Cellulitis is one of the many skin conditions that can affect people with weakened immune systems or certain medical conditions. This common skin infection is characterised by an inflammation of the skin and tissues just underneath it. It usually begins as a skin abscess. This warm, reddened area of swollen tissue develops in response to bacteria that have entered through a cut or break in the skin. The swelling becomes increasingly painful over time. Cellulitis spreads quickly, so it's important to seek treatment right away.
Oftentimes cellulitis is brought on by streptococcus A-type bacteria, which are common in the throat and cause strep throat. Symptoms usually develop within one to three days after initial infection with cellulitis-causing bacteria, although cellulitis can also be caused by different types of bacteria like Staphylococcus aureus (which is responsible for toxic shock syndrome) and E. coli (which is responsible for urinary tract infection).
The affected area may begin to feel warm and tender within one to three days after cellulitis has begun. Over time, cellulitis can spread quickly and cause fever, swollen lymph nodes and intense pain at the cellulitis site.
Source: JAMA Dermatology
Symptoms of Cellulitis
The signs of infection due to cellulitis vary depending on the type of bacteria that caused it. They may appear suddenly or slowly develop. Here, below, are the common symptoms of cellulitis:
- Warmth or redness to the skin
- Painful and swollen skin due to enlarged lymph nodes
- Skin rashes
- Pain
- Tenderness at the infected site
Additional symptoms include fever, blisters or skin lesions on the legs, headache, fatigue, chills and weakness. Cellulitis does not usually cause people any long-term harm, although it can sometimes spread around your body.
Causes of Cellulitis
While not all bacterial skin infections can be transmitted from person to person, cellulitis is an exception. It can be triggered by an infection from scabies parasites, which occurs from scratching the itch from the infestation or from sharing contaminated beddings or clothing with someone with scabies.
Cellulitis infections can also be a result of radiation therapy or steroid injections into the cellulitis site. Sometimes cellulitis is caused by insect bites. This is especially true in children and infants since it is easier for them to scratch their faces when they are bitten, resulting in facial cellulitis.
Other risk factors for developing cellulitis symptoms are:
- Skin ulcers
- Dry skin and skin disorders like eczema
- Weakened immune system
- Obesity
- People with lymphoedema or diabetes may develop secondary infection
Cellulitis can become serious depending on how deep the bacteria has embedded itself into your body. In this case, the cellulitis may quickly spread throughout your entire body and turn into a cellulitis sepsis.
Cellulitis sepsis requires immediate medical attention as it can cause organ failure, deadly blood infections and other health complications.
Complications and Long-Term Effects of Cellulitis
If left untreated or poorly managed, cellulits can lead to serious complications and have long-term effects on an individual's health. Understanding these potential consequences is crucial to prompt recognition and proper treatment of cellulitis.
Complications:
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Abscess Formation: In some cases, cellulitis can progress to form a painful and pus-filled pocket known as an abscess. Abscesses may require incision and drainage to resolve fully.
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Bacteremia: When the infection-causing bacteria enter the bloodstream, a condition known as bacteremia can occur. Bacteremia can lead to widespread infection and, in severe cases, result in sepsis, a life-threatening condition.
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Lymphangitis: Cellulitis can affect the lymphatic system, causing inflammation and red streaks that extend from the infected area to the nearby lymph nodes. Lymphangitis may indicate a more severe infection and requires immediate medical attention.
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Recurrent Cellulitis: Some individuals may experience recurrent episodes of cellulitis, particularly if they have risk factors like chronic edema, diabetes or compromised immune systems. Frequent episodes can lead to cumulative damage to the affected area.
Long-term effects:
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Chronic Swelling: After an episode of cellulitis, the affected area may remain swollen for an extended period. This chronic swelling can lead to discomfort, reduced mobility and functional limitations.
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Skin Changes: The skin over the affected area may undergo changes, becoming thickened, discolored or scarred, especially after recurrent cellulitis or severe infections.
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Lymphedema: Severe cellulitis can damage the lymphatic system, leading to a condition called lymphedema. Lymphedema causes persistent swelling due to the impaired drainage of lymph fluid, significantly impacting the patient's quality of life.
