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What is cellulitis?

Cellulitis is an infection of the deep layer of skin (dermis) and the layer of fat and other tissues just under the skin (the subcutaneous tissues).

What causes cellulitis?

The skin is usually a good barrier against infection but a break in the skin, for example from a cut, skin ulcer, infection, athlete's foot or badly scratched eczema, allows bacteria (germs) to get into and under the skin.

A variety of bacteria can cause cellulitis.

A tiny cut is all that is needed to let bacteria in. The bacteria then multiply and spread under the skin's surface to form an infection.

Although a cut or graze is found in many cases to be the main cause, sometimes the infection can occur for no apparent reason, without the skin being broken.

Who gets cellulitis?

Cellulitis can affect anyone but you are more likely to get cellulitis if you:

  • have athlete's foot
  • have swollen legs (for various reasons)
  • are overweight
  • have had cellulitis before
  • have a poor immune system
  • have poorly controlled diabetes

A common cause of cellulitis is athlete's foot, which is usually a mild fungal infection but it can cause tiny cracks in the skin between the toes. Bacteria may then get under the skin and travel up to cause a cellulitis in the leg, without looking like there is an infection of the foot.

The cellulitis can be treated but it may come back if the athlete's foot is not also treated. Unless athlete's foot is looked for, it can easily be missed as the source of the problem. Itchiness between the toes is the first sign of athlete's foot.

People that are more likely to get cellulitis, like those with swollen legs or those who are overweight, should be careful to treat any athlete's foot promptly.

How do I know I have cellulitis?

The affected skin feels warm, may look swollen, and looks red and inflamed.

The infected area may spread and is usually tender. The nearest glands may swell and become tender because they are fighting off the infection to stop it spreading to other parts of the body.

The glands in the groin may swell during a cellulitis of the leg. You may feel generally unwell and have a fever, particularly if the area of infection is large. The lower leg is the most common site for cellulitis to develop but it can affect any area of the skin.

Is cellulitis serious?

Cellulitis can range from a small area to a large area of spreading infection affecting a large area of skin. This means that cellulitis can range from mild to serious.

Without treatment, a 'battle' is fought between the immune (defence) system of the body and the invading bacteria.

Often the body will fight off the bacteria and the infection will clear but a spreading cellulitis that is getting worse can be quite worrying.
Because of this, treatment is usually advised as soon as cellulitis is diagnosed to make sure it does not spread and become serious.

What is the treatment for cellulitis?

A course of antibiotics will usually clear cellulitis.

What can I do to help?

Painkillers such as paracetamol can ease pain and reduce a fever. Always follow the guidance on the packet.

If you have a cellulitis of the leg, keep the leg raised when you are resting. This helps to prevent excess swelling, which may also ease pain.

'Raised' means that your foot is higher than your hip so gravity helps to reduce the swelling. The easiest way to raise your leg is to lie on a sofa with your leg up on a cushion. When in bed, put your foot on a pillow so that it is slightly higher than your hip.

If the cellulitis is in the forearm or hand, a high sling can help to raise the affected area to reduce swelling and pain.

Treat athlete's foot if it is present. As the infection clears and the skin begins to heal, use a moisturising cream to keep the skin supple and moist.

If you have any concerns about your condition or your treatment, please contact your Community Nurse.