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Cellulitis

Definition

Cellulitis is an infection of the skin and tissue just below the skin. The infection may occur anywhere on the body but it is most common on the lower legs. If it is not treated it can spread to deeper areas of the body like muscle and bones.

Causes    TOP

Cellulitis is caused by a bacteria. The bacteria may normally live on top of the skin or come from other sources. It enters the skin through a cut or injury on the skin surface. Once inside the skin the bacteria can grow and cause infection.

Risk Factors    TOP

Factors that may increase the chance of cellulitis include:

  • A untreated minor injury to the skin such as, a cut, scratch, blister, burn, puncture, or bite
  • Ulcer
  • Skin conditions that cause cracking or damage to the skin surface such as:
  • IV drug use
  • Surgery
  • Diabetes
  • Venous insufficiency
  • Lymphatic problems such as lymphedema
  • Having certain conditions such as diabetes, HIV, weakened immune system, kidney or liver disease, obesity, or poor circulation
  • Frequent skin to skin contact
  • Sharing personal items
  • Poor personal hygiene

Puncture Wound

Puncture Wound
Copyright © Nucleus Medical Media, Inc.

Symptoms    TOP

Symptoms may begin within hours or days. The skin around the injury may have:

  • Redness and warmth
  • Pain or tenderness
  • Swelling
  • Dimpled skin
  • Streaking—spreading of redness

Some may have a mild fever.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will also ask about any recent injuries. The area will be closely examined. The doctor may know it is cellulitis from the appearance of the skin. The outer edge of the redness may be marked. This will help to see if the infection spreads.

Your doctor may do blood tests if the infection has spread into the blood. Fluid from the area may also be tested if the infection is not responding to treatment.

Treatment    TOP

The goal is to get rid of the infection and manage pain. Most cellulitis will clear up after 1-2 weeks of treatment.

Hospital care may be needed if you have:

  • Severe cellulitis
  • Diabetes or a weakened immune system
  • An infection on your face

Treatment includes:

Medication

Antibiotics will help to clear the infection. Less severe infections may be treated with pills. The medicine may need to be injected or given by IV if the infection is severe. It is important to take all the medicine as given, even if the area looks better.

Pain medication may also be given to help manage pain.

Supportive Care

Keeping the area raised can help move fluids out. It may also speed healing.

It is important to protect the skin and stop further damage while you heal. This includes not scratching or rubbing the patch. Use and change bandages as recommended by your doctor. Keep the area clean.

Prevention    TOP

To decrease the risk of breaks in the skin:

  • Keep your skin clean and dry.
  • Moisturize dry skin with lotion.
  • Follow your treatment plan for any skin conditions
  • Wear protective gear in sports.
  • Wear long pants and long-sleeved shirts when hiking.
  • Wear sandals when at the beach, rather than going barefoot.
  • Be careful around animals. Treat pets with respect to avoid bites.

To help reduce your chance of infections:

  • Regularly wash hands and bathe
  • Do not share personal items
  • If a small cut, bite, or other injury occurs:
    • Clean cuts or scrapes with soap and water.
    • Apply antibiotic ointment.
    • Cover wounds with a bandage or dressing.
    • Do not scratch wounds.
    • Call the doctor right away if the area becomes red or inflamed.
  • Wash your hands after coming in contact with fish, poultry, eggs, or meat. Do not handle these items if you have cuts or sores.
  • If your legs tend to swell, elevate them several times a day and wear support stockings.

RESOURCES:

American Academy of Dermatology
https://www.aad.org
National Institute of Allergy and Infectious Diseases
https://www.niaid.nih.gov

CANADIAN RESOURCE;

Canadian Dermatology Association
https://dermatology.ca

References:

Cellulitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116794/Cellulitis. Updated August 14, 2017. Accessed August 17, 2017.
Cellulitis. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/rashes/cellulitis. Accessed August 17, 2017.
Cellulitis. DermNet New Zealand website. Available at: https://www.dermnetnz.org/topics/cellulitis. Updated July 2016. Accessed August 17, 2017.
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159.
Last reviewed August 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/9/2014

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