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What Is Cellulitis?

Diabetics are at greater risk for developing cellulitis.
Open wounds can allow bacteria to get inside, leading to cellulitis.
Those who need regular IV therapy or who are IV drug users are at risk for cellulitis.
Those with chicken pox can be vulnerable to cellulitis.
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  • Originally Written By: Tricia Ellis-Christensen
  • Revised By: Patti Kate
  • Edited By: Niki Foster
  • Last Modified Date: 21 October 2014
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Cellulitis is an infection in the deepest layers of the skin. It typically begins when an injury isn't cleaned well, allowing bacteria to get inside and multiply. The area usually becomes swollen and red. If not treated early, the infection can spread throughout the body with serious and even fatal consequences. Cellulitis should not be confused with cellulite, which is a dimpling in the skin caused by deep layers of fat.

Signs and Symptoms

Skin that is infected often becomes inflamed — meaning that it swells up — and feels tight. It may be tender and hurt when it is touched. The skin also typically feels warm, both to the person who has the infection and to someone touching the area. The infected area often looks glossy, as the skin is pulled tight, and turns red or develops a rash of small red dots, which can spread as the infection advances. If the lymphatic system becomes infected, red lines or streaks may appear on the skin.

Someone with cellulitis may experience other symptoms that don't seem directly related to the infected area. A fever and chills often accompany any type of infection, as do muscle aches. As the infection advances, the lymph nodes may become swollen as well. Cellulitis often spreads very quickly, so these symptoms may develop and spread over just a day or two.

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Causes

Cellulitis most often occurs when a cut in the skin is not cleaned completely, or if it is not covered and cared for properly. The bacteria that is often present on normal skin cells or in the environment can then get inside, invading the lowest layers of the skin. The most common bacteria that cause infections of this type are Streptococcus (strep) and Staphylococcus (staph).

This type of bacterial infection is not usually contagious because it affects the deeper layers of the skin. A person with an open wound can pick up the bacteria from another person, however, even if that bacteria is not making the other person sick.

Diagnosis

Anyone who has an injury that appears red and swollen should see a healthcare professional immediately. He or she will examine the area, and may take a sample to identify the specific bacteria causing the infection. The medical provider may also run a blood test to rule out other conditions, like deep vein thrombosis or gout, that have similar symptoms.

Risk Factors

While anyone who has a cut, puncture, or burn may develop cellulitis if the wound is not cared for correctly, people who are obese may be more vulnerable to infection. People with diabetes, who are more likely to experience ulcers and other open wounds on the legs and feet, are also at greater risk for infection. People with a weak immune system, such as those with HIV/AIDS or leukemia, are also less likely to be able to fight off the initial infection, leaving them open to more serious complications.

Any condition that can lead to open sores or punctures in the skin can also add to a person's risk of developing this type of infection. People who need regular intravenous (IV) therapy or who are IV drug users are at risk. Anyone with chicken pox may be vulnerable, if the pocks are scratched, as may those with chronic lymphedema, in which the skin swells and cracks. Even a seemingly minor condition, like athlete's foot, can be a risk factor when it leads to breaks in the skin. Spider bites, particularly those from the brown recluse, may cause immediate infection.

Treatment

Cellulitis is treated with antibiotics to kill the bacteria causing the infection. Depending on the type of bacteria and how advanced the infection is, the medication may be given by mouth or by IV. Serious cases, in which the infection has spread throughout the skin or into other parts of the body, may require hospitalization. In less serious cases, oral antibiotics usually work in one to two weeks.

Pain relievers and anti-inflammatory medications can be taken to relieve the pain and swelling associated with this condition. Cool compresses placed over the area can also help, as can keeping the affected body part elevated so that the swelling doesn't get worse.

Prognosis

When caught early, cellulitis can be treated relatively easily and often with few long-term problems. If left untreated, however, this infection can spread and kill the sufferer in a relatively short period of time. People who have diabetes, fungal infections, or another condition that can damage the skin are more likely to develop an infection multiple times, as are people who don't get treatment early.