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Psychological Impact: Cellulitis, especially when it becomes a recurrent condition, can take a toll on a person's mental wellbeing. It may lead to anxiety, depression, or a fear of further infections, affecting daily activities and overall happiness.
Preventing complications and long-term effects:
Preventing complications and long-term effects of cellulitis involves a combination of prompt medical care and self-management:
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Early Medical Attention: Seek medical attention at the first sign of cellulitis. Timely diagnosis and treatment can prevent the infection from spreading and reduce the risk of severe complications.
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Complete Antibiotic Courses: If prescribed antibiotics, ensure to complete the full course, even if symptoms improve. Prematurely stopping the medication can lead to antibiotic resistance and recurring infections.
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Wound Care and Hygiene: Proper wound care is essential for preventing cellulitis in the first place. Clean and cover any cuts, scrapes or insect bites promptly to minimise the risk of bacterial entry.
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Manage Underlying Conditions: For individuals with chronic conditions like diabetes or edema, managing the underlying condition can reduce the risk of developing cellulitis. Regular medical check-ups and adherence to treatment plans are essential.
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Lifestyle Changes: Adopting a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking and excessive alcohol consumption, can support overall immune function and reduce susceptibility to infections.
Diagnosis and Medical Treatment of Cellulitis
Prompt diagnosis and appropriate medical treatment are essential to prevent complications from cellulits and promote a swift recovery.
Diagnostic procedures:
Diagnosing cellulitis usually involves a thorough physical examination and a review of the patient's medical history. The affected area may appear red, swollen, warm to the touch, and may cause pain or tenderness. In some cases, the infection can spread rapidly, leading to the formation of blisters or an abscess.
To confirm the diagnosis and identify the causative bacteria, a healthcare provider may perform additional tests, such as:
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Blood Cultures: A blood sample is taken and tested in a laboratory to determine if the bacteria have entered the bloodstream. Blood cultures can help assess the severity of the infection and guide appropriate treatment.
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Wound Culture: If there is an open wound, a sample of the wound fluid may be collected and analysed to identify the specific bacteria causing the cellulitis. This information helps in selecting the most effective antibiotic.
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Imaging Studies: In severe cases or when there is a suspicion of deeper involvement, imaging tests like ultrasound, CT scan or MRI may be conducted to assess the extent of the infection and rule out complications like abscesses or deeper tissue involvement.
Medical treatment:
Cellulitis is typically treated with a course of antibiotics to eradicate the bacterial infection. The choice of antibiotics depends on the severity of the infection, the patient's medical history, and any underlying health conditions. The antibiotics are usually administered orally for mild cases or intravenously for more severe infections.
It is crucial for patients to complete the full course of antibiotics as prescribed, even if the symptoms improve. Stopping the medication prematurely may lead to the re-emergence of the infection or antibiotic resistance.
In addition to antibiotics, medical treatment for cellulitis may include:
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Elevation: Elevating the affected limb or area can help reduce swelling and promote better blood flow to the area, aiding in the healing process.
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Pain Management: Over-the-counter pain relievers can help manage discomfort and pain associated with cellulitis. However, patients should consult their healthcare provider before taking any medication.
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Wound Care: Proper wound care is essential to prevent further infection and promote healing. Keeping the affected area clean, dry, and covered with a sterile dressing can minimise the risk of complications.
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Follow-up: Patients should schedule follow-up appointments with their healthcare provider to monitor their progress, ensure the infection is responding to treatment and detect any signs of complications.
In severe cases of cellulitis or when complications arise, hospitalisation may be necessary. Intravenous antibiotics and more intensive wound care can be provided under the supervision of medical professionals.
Natural Treatment for Cellulitis
Since cellulitis is usually caused by a bacterial infection, a typical medical treatment often involves antibiotic therapy. Your doctor may give you a prescription for an antibiotic ointment, oral antibiotics, or an intravenous (IV) antibiotic treatment. Severe cellulitis is usually treated with penicillin or amoxicillin.
If bacterial infections do not respond well to antibiotics, surgery may be required to drain the cellulitis site or remove dead tissue from it. The good news is that there are natural remedies that may be effective in the treatment of cellulitis. If you're hesitant about antibiotic treatment, let alone surgical incisions, the following are worthwhile options:
Tea tree oil
A study shows that tea tree oil was found to be a promising alternative to topical antibiotics in fighting off methicillin-resistant Staphylococcus aureus (MSRA), which causes cellulitis.
