Cellulitis Symptoms

Symptoms of cellulitis

Cellulitis causes the area of affected skin to become red, hot, swollen, and tender or painful.

Cellulitis most commonly affects one of your legs, although symptoms can develop in any area of your body.

If you have cellulitis, you may also find that blisters develop on your skin.

Cellulitis can make you feel generally unwell, causing symptoms that develop before, or in combination with, changes to your skin. These symptoms include:

• nausea
• shivering
• chills
• a general sense of feeling unwell

When to seek medical advice

See your doctor as soon as possible if an area of your skin suddenly turns red, painful and hot.

Causes of cellulitis

Most cases of cellulitis are caused by an infection of the tissues beneath the skin with either the group A streptococcus or staphlococcus aureus bacteria.

See streptococcal infections and staphyloccocal infections for more information about these types of bacteria.

Cellulitis usually occurs when the surface of your skin is damaged. This damage creates an entry point for the bacteria, allowing them to attack the skin and tissue underneath. A break in the skin may be caused by a:

• cut
• graze
• burn
• animal, human or insect bite
• puncture wound
• skin ulcer
• skin condition, such as atopic eczema (this causes the skin to become dry, red and cracked) or athlete’s foot

The break in the skin may be so small that it cannot be easily identified.

Some cases of cellulitis can develop if a wound or other break in the skin is exposed to water that is contaminated with bacteria.

Who is at risk?

A number of health conditions can increase your risk of developing cellulitis. These include:

• having poorly controlled diabetes
• having circulation problems
• having long-term untreated athlete’s foot or fungal toenail infection
• having previous episodes of cellulitis

These are briefly discussed below.

Poorly controlled diabetes

If you have diabetes that is not adequately treated or controlled, it can weaken your immune system.

Poorly controlled diabetes can also affect your circulation, which can sometimes cause skin ulcers to develop. Skin ulcers are a common entry point for bacteria.

Circulation problems

Poor circulation can increase your risk of developing skin infections in the places where your body does not have an adequate blood supply.

For example, many people with diabetes have a reduced blood supply to their feet, which makes them more vulnerable to developing cellulitis.

Lymphoedema

Lymphoedema is a condition that causes fluid to build up under your skin. It may occur following surgery for some cancers. If your skin becomes very swollen it may crack, creating an entry point for bacteria.

Previous episodes of cellulitis

If you have had a previous episode of cellulitis, your risk of having episodes in the future increases.

An estimated 20-30% of people with a previous history of cellulitis will be admitted to hospital again with another cellulitis infection.

Diagnosing cellulitis

Your doctor can usually diagnose cellulitis by assessing your symptoms and examining your skin.

If you have an open wound in your skin, your doctor may take a swab of cells from the wound to see what type of bacteria is causing the infection. A swab looks similar to a cotton bud and it is used to remove small traces of tissue for testing.

Further testing may be carried out if your symptoms are serious enough to warrant admission to hospital. Testing usually involves a series of blood tests, which are an effective way of assessing the severity of the infection and how well you are responding to the antibiotics.

Treating Cellulitis

If you are diagnosed with cellulitis, your treatment will depend on the cause of your cellulitis, the severity of your symptoms, and the general state of your health.

You can usually be treated as an out-patient with antibiotic tablets if you do not have additional symptoms of being unwell, such as fever, nausea and vomiting, that suggest the cellulitis infection has spread from your skin to the bloodstream or other parts of the body.

If this is not the case admission to hospital is usually recommended.

Out-patient Treatment

Antibiotics

If you are well enough to be treated at home, you will be given a five-day course of antibiotic tablets.

You need to see a doctor immediately if your symptoms get worse 48 hours after taking the antibiotics, or you develop additional symptoms, such as a high temperature or vomiting.

Self-care

There are steps you can take at home to ease your symptoms and speed your recovery from cellulitis.

Drink plenty of water to prevent dehydration. If your leg is affected by cellulitis, keep it raised. Wear compression stocking to reduce the swelling. These should make you feel more comfortable and help to reduce the swelling.

Pain relief

If your cellulitis is causing pain or a high temperature (fever), an over-the-counter painkiller may ease your symptoms.