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Cellulitis: Causes, Symptoms, Diagnosis, Treatment & Prevention

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Cellulitis is a common bacterial skin infection affecting the deeper layers of the skin, including the dermis and subcutaneous tissues. It can occur anywhere but is most frequently seen on the lower legs. If left untreated, cellulitis can spread rapidly, leading to severe complications including systemic infections.

This comprehensive guide provides a detailed overview of cellulitis, including causes, symptoms, diagnosis, treatment, complications, prevention, and FAQs.

Cellulitis medical illustration showing infected skin layers, symptoms, causes, treatment options, and risk factors of bacterial skin infection.
Cellulitis: Causes, Symptoms, Treatment, and Risk Factors – Educational Medical Illustration

What Is Cellulitis?

Cellulitis is an acute bacterial infection of the skin and underlying tissues, typically caused by Streptococcus or Staphylococcus species. Unlike superficial infections like acne or eczema, cellulitis affects deeper skin layers, which makes it more dangerous if not treated promptly.

Key characteristics of cellulitis:

  • Redness and warmth of the affected area

  • Swelling and tenderness

  • Rapid onset that can worsen over hours to days

Note: Cellulitis is not contagious, but bacteria can enter through cuts, scratches, insect bites, surgical wounds, or chronic skin conditions.

Causes of Cellulitis

Cellulitis occurs when bacteria enter the skin through breaks or weakened skin barriers. Common causes include:

  • Skin injuries: Cuts, abrasions, burns, or surgical incisions

  • Chronic skin conditions: Eczema, psoriasis, fungal infections, or athlete’s foot

  • Insect bites or stings

  • Weakened immune system: Diabetes, HIV, or chemotherapy

  • Edema or lymphedema: Swelling increases infection risk

Common bacteria responsible:

  • Streptococcus pyogenes – rapid-onset cellulitis

  • Staphylococcus aureus, including MRSA

Individuals with chronic skin conditions like eczema or psoriasis have a higher risk due to impaired skin barriers.

Symptoms of Cellulitis

Cellulitis symptoms develop quickly, sometimes within 24 hours:

  • Redness spreading across the skin

  • Warmth and swelling of the affected area

  • Pain or tenderness

  • Fever, chills, or malaise

  • Blisters or pus in severe cases

  • Skin dimpling or tightness

Common locations:

  • Legs (most common)

  • Arms

  • Face or eyelids (requires urgent care)

Severe cellulitis can progress to necrotizing fasciitis, a life-threatening condition.

Complications of Cellulitis

If untreated or inadequately treated, cellulitis can lead to:

  • Sepsis: Life-threatening systemic infection

  • Abscess formation: Localized pus pockets requiring drainage

  • Lymphangitis: Infection spreading through lymph vessels

  • Recurrent cellulitis: Especially in patients with chronic edema or venous insufficiency

  • Chronic swelling or scarring

Early diagnosis and treatment are essential to prevent complications.

Diagnosis of Cellulitis

Clinical evaluation is the primary method for diagnosis:

  • Medical history: Recent injuries, chronic skin conditions, or insect bites

  • Physical examination: Redness, swelling, warmth, tenderness, lymph node enlargement

  • Laboratory tests:

    • Complete blood count (CBC) – elevated white blood cells

    • Blood cultures – in severe or systemic cases

    • C-reactive protein (CRP) or ESR for inflammation

Imaging: Ultrasound or MRI only if abscess or deep tissue infection is suspected.

Important: Cellulitis must be differentiated from eczema flare-ups, psoriasis, or acne infections.

Treatment of Cellulitis

Medical Management

  • Mild cellulitis: Oral antibiotics (cephalexin, dicloxacillin)

  • Moderate to severe cellulitis: IV antibiotics (cefazolin, vancomycin for MRSA)

  • Treatment duration: 5–14 days depending on severity

Supportive care:

  • Rest and elevation

  • Pain management with acetaminophen or NSAIDs

Hospitalization and Advanced Care

Hospitalization is required for:

  • Severe systemic symptoms (fever, hypotension, tachycardia)

  • Rapidly spreading cellulitis

  • Immunocompromised patients

  • Facial or periorbital cellulitis

Hospital care allows IV antibiotics, monitoring for complications, and abscess drainage if needed. For authoritative guidance, visit the Mayo Clinic – Cellulitis Overview.

Home Care Tips

  • Keep the area clean and covered

  • Elevate the affected limb

  • Avoid scratching

  • Monitor for red streaks, pus, or fever

Prevention of Cellulitis

  • Clean wounds promptly with antiseptic

  • Moisturize dry or cracked skin, especially with eczema or psoriasis

  • Protective clothing for outdoor activities

  • Manage chronic conditions like diabetes

  • Maintain good hygiene

Prevention is critical for individuals prone to recurrent cellulitis.

Frequently asked Questions

Q1: Is cellulitis contagious?

No, but bacteria on the skin can spread without proper hygiene.

Q2: Can cellulitis be life-threatening?

Yes, if it progresses to sepsis or necrotizing fasciitis.

Q3: How fast does cellulitis spread?

Symptoms can develop within 24 hours and worsen quickly.

Q4: Can chronic skin conditions increase the risk?

Yes, eczema, psoriasis, and severe acne increase susceptibility.

Q5: Do I need hospitalization?

Only for severe infections, facial involvement, or immunocompromised patients.

Q6: Can cellulitis recur?

Yes, especially in patients with edema, diabetes, or chronic skin issues.

Q7: What is the best home care?

Clean, elevate, take prescribed antibiotics, and monitor for worsening symptoms. 

About the Author

Asma Safdar is a licensed pharmacist and health content writer dedicated to sharing evidence-based information on diseases, symptoms, prevention, and healthy lifestyle practices. She writes in simple, clear language to help readers make informed health decisions. The content on this website is intended for educational purposes only and is not a substitute for professional medical advice.

Medical Disclaimer

This article is for educational purposes only and does not replace professional medical advice. The author, a licensed healthcare professional, aims to provide accurate and evidence-based information. Readers should consult a doctor for diagnosis and personalized treatment. 

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