If you develop a warm, reddish-pink lesion on your body that spreads and feels tender and swollen to the touch, you may have what’s known as cellulitis.
Cellulitis is a common bacterial skin infection that occurs in an estimated 14.5 million cases per year in the United States.
It primarily affects the middle layer of the skin, called the dermis, but can also affect surrounding tissues and muscles in some cases.
Many different kinds of bacterial infections can lead to cellulitis.
But in most cases the general course of treatment remains the same: oral antibiotics taken at home alongside a range of supportive treatments and remedies.
In this article, I’ll explain what cellulitis is and how to know if you have it.
I’ll also discuss the main types of cellulitis.
Then, I’ll cover important aspects of cellulitis treatment at home, including antibiotics, pain management, and proper wound care.
I’ll also explain other medical treatments for cellulitis and when to talk to your medical provider.
What Is Cellulitis?
Cellulitis occurs when bacteria infects a wound or rupture to the skin, and begins to spread to the surrounding tissue from that initial wound.
Many different strains of bacteria can cause cellulitis.
Most of the time this bacteria is common and harmless when living on the skin’s outer surface but can become harmful when they enter the exposed layer of the dermis.
Cellulitis infections can stem from large, obvious skin injuries like open sores, burns, surgical grafts, or needle injection sites.
But bacteria can also get in through small cuts, scratches, or bug bites that you might not even notice.
Once a bacteria strain infects a wound and begins to multiply, the body’s immune system will try to fight this invasion off.
This immune response can itself cause some of the inflammation and discomfort associated with cellulitis.
Without medical assistance, your body’s immune system may prove itself outmatched against an infected wound, in which case a cellulitis infection can spread.
It can also cross from the dermis to other systems of the body, leading to serious infections of the bloodstream, lymph nodes, and other major organs or tissues.
How To Know If You Have Cellulitis
Because it occurs in the deeper layers of the skin, cellulitis looks different from many other skin disorders.
In cases of cellulitis, infected skin appears red and swollen, but often lacks clearly defined borders.
It may also feel warm and tender to the touch.
Cellulitis usually spreads from a single initial location.
Adults often get cellulitis on a single lower leg, but not on both legs.
Children, meanwhile, tend to develop cellulitis on the face or neck.
To diagnose it, your healthcare provider will look to rule out other skin diseases.
They will also examine how well your lesions fit with cellulitis’s classic visual cues and symptoms.
Expect to be asked about any recent skin damage, but know that you can still develop cellulitis even if you didn’t have any noticeable recent skin injuries.
More rarely, your medical provider might order tests on a blood or tissue sample, either to identify whether any bacteria present is associated with cellulitis, or to rule out other diseases.
Concerned about cellulitis? Chat with a provider through K Health.
Get StartedTypes of Cellulitis
Researchers classify cellulitis according to a few different dimensions.
One dimension of classifications is the invading bacteria itself.
Doctors are able to treat most forms of cellulitis without needing to know the exact bacteria strain driving the infection; this is because common antibiotics are highly effective at eliminating most of the strains of bacteria that lead to cellulitis.
One exception is cellulitis caused by MRSA (methicillin-resistant staph aureus).
This is often treated as a separate type of cellulitis precisely because of the way it resists standard treatment.
Cellulitis caused by streptococci bacteria is also sometimes classified separately.
That’s because of its association with several unique infectious pathways, including injection of certain drugs and surgical grafting.
Some types of cellulitis are defined by their location on the body.
Periorbital or preseptal cellulitis is a bacterial infection of the eyelid or skin around the eye, while the more dangerous orbital cellulitis is an infection of the fat and muscle tissues around the eye.
Both are more common in children.
Another way it is classified is based on whether it is “purulent” or “non-purulent.”
In so-called purulent cellulitis, the inflamed dermis tissue is accompanied by swollen pus abscesses that need to be drained.
Doctors will also classify cellulitis based on whether it appears to be localized (e.g. confined to one area of the skin) or systemic.
Systemic cellulitis is an infection that has spread to affect other systems of the body and is marked by symptoms like fevers, abnormal heart rate, or abnormal breathing.
Home Treatments
The cornerstone of all cellulitis treatment at home is a course of oral antibiotics, which are medications prescribed by your healthcare provider and swallowed by mouth on a set schedule.
But there are also steps you can take at home to reduce the pain and discomfort associated with a cellulitis infection.
Performed correctly, many of these steps may also help to reduce swelling and speed up healing, as well.
When treated at home before serious complications occur, most people recover fully from cellulitis within one or two weeks.
Take prescribed medication
The most important thing you can do to treat cellulitis at home is to take any prescribed oral antibiotics exactly as your doctor has directed.
Taken correctly, these antibiotics can begin to clear up most cases of cellulitis within 24 to 48 hours.
But even if this is the case, you should continue taking the entire course of the antibiotics, which typically lasts between 7 and 14 days.
If you stop your antibiotic treatment early, there’s a chance that some of the bacteria hasn’t yet been killed off and that it can come back just as strong, or stronger, than before.
Take a pain reliever
Your doctor may direct you to take a prescription-strength pain reliever to help you manage discomfort as the oral antibiotics take their course.
Or they may direct you toward over-the-counter pain medicines like ibuprofen (Advil) or acetaminophen (Tylenol).
Apply a moist compress
In between bandagings, consider dampening a clean cloth with either warm or cold water (whichever feels better to you) and applying it as a compress to the infected area.