Liver cleanses
A liver cleanse may help eliminate cellulitis-causing bacteria and viruses from the body, which can reduce cellulitis symptoms.
Vitamin C
Eating fruits and vegetables packed with the antioxidant properties of vitamin C, such as citrus fruits, bell peppers and potatoes, may help fight the free radicals that cellulitis-causing bacteria create in your skin. A qualified nutritionist can advise you on which nutritional supplements can fill in the void if you lack vitamin C.
Prevention of Cellulitis
Since cellulitis is usually caused by skin cuts or breaks, preventing cellulitis boils down to keeping the skin clean and clear. Cellulites spares no one, not even healthy people. That said, it's important to make sure you have no open sores or cuts anywhere on your skin before you go swimming, lest cellulitis develops from bacteria in water.
While cellulitis most commonly appears in the legs, care should be taken with all skin breaks such as scrapes, cuts and insect bites. Cellulitis can quickly become life threatening if left untreated or by delaying treatment until symptoms worsen. This is especially dangerous when it occurs on the lower body and spreads to the bloodstream.
It is not always easy to diagnose cellulitis because there are so many conditions that can produce its symptoms. Cellulitis may appear after an injury or insect bite and spread to other areas in a blink of an eye, so it's important for individuals who are at risk to be able to detect its signs and seek treatment as soon as possible rather than wait for systemic symptoms.
Self-Care Tips at Home to Manage Cellulitis
While professional medical care is essential, there are self-care measures that individuals can take at home to support their recovery and manage cellulitis effectively. These self-care tips can complement medical treatment and help reduce discomfort during the healing process.
1. Keep the Affected Area Elevated: Elevating the affected limb or area can help reduce swelling and improve blood circulation to the area. Prop the affected limb on pillows or cushions when resting or sleeping to alleviate pressure and promote faster healing.
2. Practice Good Wound Care: Proper wound care is vital in preventing the spread of infection and supporting the body's natural healing process. Keep the affected area clean by gently washing it with mild soap and water. Pat the area dry with a clean towel and avoid rubbing, as it may irritate the skin further.
3. Apply Warm Compresses: Warm compresses can help ease discomfort and reduce inflammation associated with cellulitis. Soak a clean washcloth in warm water and gently apply it to the affected area for 15 to 20 minutes, several times a day. Make sure the compress is not too hot to avoid burns.
4. Manage Pain and Discomfort: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be helpful in managing pain and reducing fever if present. Always follow the recommended dosage and consult a healthcare professional if you have any underlying health conditions or are taking other medications.
5. Rest and Avoid Overexertion: Allowing the body to rest and recover is crucial during a cellulitis infection. Avoid putting unnecessary strain on the affected area and refrain from strenuous activities until the infection has cleared.
6. Avoid Scratching or Picking at the Skin: Resist the urge to scratch or pick at the affected skin, as this can introduce more bacteria and worsen the infection. Keeping the area clean and covered with a sterile dressing can help prevent unintentional scratching.
7. Stay Hydrated: Drinking plenty of water helps to flush out toxins from the body and support the immune system. Adequate hydration can also contribute to overall wellbeing during the healing process.
8. Wear Loose and Comfortable Clothing: Opt for loose-fitting and breathable clothing over the affected area to prevent friction and irritation. Avoid tight clothing that may constrict blood flow and exacerbate swelling.
9. Monitor for Signs of Worsening: Stay vigilant for any signs of worsening infection, such as increased redness, spreading warmth, or the appearance of new symptoms. If these signs arise, seek immediate medical attention.
10. Follow the Doctor's Instructions: Adhere to the prescribed treatment plan, including the full course of antibiotics if prescribed. Follow any additional instructions given by the healthcare provider to ensure a successful recovery.
Remember, while these self-care tips can be beneficial, they are not a substitute for professional medical advice and treatment. If you suspect cellulitis or have been diagnosed with it, promptly consult a healthcare professional to receive proper evaluation and guidance.
Originally published on Dec 01, 2021
