Cellulitis is a bacterial infection of the deeper layers of the skin. It usually affects the legs and makes the skin hot, swollen and painful. It needs prompt treatment with antibiotics, because it can spread quickly.
Imagine a small graze on your shin turning warm and swollen overnight, with the tender area creeping up your leg. Drawing a pen line around the edge and seeing a doctor that day can make all the difference.
Signs of cellulitis
- An area of skin that is hot, swollen, painful and tender
- On lighter skin it looks red; on darker skin it may look darker, purple or grey, so warmth and swelling are key signs
- Usually on one leg, but it can affect any area
- You may feel unwell, with fever or chills
Common causes and risks
- Bacteria entering through broken skin: cuts, insect bites, cracked heels or athlete’s foot
- Swollen legs or lymphoedema
- Diabetes, a weakened immune system or obesity
- A previous episode of cellulitis
Treatment
Most people are treated with antibiotic tablets. Rest and raise the affected leg, drink plenty of fluids and take pain relief. Many clinicians draw around the edge of the affected area so you can tell whether it is spreading. Severe infections are treated with antibiotics into a vein in hospital.
Get urgent help if you have
- Skin that is spreading quickly, or very severe pain
- A high fever, shivering, fast heartbeat or confusion
- Cellulitis around the eye or on the face
- Blisters, dark patches or skin that looks like it is dying
But my skin isn’t red, so it can’t be cellulitis, right?
Not necessarily. On brown and black skin, cellulitis may not look red at all. Compare the area with the other leg: if one is hotter, more swollen and painful, get it checked.
Your next step: If you have a hot, swollen, painful area of skin, see a doctor the same day. To prevent it, moisturise dry or cracked feet and treat athlete’s foot promptly.
Sources: NHS, “Cellulitis”; NICE guideline NG141, “Cellulitis and erysipelas: antimicrobial prescribing”; US Centers for Disease Control and Prevention (CDC), “Cellulitis”. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.
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