Complications

This skin infection spreads quickly and can lead to more serious complications, including endocarditis, an inflammation of the heart, and sepsis, in which the entire body becomes inflamed. Septic shock, a form of extremely severe sepsis where the blood pressure drops and organ systems begin failing, can also occur. These conditions are extremely serious and can be fatal.

Cellulitis can also cause serious damage to the body's tissues, including gangrene and necrotizing fasciitis, also known as "flesh-eating bacteria disease." Necrotizing fasciitis spreads extremely quickly, and requires immediate antibiotic treatment and the removal of all infected tissues. Either condition can lead to amputations.

If the infection advances to the lymph nodes, they can spread the bacteria to other parts of the body. They may need to be drained to prevent the infection from penetrating deeper into the tissues. The lymph nodes may also be damaged, causing chronic swelling in the body part.

When the infection begins in the face or head, it can spread to the eyes, causing orbital or pre-septum cellulitis. Orbital infections cause the eyeball to swell up, and can lead to problems with eye movement; if not treated, it can cause blindness. Pre-septum infections only affect the eyelid and skin around the eyes, but can spread to the eye itself. In serious cases, cellulitis in the face may lead to bacterial meningitis, an infection of the membranes around the brain and spinal cord, which is a potentially life threatening condition.

Prevention

The easiest way to prevent cellulitis is to clean any cuts or abrasions immediately, apply an antibiotic ointment, and keep all wounds covered and protected until they heal. The injured person should rewash the injury daily and reapply the antibiotic unless otherwise advised by a medical professional. Chicken pox or injuries that have scabbed over should not be picked at, as it risks reopening the wound. An individual who suspects he or she has been bitten by a poisonous spider should seek medical attention immediately.

People with diabetes should check their legs and feet for injuries and athlete's foot regularly, and care should be taken when cutting the toenails to prevent small, unnoticed cuts. Those with suppressed immune systems should be especially careful to avoid injury whenever possible, and treat any wounds immediately. Keeping the skin moisturized and healthy can also help prevent cracks and other damage that can allow bacteria to enter.

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Discuss this Article

anon328944
Post 36

This week, I've had my second battle with cellulitis. I feel like a loser. I am not a dirty person. Now I am just a depressed person, and broke from medical bills.

anon327691
Post 35

I was hospitalized for five days with cellulitis. It was in both of my feet and there were no injury or cut to my feet. The doctors were baffled why I had it in both feet at the same time with no apparent trauma to my feet. Antibiotics were given and I'm still having some problems with my right foot. It hurts when I put pressure on it. It's been almost two months and I still have a dark spot on each foot and the skin is peeling. Could it be returning?

anon294492
Post 34

I was bitten and scratched by my cat as I grabbed him before he was about to fight another cat, and within six hours my entire right hand and lower arm were swollen and agonizingly painful. I saw a doctor 10 total hours after the bite, and she put me on 875 mg of Augmentin twice daily, and then two days later a different doctor at my follow-up added 500 mg of Cipro twice daily to the regimen.

The two are working, however it's very slow, and I'm not yet free of the infection 10 days post-injury. I hope to be three or four days from now when my antibiotic run ends. But if I can say anything to anyone who thinks they even might have cellulitis after any kind of animal bite, get seen immediately and start the antibiotics as soon as is humanly possible. The infection can and does spread very rapidly, so it is paramount it gets treated immediately. Good luck.

anon292228
Post 33

Can one of the symptoms be your legs swelling up and holding water?

anon278677
Post 32

I am also suffering from cellulitis. I've had a swollen foot for almost 1 month for no reason then last week my foot became bright red and extremely painful! The doc sent me to hospital for IV antibiotics twice daily, and they also opened it to drain from inside! It's a really painful process and I have no idea how this started, nor does the doctor! I just hope it goes soon!

anon256184
Post 31

I have had it three times on the same leg but don't know what's causing it. Does anyone know any fast cures for it?

lara
Post 30

I got cellulitis for the first time when a parasitic wasp stung me. Then one month later, a scorpion stung me and I got it again, but worse. Now, if any bug stings or bites me I get it within 10 minutes and get put in the hospital.

