Cellulitis: Signs, Symptoms, Causes, Treatments

What is Cellulitis?

Cellulitis is a bacterial skin infection that occurs when cracked, cut, and/or wounded skin becomes infected.

Cellulitis is common and if caught early, is very treatable. However, if the infection remains without treatment, it can spread to the lymph nodes and bloodstream, becoming life-threatening.

Cellulitis most commonly affects the lower leg and feet, as they are more exposed to harmful bacteria and harder for some to clean than other parts of the body. However, it can afflict any break in the skin, regardless of where it is on the body.

Early signs and symptoms of cellulitis can vary quite a bit. Learn what cellulitis is and when you should contact a doctor.

Is Cellulitis Contagious?

Cellulitis is not typically contagious.

Because cellulitis is a bacterial infection of the deeper layers of the skin, it is not typically spread from person to person.

That said, the bacteria that cause the infection is living on our skin, so it is important to clean breaks in the skin well.

It is recommended you thoroughly wash your hands with unscented soap and warm water before checking or treating your skin injuries.

That said, cellulitis affects areas and injuries on the skin such as abrasions, animal bites, shingles, ulcers, burns, and eczema.

Early Signs and Symptoms

Knowing the early signs and symptoms of cellulitis will help you identify a cellulitis infection before it worsens and spreads. This information will help you know when to contact your doctor and seek proper treatment.

The symptoms of cellulitis vary, but they can include:

• Redness that tends to expand around the break in the skin
• Swelling of the area
• Tight glossy appearance of infected area 
• Tenderness
• Pain
• Warmth of the infected area 
• Fever
• Red spots
• Blisters
• Skin dimpling
• Symptoms of serious cellulitis include rapid growth of the affected area  with or without fever or chills

Cellulitis on Leg

The legs, particularly lower legs, are extremely common places for cellulitis to occur. That is because legs are more prone to injury and skin breaks than other parts of the body. Additionally, they are exposed to more harmful bacteria so the risk of infection is higher. To top it off, we don’t clean our lower legs as often as other parts of the body (such as our hands). So, cuts are more prone to happen, more likely to be infected, and less likely to be cleaned properly on the leg. These three factors lead to cellulitis on the leg.

When to See a Doctor

If you are experiencing any of the above symptoms, it is important to contact a doctor immediately.

While cellulitis is common and treatable when caught early, it can rapidly become life-threatening if left without treatment. This is because the bacteria spread from the infected area to the lymph nodes and bloodstream. Once this happens, the infection is much more harmful and difficult to treat. It is no longer central to the wound in the skin, but rather a whole-body infection traveling through the blood.

Seek emergency treatment if:

• The area of concern is rapidly becoming more red, swollen, glossy, tender, and painful
• You have a fever
• The area of concern is red, swollen, glossy, tender, and painful—it is  worsening and you don’t have a fever

Causes of Cellulitis

Cellulitis is a bacterial infection of the deeper layers of the skin. Two types of bacteria typically cause it: Staphylococcus and Streptococcus. In order for these bacteria to reach the deeper layers of skin there must be a break in the skin.

Common points of entry for bacteria that cause cellulitis are:

• Cuts
• Puncture wounds
• Burns
• Ulcers
• Athlete’s foot
• Dermatitis
• Animal bites
• Insect bites
• Recent surgery incisions
• Cracked, dry skin

Risk Factors for Cellulitis

There are certain pre existing conditions that can increase the risk of contracting cellulitis. These include:

• A weakened immune system due to conditions such as Diabetes, HIV/AIDS, and Leukemia
• Skin conditions that cause breaks in the skin, such as eczema and athlete’s foot
• Intravenous (IV) drug use
• A history of cellulitis
• Obesity

Cellulitis Prevention

If you have an open wound, burn, surgical incision or any other break of the skin, including dry skin there are many things you can do to prevent cellulitis. These include:

• Washing your wound with soap and water daily
• Applying protective cream or ointment (Vaseline, Polysporin and other over the counter options provide great protection)
• Cover your wound with a bandage and change at least daily
• Watch for signs of infection such as redness, pain, swelling, and drainage, so you know when to contact a doctor for immediate treatment.

For those at higher risk of cellulitis as a result of any of the aforementioned pre-existing conditions, there are additional preventative measures you can take, including:

• Inspecting your feet and lower legs daily to ensure there are no cuts and/or infections
• Moisturizing your skin regularly to prevent cracking and flaking both of which can be entrance points for bacteria
• Trimming fingernails and toenails carefully to not break the surrounding skin
• Wearing proper shoes to reduce the risk of cuts
• When the skin does break, it is important to treat it right away by cleaning it and properly bandaging it to prevent cellulitis

Diagnosis of Cellulitis

Cellulitis is easy to diagnose on sight. Upon examining the area and based on an accurate and detailed description of your symptoms, including where/when you were cut, when the symptoms started, and what symptoms you have (including those that may seem unrelated), your doctor will most likely be able to diagnose your cellulitis right away.

In some rare cases, your doctor may take a blood sample to confirm the diagnosis and rule out other conditions.

Treatment of Cellulitis

Cellulitis is typically treated with an antibiotics prescription that is taken orally, ranging from 5-14 days, depending on the severity of the infection and type of antibiotics.

According to the Infectious Diseases Society of America, penicillin or amoxicillin can be the first line of treatment for cellulitis.

It is important that you continue to take the antibiotics for the entire extent of the prescribed time, even after symptoms subside. Symptoms should begin to go away within a few days of taking antibiotics.

PlushCare online doctors can prescribe antibiotics online. If you would like to book a PlushCare appointment, click here.

If after 3 days your symptoms remain, have worsened, or you have developed a fever you should contact your doctor, as you may not be responding to the prescribed antibiotics.

If this is the case, you will likely need to come in for treatment in the hospital. Antibiotics will be administered intravenously, and your condition and symptoms will be more closely monitored.

While undergoing treatment, it is important to rest so your body can focus on fighting the infection.

It is recommended to raise the infected area. This elevation will reduce swelling and aids the healing process.

Cellulitis Home Treatment

There are in-home treatments that can reduce the symptoms of cellulitis and ease discomfort. These include:

• Alternating between warm and cold compress to reduce pain and swelling of the infected area. This should be done as often as needed
• Wear loose, breathable clothing made from natural fibers such as cotton
• Keep any chemical products, detergents, scented body soaps, perfumes, lotions, etc. off the infected area
• Elevate the area to decrease swelling
• Ask your doctor if over-the-counter painkillers are recommended such as acetaminophen (Tylenol) or ibuprofen (Motrin) to reduce pain

There are also several essential oils and other natural plants that can be used to ease signs of cellulitis or treat minor injuries on the surface of the skin. Be sure to get clearance from your doctor before trying these at home.

• Tea Tree Oil: known for its potent antibacterial, antifungal, antiviral and anti-inflammatory properties, it can be applied on the site of skin break.
• Coconut Oil: contains antiseptic properties and monolaurin (a by-product of coconut) known for fighting bacteria in skin infections. It can be applied to the area and dry skin. Leave it on for several hours and reapply several times a day.
• Calendula: speeds up wound healing as it helps new tissue to grow.
• Oil of Oregano: known as a natural antibiotic, antioxidant and anti-inflammatory oil of oregano can be used to treat minor injuries

In-home treatments such as the ones listed above are a great way for skin daily check and treating minor injuries and dry skin; however, it is crucial you see a doctor to ensure the treatment of your cellulitis is safe and is effective. PlushCare online doctors can prescribe antibiotics online. If you would like to book a PlushCare appointment, click here.

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