Cellulitis

What is cellulitis?

Cellulitis is a common skin infection. You can get cellulitis when bacteria enter your skin through a break like a cut, scrape or insect bite. 

Most of the time, these minor injuries heal on their own. But sometimes, that opening in the skin creates an opportunity for germs to enter and infect the skin and the tissue under it.

Cellulitis is often mild and treatable, but sometimes it can lead to severe complications. Knowing the signs of infection and when to seek care can help you recover. Learn more about the symptoms of cellulitis, how it’s treated and steps you can take to lower your risk. 

Symptoms of cellulitis

Cellulitis can appear anywhere on the body but it’s most common on the legs, arms and face. 

Signs of infection include: 

• Redness or darkness. It’s normal to see redness or darkness when you injure your skin. With cellulitis, the red or dark area may spread out from the injury. 
• Swelling and warmth 
• Pain or tenderness
• Skin that looks stretched, shiny or tight
• Blisters

In more severe cases, you might notice: 

• General symptoms of infection such as fever, chills, dizziness, muscle aches or fatigue
• Pus, blisters, abscesses or drainage
• A rash that’s spreading quickly
• Red or brown streaks that extend out from the injured area
• Symptoms that get worse even though you’re treating them

If you have any of these symptoms or you have symptoms around an eye or ear, get medical attention right away. With early diagnosis, you can get treatment more quickly and lower your risk of complications.

Causes and risk factors for cellulitis

Cellulitis develops when bacteria - most often Streptococcus (strep) or Staphylococcus aureus (staph) - enter the skin. These germs live on your skin and in your nose and mouth and can enter the skin if it’s injured.

A strain of bacteria called methicillin-resistant Staphylococcus aureus (MRSA) can cause more serious infections that are harder to treat. 

These germs can enter your skin anywhere there’s a break, such as:

• Cuts or scrapes
• Dry or flaky skin
• Wounds from surgery, piercings or tattoos
• Insect or animal bites
• Athlete’s foot, dermatitis, eczema, shingles, psoriasis or other skin conditions that cause cracks

Understanding your risks can help you prevent cellulitis. You may be at higher risk of cellulitis if you have: 

• A weakened immune system from diabetes, cancer, HIV/AIDS, leukemia or certain medications 
• Poor circulation or edema (swelling) in the legs 
• Obesity
• A sedentary lifestyle
• Chronic skin conditions
• Previously had cellulitis

Cellulitis is not contagious, so you don’t have to worry about getting it through contact with another person. 

Diagnosing cellulitis

To diagnose a case of cellulitis, your provider will perform a physical exam to check for signs of infection and symptoms of cellulitis. They may draw a line around the area to see if the redness or darkness is spreading.

They may recommend tests to confirm the diagnosis, including: 

• Bacterial culture to identify the type of bacteria causing the infection. Knowing the type of bacteria means you can get the right antibiotic to fight it.
• Blood tests to see if the infection has spread. 
• Imaging tests, such as ultrasound or MRI, to look for deeper infections.

Your provider may also check for other conditions, such as chronic (long-lasting) leg swelling or dermatitis, that could cause symptoms similar to cellulitis.

How is cellulitis treated?

Cellulitis generally won’t go away on its own. Most of the time it clears up with antibiotics that you take by mouth, such as penicillin, dicloxacillin or cephalexin. 

You should start feeling better a few days after starting antibiotics. It’s important to take the full course of antibiotics to prevent the infection from coming back. 

For more serious infections, especially those caused by MRSA or that show signs of spreading, you may need IV antibiotics in a hospital. 

Along with antibiotics, these steps can help you heal and feel better:

• Rest and elevate the affected area to reduce swelling 
• Place a cool, damp cloth on the area
• Apply antibiotic ointment if your provider recommends it 
• Keep wounds covered 
• Take pain relievers, if needed

Monitor your symptoms closely. If they aren’t getting better a few days after you start taking the antibiotics, contact your health care provider. You may need a different antibiotic or a more aggressive treatment.

Complications of cellulitis

Getting treatment quickly and taking all of your medication as directed lowers your risk of complications. Without treatment, cellulitis can spread from the skin to the bloodstream and lymph nodes and become life-threatening. It can reach your muscles and bones.

Possible complications include: 

• Abscesses or pockets of pus that need to be drained 
• Bacteremia, sepsis or toxic shock syndrome (bloodstream infections) 
• Endocarditis (heart lining or valve infection)
• Osteomyelitis (bone infection)
• Damage to your lymphatic system and permanent swelling in the infected area 
• Necrotizing fasciitis, a rare, life-threatening infection that can destroy skin, muscle and fat

Preventing cellulitis

Take these steps to lower your risk of developing cellulitis: 

• Treat cuts and scrapes right away. Wash them with soap and water, apply an ointment or cream and cover them with a clean bandage. Clean them daily and replace the bandage.
• Contact your health care provider if you have signs of infection such as discomfort, redness or pus.
• Keep your skin and nails healthy.
• Moisturize dry skin to keep it from cracking. 
• Wear protective gloves when gardening or working outdoors so you’re less likely to get a cut or scrape.
• Treat skin conditions like athlete’s foot that may create places where bacteria can get into your skin. 
• If you’re recovering from surgery, follow your provider’s instructions for caring for the incision site. 
• If you have any conditions that increase your risk, take your medications as directed and see your provider regularly for monitoring.
• If you’ve had cellulitis before, talk to your provider about ways you can prevent it in the future.

If you have diabetes or poor circulation, you need to be extra careful to take care of your skin and prevent injuries. It can help to:

• Inspect your feet every day for any cuts, scrapes or sores.
• Moisturize your skin to help keep it from peeling or cracking.
• Be careful when you cut your fingernails and toenails, so you don’t harm the skin around them.
• Wear the right shoes and gloves to protect your feet and hands.
• Treat any minor skin infections right away.

When to see a provider

Get medical attention right away for: 

• Redness or darkness that is spreading quickly or swelling 
• High fever or chills 
• Skin that becomes numb, tingling or dark near the infection
• Symptoms that get worse after you start treatment

Why choose Banner Health for cellulitis treatment?

Cellulitis is a common skin infection that you can get if bacteria enter the skin through a cut, scrape or bite. It usually clears up with oral antibiotics, but it can lead to serious complications if you don’t treat it right away.

At Banner Health, our skin care and infectious disease experts can evaluate you quickly and get the testing and imaging you need for a diagnosis. Along with oral and IV antibiotics, we offer comprehensive care for severe infections and follow-up care designed just for you to help prevent future cellulitis infections.