Cellulitis
Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on May 15, 2018 — Written by Bree Normandin
Cellulitis is a common bacterial skin infection. Cellulitis may first appear as a red, swollen area that feels hot and tender to the touch. The redness and swelling often spread rapidly. Cellulitis is usually painful.
In most cases, the skin on your lower legs is affected, although the infection can occur anywhere on your body or face. Cellulitis usually affects the surface of your skin, but it may also affect the underlying tissues. Cellulitis can also spread to your lymph nodes and bloodstream.
If cellulitis isn’t treated, the infection might become life-threatening. You should get medical help right away if you experience the symptoms of cellulitis.
The symptoms of cellulitis may include:
- pain and tenderness in the affected area
- redness or inflammation of your skin
- a skin sore or rash that appears and grows quickly
- a tight, glossy, swollen appearance of the skin
- a feeling of warmth in the affected area
- a central area that has an abscess with pus formation
- a fever
Some common symptoms of a more serious cellulitis infection are:
- shaking
- chills
- a feeling of illness
- fatigue
- dizziness
- lightheadedness
- muscle aches
- warm skin
- sweating
Symptoms such as the following could signal that cellulitis is spreading:
- drowsiness
- lethargy
- blistering
- red streaks
You should contact your doctor immediately if any of these symptoms occur.
Cellulitis occurs when certain types of bacteria enter through a cut or crack in the skin. Cellulitis is commonly caused by Staphylococcus and Streptococcus bacteria.
Skin injuries such as cuts, insect bites, or surgical incisions are commonly the sites of the infection. Certain factors also increase your risk of developing cellulitis.
Common risk factors include:
- a weakened immune system
- skin conditions that cause breaks in the skin, such as eczema and athlete’s foot
- intravenous (IV) drug use
- diabetes
- a history of cellulitis
Your doctor will likely be able to diagnose cellulitis on sight, but they’ll perform a physical exam to determine the extent of your condition. This exam might reveal:
- swelling of the skin
- redness and warmth of the affected area
- swollen glands
Depending on the severity of your symptoms, your doctor may want to monitor the affected area for a few days to see if redness or swelling spread. In some cases, your doctor may perform a blood draw or a culture of the wound to test for the presence of bacteria.
Your doctor will usually prescribe a 10- to 21-day regimen of oral antibiotics to treat your cellulitis. The length of your treatment with oral antibiotics will depend on the severity of your condition.
Even if symptoms improve within a few days, it’s important to take all of the medication prescribed to ensure proper treatment.
While you’re taking antibiotics, monitor your condition to see if symptoms improve. In most cases, symptoms will improve or disappear within a few days.
Your doctor may also prescribe pain relievers.
You should rest until your symptoms improve. While you rest, raise the affected limb higher than your heart to reduce any swelling.
Contact your doctor immediately if you don’t respond to treatment within three days after beginning a round of antibiotics, if your symptoms get worse, or if you develop a fever.
Cellulitis should go away within 7 to 10 days of starting antibiotics. Longer treatment could be necessary if your infection is severe. This can occur if you suffer from a chronic disease or if your immune system isn’t working properly.
People with certain preexisting medical conditions and risk factors may need to stay in the hospital for observation during treatment. Your doctor may advise hospitalization if you have:
- a high temperature
- high blood pressure
- an infection that doesn’t improve with antibiotics
- a compromised immune system due to other diseases
You may also be hospitalized if you require IV antibiotics when oral antibiotics don’t work.
Sometimes cellulitis can spread throughout the body, entering the lymph nodes and bloodstream. In rare cases, it can enter into deeper layers of tissue. Potential complications that can occur are:
- a blood infection
- a bone infection
- an inflammation of your lymph vessels
- tissue death, or gangrene
If you have a break in your skin, clean it immediately and apply antibiotic ointment regularly. Cover your wound with a bandage and change it daily, until a scab forms. Watch your wounds for redness, drainage, or pain. These symptoms could indicate an infection.
People with poor circulation or who have preexisting conditions that put them at risk for cellulitis should take extra precautions, including:
- keeping skin moist to prevent cracking
- promptly treating superficial skin infections, such as athlete’s foot
- wearing protective equipment when working or playing
- inspecting feet daily for signs of injury or infection