Cellulitis

CELLULITIS: OVERVIEW

What is cellulitis?

Cellulitis is a common and potentially serious infection caused by bacteria. The bacteria infect the deep layers of skin and tissue beneath the skin.

The first sign of cellulitis is usually red and swollen skin. When you touch the infected area, it often feels warm and tender.

This infection can show up anywhere on the skin. Adults often get it in a lower leg. In children, cellulitis tends to appear on the face or neck.

While cellulitis often develops in a leg, redness and swelling in both legs usually means you have another condition. You could have stasis dermatitis or contact dermatitis.

If you think you have cellulitis, you should get immediate medical care. Caught early and treated, cellulitis usually clears completely without causing any long-term problems.

Without treatment, the infection can spread quickly. The bacteria may travel to lymph nodes and into the bloodstream. This can lead to a blood infection or permanently damage lymph vessels, which are part of your immune system. Other complications can also develop.

When treated before complications occur, most people recover fully. Caught early, your doctor can treat it with oral (take by mouth) antibiotics and good wound care.

After starting treatment for cellulitis, you should notice improvement in 24 to 48 hours. If you don’t, call your doctor’s office. Severe cellulitis may require you to be treated in a hospital.

CELLULITIS: SIGNS AND SYMPTOMS

If you have cellulitis, you’ll notice that the affected area of your body is red and swollen. It may be difficult to tell where the redness ends and normal-looking skin begins. When you touch the area, it feels warm. Pressing on the warm, hard, and swollen skin is often painful.

Before you notice signs on your skin, you may feel ill. Some people have a fever, chills, or fatigue. These are all signs of an infection. If you have a severe infection, you may also have intense pain, cold sweats, nausea, drowsiness, or trouble concentrating.

When the infection is severe, some people develop blisters on the red, swollen skin. The lymph nodes nearest the infection may feel swollen. You may see a streak of red in the area, an open sore, or a pus-filled bump.

People who have severe cellulitis may have a rapid heartrate, low blood pressure, or trouble concentrating.

Where cellulitis develops

Cellulitis can appear anywhere in the body. Adults, however, usually get it on a leg or foot. Children often have cellulitis on their face or neck. Intravenous drug users tend to develop it on an arm or part of their body that they frequently inject.

CELLULITIS: CAUSES

Who gets cellulitis?

Cellulitis is common, and anyone can get this infection. It’s estimated that 14.5 million cases of cellulitis are diagnosed in the United States each year.

The number of people who get cellulitis is expected to grow. That’s because more people than ever have an increased risk because they are:

• Middle-aged or older
• Overweight or obese
• Diabetic, especially if the diabetes is poorly controlled

All of these decrease the body’s ability to fight an infection.

What causes cellulitis?

Bacteria cause cellulitis. Streptococcus (strep) and Staphylococcus (staph) are responsible for most cases of cellulitis. MRSA (methicillin-resistant Staph aureus) and other bacteria can also cause cellulitis.

Many of these bacteria live on our skin without causing a problem. Once they get inside the body, however, they become harmful.

The bacteria may get inside the body when we injure our skin. An injury can be obvious, such as an open sore or severe burn. Cuts, scratches, and abrasions also provide a way for the bacteria to get inside.

Cracks in the skin offer another way for the bacteria to get in. People who have eczema, athlete’s foot, or very dry skin often have deep cracks in their skin. Bacteria can get into the body through these cracks.

Of course, not everyone who has a skin injury or deep cracks will get cellulitis. The body’s immune system works hard to destroy the harmful bacteria.

What increases the risk of getting cellulitis?

If any of the following apply to you, you have a higher risk.

Diseases and treatments: The following can increase your risk because they either make it easier for bacteria to get inside your body or harder for your body to fight the bacteria:

• Athlete’s foot
• Atopic dermatitis (eczema)
• Cellulitis (already had)
• Chemotherapy (undergoing)
• Corticosteroids (taking)
• Diabetes (poorly controlled)
• HIV or AIDS
• Kidney disease (long-term)
• Liver disease (long-term)
• Lymphedema
• Medicine taken to prevent rejecting a transplanted organ
• Poor circulation and a related condition like stasis dermatitis or a leg ulcer
• Surgery (recent)

Athlete’s foot can cause tiny cracks in the skin. When bacteria get into the body through these cracks, cellulitis tends to appear in the calf. Treating athlete’s foot early can prevent this.

People who frequently injure their skin: Research shows that the following people, who tend to have more skin injuries, often have a higher risk of getting cellulitis:

• Athletes
• Children
• Drug abusers who use needles to inject drugs
• Military personnel on active duty
• Prisoners
• Residents in a long-term care facility

How is cellulitis diagnosed?

We don’t have a medical test that can diagnose cellulitis. Doctors diagnose it by examining the infected skin and asking questions.

Be sure to tell your doctor about:

• A recent injury to your skin
• All medical conditions you have
• All medications you take

This information can help make sure you get the treatment you need and prevent problems.

To get an accurate diagnosis, some patients need:

Medical tests: While a test cannot tell whether you have cellulitis, testing can tell what germs are causing an infection.

A referral to a dermatologist: If you are seeing a doctor other than a dermatologist, you may be sent to a dermatologist. Cellulitis can look like other skin conditions and infections.

Dermatologists have extensive training in diagnosing the many conditions that can look like cellulitis. An accurate diagnosis is essential to clear your skin condition.

How is cellulitis treated?

If you are diagnosed with cellulitis, treatment is important. It can prevent cellulitis from worsening. It can help you avoid serious medical problems like blood poisoning and severe pain.

To treat cellulitis, doctors prescribe:

Antibiotics: An oral (you take by swallowing) antibiotic can effectively clear cellulitis.

The type of antibiotic you need and how long you’ll need to take it will vary. Most people take an antibiotic for 7 to 14 days. If you have a weakened immune system, you may need to take the antibiotic for longer.

Some people need to take more than one type of antibiotic.

Sometimes, the antibiotic is given through an IV. When this is necessary, a hospital stay is often prescribed. This can help clear severe cellulitis or cellulitis on the face. Most people are hospitalized for just over 1 week.

Wound care: This is an important part of treating cellulitis. Covering your skin will help it heal. If you need special wound coverings or dressings, you’ll be shown how to apply and change them.

Rest: This can help prevent cellulitis from becoming serious and help your body heal.

Elevation: If you have cellulitis in your leg, keeping your leg elevated can help reduce the swelling and help you heal.

Treatment for another medical condition: If the bacteria got into your body because you have another skin condition like athlete’s foot, it’s important to treat that condition, too.

What is the outcome for someone who gets cellulitis?

With treatment, you should quickly start to see less redness, swelling, pain, and warmth.