Cellulitis

Cellulitis is a common bacterial infection that affects your skin and the tissues beneath it. It causes pain, swelling and skin discoloration. It may also cause flu-like symptoms, such as fever and body aches. It can affect any area of skin. But it most commonly affects the legs.

Without treatment, cellulitis (pronounced “sel-yuh-LYE-tis”) can lead to serious illness if the infection spreads. This includes sepsis.

Healthcare providers can treat most cases of cellulitis with oral antibiotics. But in severe cases, you may need treatment at a hospital.

Symptoms of cellulitis

The infection can affect skin anywhere on your body. But you’re more likely to have it in your legs, feet and toes. The affected area of your skin may feature symptoms like:

• Pain or tenderness
• Swelling
• Warmth
• Discoloration (red, purple or slightly darker than your usual skin color)
• Blisters
• A pocket full of pus (abscess)
• Lumpy or pitted skin, like an orange peel

You may also have flu-like symptoms, including fever, chills, sweats, body aches and fatigue.

If cellulitis affects the skin around one or both of your eyes (orbital cellulitis or periorbital cellulitis), it may cause symptoms like:

• Swollen eyelids
• Bulging of your eyes
• Pain or difficulty moving your eyes
• Trouble seeing

What is the main cause?

Many different bacteria can cause cellulitis. But Streptococcus (strep) and Staphylococcus (staph) cause most cases.

The bacteria usually enter your body through skin breaks. These may include:

• Insect bites
• Scrapes
• Cuts
• Burns
• Surgical wounds

It isn’t usually contagious (communicable). But in rare cases, you may be able to get cellulitis if you have an open wound and have skin-to-skin contact with an infected person’s open wound.

Types

Your healthcare provider may classify cellulitis as purulent or nonpurulent:

• Purulent cellulitis: The group of bacteria Staphylococcus aureus usually causes this type. “Purulent” means pus is present.
• Nonpurulent cellulitis: Streptococcus bacteria usually cause this type. Pus usually isn’t present. Most cases of cellulitis are nonpurulent.

Risk factors

You’re more likely to have cellulitis if you have:

• A skin break
• Certain skin conditions that cause skin breaks, like eczema or athlete’s foot
• A weakened immune system
• Had cellulitis in the past
• Long-term swelling in your arms, hands, legs or feet
• Diabetes
• Poor circulation
• A body mass index (BMI) greater than 25 (have overweight/obesity)

Complications

Without treatment, cellulitis may lead to serious complications, such as:

• Bloodstream infection (bacteremia)
• Heart inflammation (endocarditis)
• Bone infection (osteomyelitis)
• Flesh-eating disease (necrotizing fasciitis)
• Toxic shock syndrome
• Sepsis

These conditions can cause permanent damage. Some may even be fatal.

How long before it turns into sepsis?

It depends. But in severe cases, cellulitis can cause life-threatening complications in a few hours.

Sepsis is a medical emergency. Get immediate medical help if you have cellulitis and develop sepsis symptoms like:

• A body temperature above 101 degrees Fahrenheit (38.3 degrees Celsius) or below 96.8 F (36 C)
• Rapid heartbeat
• Trouble breathing
• Confusion or dizziness

How doctors diagnose cellulitis

A healthcare provider will:

• Review your medical history
• Ask about your symptoms
• Perform a physical exam

Often, your provider can make a cellulitis diagnosis just by looking at the affected area. But if you have symptoms of a severe infection, they may recommend tests to make sure it hasn’t spread. These may include:

• Blood tests to see if you have a blood infection
• Skin tests or a bacterial culture to identify the type of bacteria and prescribe the best antibiotic

How is cellulitis treated?

Your healthcare provider will usually prescribe oral antibiotics. Be sure to finish the full course of medicine. If you don’t, cellulitis can come back and become more challenging to treat. Common antibiotics for cellulitis include:

• Dicloxacillin
• Cephalexin

In severe cases, you may need intravenous (IV) antibiotics to get rid of cellulitis. This is when your provider gives you antibiotics directly into a vein.

Cellulitis won’t go away on its own. If you have symptoms, reach out to a provider for an official diagnosis and treatment.

Recovery time

Most people recover from cellulitis within a week to 10 days after starting antibiotics.

Cellulitis symptoms should start to improve a few days after starting antibiotics. But swelling and pain may last for over a week.

When should I see my healthcare provider?

Reach out to your healthcare provider if you have cellulitis symptoms, including pain, swelling and warmth.

It’s also a good idea to use a pen or marker to outline the affected area. Contact your provider again if the infection spreads beyond the outline or you don’t start to feel better a few days after starting antibiotics.

What can I expect if I have cellulitis?

With an early diagnosis and treatment, the outlook for most people is good. You should feel better after about a week.

It’s important to take cellulitis seriously. It can quickly get worse and cause severe complications. Some complications can be fatal.

Is there anything I can do to feel better?

The following home treatments can help reduce cellulitis symptoms and make you feel better faster:

• Applying a warm compress to your affected area to help reduce swelling
• Elevating the affected area to help lower blood pressure and improve blood flow
• Wearing compression wraps or stockings to help reduce swelling and improve blood flow
• Taking over-the-counter pain relievers like NSAIDs or acetaminophen

Can cellulitis be prevented?

You can help reduce your risk of developing an infection by:

• Cleaning any skin wounds with antibacterial soap and clean water
• Applying an antibiotic ointment on any skin wounds
• Covering wounds with a clean bandage to protect them from dirt or bacteria
• Cleaning and trimming your nails
• Showering regularly and thoroughly drying afterward
• Not touching or rubbing the affected area
• Seeing your healthcare provider right away for any deep cuts