What Is Cellulitis?
Cellulitis is a common bacterial infection of the skin and the soft tissues underneath. It can become serious if left untreated. Cellulitis can cause swelling, redness, pain, or warmth in the skin.
Cellulitis can develop from a break or cut in the skin. A cellulitis infection typically affects the lower legs but can occur in the face, arms, and other parts of the body. Left untreated, the infection can spread into the bloodstream and become life-threatening.
Erysipelas vs. cellulitis
Erysipelas is another type of skin infection. Both erysipelas and cellulitis cause the same symptoms -- red, warm, and swollen skin. The two conditions can be hard for even doctors to tell apart. One difference is that cellulitis affects deeper layers of skin than erysipelas does.
Lymphedema and cellulitis
The lymphatic system is a network of vessels that's part of your immune system. These vessels carry a fluid called lymph that flushes bacteria out of your body to prevent infections.
Lymphedema is swelling under the skin caused by a buildup of lymph fluid. It happens when damage or a blockage in the lymphatic system prevents lymph fluid from draining.
You're more likely to get cellulitis if you have lymphedema. That's because a damaged lymph system can't protect you as well against infections.
Cellulitis vs. abscess
Cellulitis is a bacterial infection of the skin that can cause redness, pain, and swelling at the infection site.
An abscess has similar symptoms as cellulitis but is a collection of pus under the skin. A doctor’s care is sometimes required to drain the pus from the abscess, and they may prescribe antibiotics to continue treatment after it's drained.
Cellulitis Causes
Cellulitis happens when there's a break in the skin and bacteria get inside. It usually shows up on damaged skin such as inflamed wounds, dirty cuts, and areas with poor blood circulation.
Although many different types of bacteria cause cellulitis, the two most common types are Group A streptococcus and Staphylococcus aureus. These bacteria live on your skin and underneath your fingernails.
Bacteria get into a cut or tear in the skin from:
- An injury
- Surgery
- A skin condition such as eczema, athlete's foot, or psoriasis
- Foreign objects in the skin
- Open wounds underneath the skin
Is cellulitis caused by poor hygiene?
Breaks in the skin are the most common cause of cellulitis. But it can also happen in areas that aren't clean. To lower your risk, wash your hands with soap and water before you touch your skin. Shower regularly and put on clean clothes. Also, clean any wounds to prevent bacteria from getting inside.
Is cellulitis contagious?
Cellulitis isn't contagious. Usually, it doesn't pass from one person to another. The only way it might spread is if one person has an open wound that directly touches another person's open wound.
Types of Cellulitis
Common parts of the body affected by cellulitis are your legs, feet, toes, arms, hands, and fingers. Doctors also label types of cellulitis based on where the infection starts, including:
Periorbital cellulitis
This is an infection of the eyelid or the skin around the eye. It's most common in children. The cause is often an injury or sinus infection. Periorbital cellulitis usually isn't serious. Most children with this infection get better after they take antibiotics for about a week.
Orbital cellulitis
Orbital cellulitis is less common than the periorbital type, but it can be more serious. Like periorbital cellulitis, it starts when bacteria spread from an injury or sinus infection into the eye. But in this case, the bacteria get deeper into the fat and muscles of the eye. Orbital cellulitis can cause blindness without treatment.
Perianal cellulitis
This infection mainly affects children under 10. It starts in the perineum, the area between the anus and the scrotum in boys, or between the anus and vulva in girls. Strep bacteria most often cause perianal cellulitis.
Facial cellulitis
Cellulitis can affect the face, although a skin infection on the face is more likely to be from erysipelas. Facial cellulitis happens when bacteria spread to the face from a(n):
- Ear infection
- Gum infection
- Injury
- Insect bite
- Sinus infection
Breast cellulitis
Breast cellulitis is an infection of the breast. It happens when bacteria build up in the sweat underneath the breasts. The skin of the breast becomes red, warm, and swollen. Some people also have flu-like symptoms such as fever and chills.
You're more likely to get breast cellulitis if you:
- Are overweight
- Have large breasts
- Had surgery or radiation therapy to treat breast cancer
Cellulitis in the breast can spread quickly if you don't treat it.
Cellulitis from a bug bite
Insects don't transmit the bacteria that cause cellulitis through their bites or stings. However, the break in your skin from a bite or sting gives the bacteria a way to enter your body and cause an infection. The bacteria that cause cellulitis live on your skin and in your nose and mouth even if you're healthy.