What can I do to lessen the chances of me getting cellulitis? I am scared. I live in the woods and don't want to move. Is there vitamins I could take, creams I could ware. Please, if anyone knows, write me back.

anon214390
Post 28

I had a honeybee sting me on the arm. The first day the area was red and about the size of the bottom of a coffee cup. I got up the next morning to a little more swelling and a little bigger red area. By the time I was off work, the red area had increased about twice the size and was hot to the touch.

I went to the doctor, got a steroid injection and a script for steroids and she drew on my arm and said if it got any bigger, go straight to the ER. Four hours later, the red area was now three times the size and burning to touch, and the swelling reached my wrist from the elbow where sting was.

I was diagnosed with cellulitis, put on iv antibiotics and given script for antibiotics. The next day, the swelling decreased tremendously and the red area was almost now back to original size post sting. If you have cellulitis, don't hesitate to go to the doctor if it isn't going away.

anon178934
Post 27

About a month and a half ago I got a sliver in the side of my foot. I removed it right away, cleaned the area with peroxide, put triple antibiotic ointment on it and covered it with a band aid. That night I woke up with a fever. the next morning my ankle was all red and swollen. I went to the doctor and was sent right to the ER. I was told that I had cellulitis, staph and strep A infections. I stayed in the hospital for two weeks. There were blisters that formed on my leg so they had to take me into surgery and debrede them. all the open spots from that are healed but my leg still swells and the redness does not seem to be going away. Will it? Just wanting to know if I am going to have to deal with the red and swelling for the rest of my life.

anon173136
Post 26

anon how long after the surgery did it take for swelling to go down in your eye?

anon166810
Post 25

I have had my first encounter with cellulitis. I have had it three days and am now on diclocellin antibiotics, ibuprofen and paracetamol. not sure how i got it but i have never seen my foot this size!

I'm in thailand, so maybe an insect bite or cut then swim in seawater? No idea. I was perfectly healthy and then this flared up! I fly home tomorrow. Is it ok to fly with cellulitis? Also, how long before the itching/swelling goes down? I've been on antibiotics two days now.

anon146593
Post 24

I read that Agave is like honey too and Aztecs would mix with salt and use for skin infections. This is claimed to help staph when you look it up. Antibiotics haven't been around forever but plants have. Indians had to know their resources. So, someone try this a few times and post it!

I would do it a few days even after it looks gone. Staph is a nasty thing when it has its way.

I also read that in studies, white tea killed staph and strep on contact. These types of bacteria mutate and grow so quickly that our antibiotics become obsolete so quick. Funny how nature has its remedies. On the white tea, my bf had growth in mouth that burst and turned his mouth different color. He soaked a white tea bag in there and it helped a bunch. The color went away and then he got on antibiotics. He is normal now.

anon146477
Post 23

I've been reading your questions. I think the answer is stay natural. Cellulitis, if it gets bad, can become MRSA! Hospitals and doctor's offices can have this, it is contagious and is resistant to most antibiotics. People who have skin allergies will find this is their worst enemy. So, take care of your skin by decreasing the likelihood of breaking your skin. This works for me (I also have eczema and other skin allergies). This will shrink acne or bumps, hydrate skin, clear out bacteria, and reduce ingrown hair problems if you combine with exfoliating.

It is, and I know it sounds crazy, a honey milk bath. 2 cups of whole milk, 1/2 cup baking soda, 1/2 cup salts, and 1/2 cup of raw honey. 20min bath lightly exfoliate with wash cloth. The lactic acid in milk will eat away dead skin and hydrate with it's fat. Baking soda just look it up. It's great. Salt has cleaning and healing properties. Last of all, honey. It is antibacterial, anti-inflammatory, and makes your skin absorb more moisture. So, you leave the bath with clean super soft anti-scratch skin.

