Learn more about the skin infection that causes redness, swelling & pain
Cellulitis is a bacterial skin infection that’s commonly found in the legs and feet, although it can develop in other parts of the body. Recognised by swelling, heat and pain, it’s important to seek early treatment to prevent complications.
What is cellulitis?
Cellulitis occurs when bacteria enters the inner layers of the skin due to an injury, a cut, a bite, or cracked skin. It makes the skin appear swollen and feel painful and hot. You may also notice redness, but this can be harder to detect in darker skin tones.
In some cases, you may also develop blisters or develop a fever before you notice any changes in the skin.
Having cellulitis in both legs is rare – it usually occurs in just one leg. Despite having a similar sounding name, it’s not related to cellulite (dimpling of the skin in fat-prone parts of the body, like the thighs).
Sometimes cellulitis is caused by bacteria which is naturally found on the skin, but it may also be caused by bacteria from elsewhere. Cellulitis affects the deeper layers of the skin, so it’s not considered contagious.
In some cases, cellulitis can develop into a life-threatening condition, so it’s essential to get treatment promptly if you notice any symptoms.
Who is at risk from cellulitis?
You are more at risk from cellulitis if you:
• Have poor circulation in your arms, legs, hands or feet
• Have lymphoedema, which is the build-up of fluid under the skin
• Have a weakened immune system due to chemotherapy, for example
• Are overweight, as this can cause difficulty moving and lead to poor circulation
• Find it difficult to move
• Have a wound from surgery
• Have had cellulitis before
• Have diabetes
• Inject drugs
If you are at risk of cellulitis, make sure you treat any instances of athlete's foot promptly.
When should I seek treatment for cellulitis?
Getting treatment for cellulitis early can help prevent it from spreading to other parts of the body or causing life threatening complications like sepsis (blood poisoning). Early treatment also helps to reduce the chances of recurrence, which can be common with cellulitis.
Your GP would typically diagnose cellulitis by examining the appearance of the skin and considering your medical history, for example whether you have had cellulitis before and whether you are at an increased risk of developing it.
You may also be asked questions to help rule out conditions with similar symptoms, such as deep vein thrombosis, septic arthritis and acute gout.
To access medical help, you can contact your GP or call the NHS helpline on 111.
When to get emergency help
Call 999 or go to A&E right away if you have cellulitis and:
• Feel very hot or shivery or have a very high temperature
• Have a fast heart rate
• Are breathing fast
• Feel dizzy or faint
• Are confused or feel disorientated
• Feel cold, clammy or look pale
• Lose consciousness or become unresponsive
• Have purple patches on the skin, although this may be less apparent on darker skin
What is the recommended treatment?
In most cases, mild cellulitis can be treated with a course of antibiotics for a week. Most people recover within 10 days and don’t experience complications. It’s important to complete your course of antibiotics in order to avoid any remaining bacteria becoming resistant to treatment.
Unfortunately, you may feel worse in the first 24 to 48 hours after starting treatment but if you don’t notice any improvement after two to three days, you should contact your GP.
If symptoms don’t improve or get worse, then you may be referred to hospital. Children under one may also be referred to hospital, as well as those who have a weakened immune system or are showing signs of facial cellulitis (unless it is very mild).
In severe cases, or if the prescribed treatment is not working, further investigations may be necessary. For example, if there is a visible open wound, a swab may be taken to carry out lab tests to determine which type of bacteria is causing the infection.
How can I help my recovery at home?
In addition to taking antibiotics, you can help your recovery by:
• Taking paracetamol or ibuprofen to help with the pain, if these are suitable for you
• Regularly moving the affected part of the body to stop it getting stiff
• Raising the affected limb if you are lying or sitting down, to help ease swelling
• Drinking plenty of fluids to avoid dehydration
• Not wearing compression stockings until you are better
To reduce your chances of further infections it can be helpful to:
• Keep your skin clean
• Ensure your skin is well moisturised to avoid it cracking
• Clean any cuts or wounds and use an antiseptic cream
• Wear appropriate footwear and clothing when you’re at risk of an injury
• Wear gloves when doing manual work like gardening
