, try to rest and keep your leg up as much as possible. This helps reduce swelling and pain. You can usually go back to your normal activities once the infection starts to clear, but take it easy until you feel fully recovered.

Lifestyle tips

• Take good care of your skin – keep it clean, moisturised and free of cracks.
• Treat any fungal infections like athlete's foot promptly with over-the-counter creams – ask your pharmacist for advice.
• If you have diabetes, keep your blood sugar under good control to help prevent infections.
• Wear comfortable shoes and loose clothing to avoid rubbing or injuring your skin.

Diet and exercise

A balanced diet rich in fruits, vegetables and protein supports your immune system. Staying active within your limits can improve circulation – gentle walking is usually fine once the acute infection is over.

Mental health and emotional wellbeing

Having cellulitis can be worrying, especially if it is severe or keeps coming back. You may feel anxious about your health or your leg’s appearance. It is normal to feel this way. Speak to your doctor or a counsellor if the worry becomes overwhelming.

Prevention

It is not always possible to prevent cellulitis, but you can lower your risk by taking care of your skin and treating any breaks or infections quickly. Keep your skin moisturised, treat athlete's foot, clean and cover cuts, and avoid insect bites where possible.

Complications

If left untreated

• The infection can spread deeper into the skin and cause an abscess.
• Bacteria might enter the bloodstream, leading to sepsis – a life-threatening condition.
• Chronic swelling of the leg (lymphoedema) can develop after repeated infections.

Long-term outlook

With prompt antibiotic treatment, most people recover fully from cellulitis. The skin may take several weeks to return to its normal colour and texture. Sometimes cellulitis can come back, but good skin care and managing any underlying conditions can reduce this risk. Your healthcare team will support you every step of the way.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.