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

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 is 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 aflict any break in the skin, regardless to where it is on the body.

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 can be lurking on common surfaces and while unlikely, can be passed from an infected persons wound to another’s wound, so it is important to clean breaks in the skin well.

If you do come into direct contact of an area infected with cellulitis without a proper barrier, such as medical gloves, it is recommended you thoroughly wash the area that came into contact with the infection with unscented soap and warm water.

That said, cellulitis only affects open wounds in the skin such as:
• Abrasions
• Lacerations
• Punctures
• Avulsions

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
• Abscess with puss and/or fluid
• Tenderness
• Pain
• Warmth of the infected area
• Fever
• Red spots
• Blisters
• Skin dimpling

Symptoms of serious cellulitis include:
• Shaking
• Chills
• A feeling of illness
• Fatigue
• Dizziness
• Lightheadedness
• Muscle aches
• Warm skin
• Sweating

Symptoms that cellulitis is spreading include:
• Drowsiness
• Lethargy
• Blistering
• Red streaks

Cellulitis Nose

Nasal cellulitis is very common and occurs when the tissues of the nose become infected with streptococcus or staphylococcus bacteria.

The nose will become red, and swollen, increasing in size. Nasal cellulitis is painful and often not treated right away as suffers think they just have a cold. It is important to distinguish between a common cold and nasal cellulitis early on so proper treatment can be given. If you are unsure, contact your doctor right away.

Nasal cellulitis will more commonly affect people with bad blood circulation. These people can develop cellulitis from a minor cut or scratch on the nose and should be extra precautious. Cleaning and bandaging wounded skin is crucial.

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 nods 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—but not rapidly 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, 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 or band aide 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, taken orally, ranging from 10-21 days, depending on the severity of the infection.

The antibiotic must be effective against both streptococci and staphylococci. Antibiotic Doxycycline for cellulitis treatment is often prescribed, as it is a common antibiotic for skin infections.

It is important that you continue to take the antibiotics for the entire extent of 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 above your heart. 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 twice daily
• 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 above your heart to decrease swelling
• Use over the counter painkillers 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 treat cellulitis. 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 can be applied to the infection.
• Moisten a cotton ball with water and add one or two drops of tea tree oil, press the cotton ball directly onto the wound and leave it on for several hours.
• Coconut Oil: contains antiseptic properties and monolaurin (a by-product of coconut) known for fighting bacteria in skin infections can be applied to the area. Leave it on for several hours and then wash it off with water. Reapply several times a day.
• Turmeric: known to be natural antibiotic, antiseptic and anti-inflammatory turmeric can help in several ways. Take turmeric orally by mixing one teaspoon of turmeric powder in a glass of milk and boil it. You can add honey if you like and drink the mixture once or twice daily.
• Calendula: can fight infection, and sooth tender and inflamed skin. Steep two teaspoons of calendula flowers in a cup of hot water for 10 minutes. Dip a clean piece of cloth into the water and apply it to the infected area for 15 to 20 minutes, repeat this 3 or 4 times daily.
• Oil of Oregano: known as a natural antibiotic, antioxidant and anti-inflammatory oil of oregano can be used to treat cellulitis. Dilute 10 to 12 drops of oil of oregano in 2 tablespoons of coconut oil, apply it on the affected area and leave it on for a few hours, wash off with water and reapply several times a day.

In home treatments such as the ones listed above are a great alternative antibiotics, however, it is crucial you see a doctor to ensure the cellulitis in home treatment you use is safe and is effective.

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