Common Cellulitis Locations
Cellulitis most commonly shows up in the lower legs but can occur anywhere in the body. Some examples include:
Cellulitis on toes
Cellulitis on your toes can cause the skin to become swollen, red, painful, and warm to the touch. Flaking and peeling skin and blisters can happen, too. Cellulitis on the toes happens for a variety of reasons, but especially if you have athlete’s foot, diabetes, or poor circulation.
Cellulitis on legs
Cellulitis on your legs can appear as peeling, pitted, or blistered skin and can cause the skin to become red, swollen, and/or warm to the touch.
Cellulitis in eyes
Cellulitis in your eyes, or orbital cellulitis, can infect the skin, fat, and muscles around the eye, causing a bulging or swollen eyelid and redness. Orbital cellulitis is rare but can become severe and cause long-term problems, including blindness.
Periorbital cellulitis, occurring in the skin around your eye, is more common in younger children. Still, it's important to treat it before it spreads and becomes the orbital type.
Facial cellulitis
Cellulitis on your face can happen when bacteria enter through a break in your skin. Symptoms include swollen, red, and painful skin along with tenderness, bruising, or discoloration.
For all cellulitis cases, the infection can spread if symptoms aren't treated.
Cellulitis Symptoms
Cellulitis symptoms usually start with a small area of skin that's red, swollen, tender, and warm. The skin may be pitted like an orange peel or develop blisters. You may have a fever and chills.
Other common symptoms include:
- A sore or rash that grows quickly
- Warmth
- Pain or tenderness
- Tiredness
- Yellow, clear fluid or pus leaking from the area
Get medical help for any of these more serious symptoms:
- High fever (100.4 F or higher)
- Nausea and vomiting
- Shaking chills (rigors)
- Growing or hardening of the reddened area
- Increased pain
- Numbness when you touch the area
- Dizziness
- Confusion
Is cellulitis itchy?
Cellulitis doesn't generally itch. However, your skin can itch as it begins to heal during treatment.
Is cellulitis painful?
Cellulitis is frequently painful. Pain at the site, swelling, and skin that is hot to the touch are some of the most common symptoms of cellulitis.
Cellulitis Risk Factors
You’re more likely to get cellulitis if you:
- Have an injury to the skin
- Have a weak immune system from diabetes, cancer such as leukemia, or HIV/AIDS
- Have circulatory problems, such as insufficient blood flow to your arms and legs, poor drainage of your veins or lymphatic system (lymphedema), or varicose veins -- twisted, enlarged veins near the surface of the skin
- Had chickenpox or shingles
- Had cellulitis in the past
- Have a skin condition such as eczema, psoriasis, or athlete's foot
- Have liver disease such as chronic hepatitis or cirrhosis
- Are overweight
- Had a coronary artery bypass graft procedure
Cellulitis Diagnosis
Often doctors can diagnose cellulitis based on how your skin looks. Your doctor will ask about your symptoms and examine your skin. You might need a blood test to rule out other conditions with similar symptoms. Other procedures could include:
X-ray. This is used to see if there’s a foreign object in your skin or if the bone underneath is possibly infected.
Bacterial culture. Your doctor will use a needle to remove fluid from the area and send it to the lab.
Cellulitis Complications
Rarely, the infection can spread and cause complications such as:
- Bacteremia, a blood infection
- Endocarditis, an infection of the inner linings of the heart's valves and chambers
- Osteomyelitis, a bone infection
- Sepsis, an extreme whole-body response to infection
- Toxic shock syndrome, a life-threatening condition caused by bacterial toxins
- Suppurative arthritis, an infection in a joint
- Necrotizing fasciitis, an infection that destroys tissue under the skin
Get medical help right away if you have cellulitis along with any of the following symptoms:
- A large area of skin that's red and inflamed
- Numbness, tingling, or other changes in the affected area
- Skin that has turned black
- A red and swollen area around your eyes or behind your ears
Cellulitis Treatment
While treating cellulitis, the goal is to get rid of the bacteria that caused the infection. Usually, the way to do that is with antibiotics.
Cellulitis antibiotics
Cellulitis treatment usually includes an antibiotic such as dicloxacillin or cephalexin, which you take by mouth for 5 days (or longer if specified). Which antibiotic you need will depend on what type of bacteria caused your cellulitis.
Take the full course of antibiotics even if you feel better. You may need to take antibiotics for 7-14 days or longer if you have a weakened immune system. Some people need more than one type of antibiotic.
What are the signs that cellulitis is healing?
Once treatment has begun, symptoms of cellulitis will begin to go away. Redness will ease, swelling will go down, and discoloration will fade.
You may get treatment in a hospital if:
- Cellulitis doesn't get better after a few days of taking antibiotic pills.