I get scratched by my puppy and get no scratches on my skin now. See how this works? I had acne really bad and did this bath for those reasons but didn't realize I also had cellulitis on my forehead. For that tough spot, I let honey sit on it later for a few hours. It's natural, I don't get exposed to other types of staph (yes, there are different strains), and it's cheap compared to a doc visit. My eczema is now in check too. I really recommend this. Just look it up and read up on it. You'll see.

anon118634
Post 21

my dad got a spider bite and his kidneys are hurting and his waist and below is too. He got the spider bite on the side of his stomach. is this cellulitis?

anon112568
Post 20

I got cellulitis from a sprained ankle - no cuts nothing! walking on it must have strained it and caused the muscles to tear and cause the infection. I didn't go to the doctor until a week after spraining it. Nearly five days of rest, ice and antibiotics and it still hurts and redness seems to have got bigger. Should I go back to the doctor? or does it take longer to heal? The antibiotics I am on are Flucloxacillin 500mg and I only got seven days' worth.

anon112494
Post 19

What causes cellulitis to continue? It seems after major antibiotics it would appear gone, but not. Seriously, I only hope this (five weeks of strong antibiotics, i.v. and oral) time does it, only I am a little skeptical.

anon98746
Post 18

I've have four of these infections before under my arm. Then a doctor recommended I take once a day immune booster pills and I've been fine since. Then one day I got an in grown hair on my private area. It has gotten so big -- about two quarters wide. And it just keeps draining too much pus. And due to this health care system we have here there's nothing I can do about it but hope I drain it right.

And that's to the people who abuse the medical system: I can't get any help from them either. it hurts so bad and I just don't know what to do any more.

anon83411
Post 17

My mother is 56 and diabetic and has been diagnosed with cellulitis. Can she die from it?

anon79105
Post 16

I have bright pink symmetrical (warm to the touch) areas on my lower legs with slight edema.

I don't see the doctor until Friday afternoon. Should I see the doctor now instead?

anon78672
Post 15

I am in the hospital right now, with my second round of cellulitis in 11 months.

Last year I was out of shape and had edema- basically prediabetic. Since then I have lost 20 lbs and work out three or four times a week. no more edema. I thought I was in the clear with this stuff.

One ingrown toenail later that was not properly disinfected and boom, my leg explodes with redness and pain very fast, and oral antibiotics had no effect to stop spread past my knee. I am a virologist (not a bacteriologist) and I also have eczema.

I think that people with eczema may be hypersensitive to cellulitis because we do not have normal levels of an antimicrobial peptide (this also makes us unavailable to get the smallpox vaccination, btw).

Anyway, I am going to have to stop picking at my toes I suppose. Now that I know reproducibly what cellulitis feels like, it is straight to emergency for me.

anon77619
Post 14

I'm concerned. About four days ago, my wife had a small red infected area below her lower left butt cheek. We noticed that it was getting more red and it was growing in size. It became more inflamed, so we went to the hospital.

The doctor made a small cut and squeezed out most of the fluid, then told her to return three days later for a check up. We did return and she saw a different doctor this time. That doctor had more concern and admitted her into the hospital for further examination.

We are still waiting on more info to see what is going on. They had her on two different antibiotics, SMZ and cephalexin and today the doctor is going to take a sample and see if it is a tumor or just a severe case of cellulitis. We are waiting for something.

anon59530
Post 13

I developed a bad cellulitis infection two weeks after having my son by emergency cesarean.

I believe that the doctors did not have time to make sure the area was properly cleaned or properly shaved before they did the surgery. It all happened so fast. But thankfully, I got the treatment I needed and everything turned out ok in the end.