Doing so can help to reduce inflammation and disperse fluid swelling (edema).
It can also help to reduce pain (and your body’s stress response to pain) which may also speed up healing.
After applying the compress for a few minutes, be sure to follow any guidelines from your healthcare provider around keeping the area dry for bandaging.
Clean the area
You should try to keep the infected area as clean and dry as possible during the course of oral antibiotic treatment when you’re not actively applying a moist compress.
If the infected area is surrounded by any other cuts, wounds, or abrasions, you should also pay attention to keeping them clean as well, and make sure to always wash your hands before touching any of these areas, to ward off any further infections.
Cover the wound
Wound care is a crucial part of treating cellulitis.
As is the case with many skin wounds, covering the area that’s infected with cellulitis will help it to heal.
Your healthcare provider will give you directions on what coverings or dressings to use, as well as on how often to change them.
Elevate the area
Elevating the infected area can help reduce swelling, drain fluid, and help you to heal.
This approach is especially recommended for cases of cellulitis in the leg.
If possible, try to elevate the infected area to a height that’s above the heart.
Treat underlying conditions
As many as 49% of cellulitis patients will experience another cellulitis infection in their lifetimes, and a significant portion of patients (between 8 and 20%) experiences cellulitis outbreaks in successive years.
People with chronic conditions like kidney disease, diabetes, liver disease, lymphedema are all at increased risk of developing cellulitis again because of the way these diseases make it easier for bacteria to get inside your body, or reduce your immune system’s response.
People with fungal infections of the feet are also more vulnerable to repeat cellulitis infections, because of the cracks fungal infections can create in the skin, which may allow bacteria to enter the body.
While completing an at-home course of treatment for cellulitis, you should continue to follow your treatment plans for any of these underlying conditions.
You should also talk to your healthcare provider about whether it makes sense to modify your treatment approaches going forward, to better guard against further cellulitis infections.
Seek medical attention when necessary
If your initial course of oral antibiotics is working well, you should expect to see improvement in your cellulitis symptoms within 24 to 48 hours.
But in around 18% of cases this first course of treatment isn’t effective enough in lessening symptoms, in which you should seek immediate medical attention.
At-home remedies for cellulitis may fail if the bacteria driving your infection is resistant to the most commonly prescribed oral antibiotics.
This is the case, for instance, in cellulitis caused by methicillin-resistant staph aureus (MRSA).
If your immune system itself has been compromised in a way that makes treatment more difficult, this may also make at-home remedies less effective.
If it seems like your initial treatment isn’t working, your medical provider may switch you to a different oral antibiotic.
They may also order diagnostic tests like a blood culture or a biopsy to better pinpoint the kind of bacteria causing the cellulitis infection, which can help them choose a more effective antibiotic.
And in some cases, your healthcare provider may decide to immediately prescribe more intensive medical treatments.
Severe complications may result if cellulitis progresses without proper treatment.
These include blood infection, heart inflammation, and tissue death (gangrene).
Other Medical Treatments
While most cases of cellulitis clear up from taking oral antibiotics at home, more severe or threatening cases of cellulitis may require treatment at a hospital.
There, staff will administer a more intensive course of antibiotics intravenously (through a vein) directly into the bloodstream, using an IV drip.
This is called a “systemic antibiotic” treatment and involves a hospital stay of around a week.
These hospitalizations allow medical staff to both administer the stronger antibiotic infusions safely, as well as to monitor patients for more severe complications and for pain management. (Some medical systems have also launched trial programs that allow these treatments to be administered by traveling medical staff in the comfort of patients’ own homes.)
Concerned about cellulitis? Chat with a provider through K Health.
Get StartedWhen To See a Medical Provider
You should see a healthcare provider if you think you have any symptoms of cellulitis. The condition is most easily treated when caught early.
You should also stay in contact with your healthcare provider while completing your course of antibiotics or any cellulitis treatment at home.
They’ll want to know if your cellulitis does not begin to get better after the first 48 hours, as well as if you develop any new symptoms, such as:
- Persistent fever
- Drowsiness
- Lethargy
- Blistering over the cellulitis
- Red streaks that spread
In these cases the doctors may try a different antibiotic, or start you on an IV drip.
How K Health Can Help
Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
-
Cellulitis: Who gets and causes. (N.D.).
https://www.aad.org/public/diseases/a-z/cellulitis-causes -
Cellulitis. (2021).
https://medlineplus.gov/ency/article/000855.htm -
Cellulitis: Overview. (N.D.)
https://www.aad.org/public/diseases/a-z/cellulitis-overview -
Cellulitis. (2021).
https://www.ncbi.nlm.nih.gov/books/NBK549770/ -
Orbital cellulitis. (2020).
https://medlineplus.gov/ency/article/001012.htm -
Clinical Guidelines for the Antibiotic Treatment for Community-Acquired Skin and Soft Tissue Infection. (2017).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754343/ -
Cellulitis: Diagnosis and Treatment. (N.D.)
https://www.aad.org/public/diseases/a-z/cellulitis-treatment -
EMRA: Dermatologic Pain. (2020).
https://www.emra.org/books/pain-management/dermatologic-pain/ -
Hot or cold? Treating cellulitis. (2011).
https://journals.lww.com/nursing/Citation/2011/03000/Hot_or_cold__Treating_cellulitis.16.aspx -
Comparing the Intravenous Treatment of Skin Infections in Children, Home Versus Hospital. (2021).
https://clinicaltrials.gov/ct2/show/NCT02334124