- It covers a large area of your body.
- You have a weak immune system.
- The infection is around your eyes.
The hospital can give you antibiotics right into one of your veins (IV treatment). You may need to stay in the hospital for a few days if you have a serious case of cellulitis.
Cellulitis home remedies
Take care of your wound. Keep it covered to help it heal faster. Your doctor will let you know if you need to put special dressings or medicines on the infected area.
Here are some other ways to manage cellulitis at home:
- Prop up the part of your body with cellulitis. This will relieve swelling and help the infection heal.
- Hold a warm compress to your skin in the affected area.
- Wear a compression wrap or stocking to bring down swelling and improve blood flow.
- Ask your doctor if you can take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) pain reliever such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve) to keep you comfortable.
How long does cellulitis last?
With treatment, cellulitis can last 7-10 days, or longer if there are complications. Patients with a weakened immune system can take longer to recover.
Cellulitis Surgery
Most of the time, antibiotics are enough to treat cellulitis. Surgery usually isn't necessary, unless your doctor needs to open and drain an abscess or remove pus that has collected in the tissue. They may also cut away dead tissue to help the area heal.
Cellulitis Prevention
Use these tips to avoid cellulitis:
- Practice good personal hygiene, and keep your skin clean.
- Rub a lotion or moisturizer onto your skin to prevent cracks.
- Wear sturdy, well-fitting shoes or slippers with loose-fitting cotton socks. Don’t walk barefoot outdoors.
- Keep your wounds clean. Wash the wound every day with soap and water and cover it with a fresh, clean bandage. Watch for signs of infection such as redness and pus.
- Trim your nails carefully to avoid injury.
- If you have diabetes, check your feet every day for sores you might not feel. Quickly treat any injuries or infections.
- Manage conditions that can cause cellulitis, such as eczema, athlete's foot, and lymphedema.
- To prevent insect bites, use an insect repellent approved by the Environmental Protection Agency (EPA). Wear a long-sleeved shirt and pants when you go outside in areas where there are biting insects.
- Clean insect bites with soap and water. Apply an antibiotic ointment if the skin is broken. Cover the bite with a bandage to keep it clean and prevent yourself from scratching it.
Some injuries are more likely to cause cellulitis than others. See your doctor if you have:
- Animal or human bites
- Puncture wounds deeper than 1/2 inch, such as from stepping on a nail
- Crushed tissue that bleeds
- Burns that blister
- Frostbite
- Deep injuries with dirt in them
- Injuries that touch seawater (making them more prone to infection), especially if you have liver disease
- Diabetes or other major medical conditions, such as liver or kidney disease
- Swelling in your arms and legs that does not go away
Cellulitis Outlook
Cellulitis should go away after you take antibiotics as prescribed. You may need to take antibiotics for longer than a week if the infection is serious.
In rare cases, cellulitis can spread through the bloodstream and cause more serious problems, such as a heart infection or blood infection. You may need treatment in a hospital if that happens.
Takeaways
Cellulitis is a common bacterial infection of the skin that can occur all over the body but most commonly appears in the lower legs. Symptoms include redness, swelling, and skin that is warm to the touch. If left untreated, cellulitis can become serious and spread to the bloodstream. Treatment usually involves a course of antibiotics that clears up symptoms within 7-10 days.
Cellulitis FAQs
Is cellulitis very serious?
Cellulitis is a bacterial infection of the skin and not usually serious if treated. Most forms of cellulitis, which can occur all over the body, clear up following a course of antibiotics.
Some types, such as cellulitis in the eye, can be very serious and can cause blindness. If your case of cellulitis isn't treated, it also can spread to your lymph nodes and bloodstream, which can be life-threatening.
What is the fastest way to get rid of cellulitis?
The fastest way to treat cellulitis is to see a doctor and receive a course of antibiotics to take care of the infection.
What are the warning signs of cellulitis?
The most common warning signs of cellulitis are patches of skin that are swollen, red, painful, and warm to the touch. Cellulitis most commonly occurs in the lower legs but can appear all over the body, including the toes, arms, face, and belly. Flaky, dimpling, or pitted skin around the swollen site can also be a warning sign.
What are the red flags of cellulitis?
Symptoms of cellulitis include skin that becomes painful, swollen, red, and warm to the touch, especially in the lower legs. Red flags that mean you should see a doctor immediately for treatment include:
- Fever and increased pain at the infection site
- Nausea or vomiting
- Shaking chills (rigors)
- Growing or hardening of the reddened area
- Numbness when you touch the area
- Dizziness
- Confusion