If you suspect the possibility of infection don't waste a minute! Call your doctor.

anon55740
Post 12

I would like to know if it is contagious?

anon39328
Post 11

I have a 4 year old daughter who keeps getting cellulitis. She has been treated 5 times this summer for the same thing. Each time the infection is on a different part of her body, arm eye foot ect. I'm shocked by how quickly the infections show up. At night there won't be a mark on her but by the next day she'll have cellulitis. She's geting bathed daily using Hibiclens an antisptic / antimicrobial skin cleaner. Still we are dealing with the infections. Anyone have some advice on how to stop this.

anon37138
Post 10

Hi! i have developed a swelling on my right leg and it seems to be growing and spreading from the ankle to the knee. i've not been bitten by any insect nor have i been injured. What could be the cause?

I have been to various doctors and they can't seem to see the problem.

anon34138
Post 9

I developed an eye infection in my right eye. I ended up going to the eye doctor and he diagnosed me with allergies. 24 hours later, my eye became swollen shut, face was swollen, and my lymph nodes became swollen to the point it was hard like a cyst and i noticed a brown spot on my eyelid. I immediately went to another eye doctor and i ended up in the er, a day later i went back to the er because my face was swollen twice the size and i was feeling pain shooting in my face and brain.

I was admitted to intensive care for 3 days with a 24 hour iv (strongest anti viral? medicine ) and was getting eye drops twice a day, blood work, shots of morphine, zanex for sleep and loritabes.

I have no idea what caused it, except i think a brown recluse bite me.

anon33849
Post 8

This is interesting. I have huge what I thought was a cyst under my arm for 4 yrs. Until diagnosed by an urgent care doc...now I am facing drainage after attempting to clear up infection.

Taking Keflex and Tylenol 3.

The pain is ridiculous. I believe my own doctor misdiagnosed mine.

concernedone
Post 7

this site is great. I get cellulitis on a regular basis. Since I am a diabetic I am concerned about how to tell if you have had it spread to your lymph nodes and how its treated differently from just being localized.

anon17676
Post 6

If someone were to be diagnosed with cellulitis while on holiday. what would be the risks of flying?

Shoyen
Post 5

beffalucy :

Are you on antibiotics? If you have cellulitis with those symptoms, have your doctor prescribe antibiotics, if have not already done so. While you are at it, ask your doctor for an appropriate way to attend to the pain according to your condition.

Shoyen
Post 4

anon11493 :

It is possible to get cellulitis from a blister if it pops. The breaking open of the skin allows bacteria to enter, causing an infection. It depends on the person and severity of the wound to determine if you get cellulitis. However, the chances will be minimized if you wash the area thoroughly with soap and water, and apply an antibacterial or antiseptic throughout the affected area.

With the issue of going black...I can't say. I have never had a blister go black on me, so it is important to consult your doctor immediately if that were to happen.

anon11493
Post 3

Can u get Cellulitis for a blister on your foot? And will it go black???

beffalucy
Post 2

I have Cellulitis now and have had for 7 days now. I have blisters coming up on my lower right leg. Is there anyway to get rid of the pain and the water oozing from it?

Shoyen
Post 1

Hello. I have had already 3 encounters with cellulitis, and with all three of them I had to be taken to the hospital. However, in all 3 cases, they have been caused by an insect bite (the most recent was a mosquito) on the lower right leg. I did not scratch the bite, but I also did not clean the affected area since it is not common to clean a mosquito bite.

I am concerned at why after only a few days after seeing a doctor (the most recent was less than 24 hours after the bite) I had to be transferred to the hospital for intravenous antibiotic treatment. The bite had grown to such a large size (about 3 to 4 inches in diameter) so quickly - even when I was on oral antibiotics. If I get bitten on other parts of my body such as my arm, the bite heals normally. It puzzles both me and my doctors why; I even saw an Infectious Disease doctor, and even she had no conclusion.

After every cellulitis infection, the next one became worse, so I am a little concerned about the next encounter from it, which is why I am wondering if you know any cause for a condition such as this.

Thank you for considering.

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