Cellulitis 

Introduction 

Cellulitis causes the affected area of skin to turn red, painful, hot and swollen. 

Cellulitis vs cellulite

Cellulite is a cosmetic problem caused by fatty deposits that form underneath the skin. It is not related to cellulitis.

Losing weight is the best way of dealing with cellulite. See the Live Well section of the website for information and advice about losing weight.

Cellulitis is an infection of the deeper layers of the skin and the underlying tissue.

The main symptom of cellulitis is the affected area of skin suddenly turning red, painful swollen and hot.

Cellulitis can have a wide range of causes, but the majority of cases are caused by a type of bacteria called group A streptococcus, or a different type of bacteria called staphylococcus aureus.

The skin

The skin is the largest organ of the human body. It is made up of three main layers:

  • the epidermis – the outer surface of skin and an underlying section of cells, which the body uses to create new skin cells
  • dermis – the middle layer of skin that contains blood vessels, sweat glands and hair follicles 
  • subcutis – the bottom layer of skin that consists of a layer of fat and collagen (a tough, spongy protein), which helps protect the body and regulate temperature

Causes of cellulitis

Cellulitis develops when bacteria, or sometimes fungi, move down through the skin’s surface into the dermis and subcutis through a damaged or broken area of skin, such as a cut, burn or bite.

Having a skin condition such as eczema or a fungal infection of the foot or toenails (athlete’s foot) can cause small breaks and cracks to develop in the surface of the skin. This makes a person more vulnerable to cellulitis.

Other known risk factors for cellulitis include:

  • having a weakened immune system (the body’s natural defence against infection and illness) as a result of health conditions such as HIV or diabetes, or as a side effect of a treatment such as chemotherapy
  • lymphoedema – a condition that causes swelling of the arms and legs, which can sometimes occur spontaneously or may develop after surgery for some types of cancer
  • intravenous drug misuse (injecting drugs such as heroin)

Learn more in causes of cellulitis.

Symptoms of cellulitis

Cellulitis causes affected skin to become red, swollen, hot and tender.

It most often affects the legs, but can occur anywhere on the body.

See your GP immediately if an area of skin suddenly turns red, hot and tender. If you cannot see your GP on the same day, you should go to a walk-in centre or minor injuries unit.

Find a local walk-in centre or minor injuries unit using our service search.

Certain symptoms can indicate that the infection has spread from your skin to other parts of the body, such as the blood. These include vomiting, fever, rapid breathing and confusion or disorientation. If you experience these symptoms, call 999 for an ambulance.

Learn more in symptoms of cellulitis.

Who is affected?

Cellulitis can affect people of all ages, including children. Rates are thought to be roughly similar in both sexes.

In England in 2009, around 80,000 people were admitted to hospital as a result of cellulitis. The number of annual cases of cellulitis has increased three-fold over the past 15 years.

Treating cellulitis

Cellulitis usually responds well to treatment with antibiotics if it's diagnosed and treated promptly.

As a precaution, hospital admission is usually recommended for more severe cases of cellulitis that fail to respond to antibiotic tablets.

Learn more in treatment for cellulitis.

Complications

In some cases of cellulitis the bacteria triggers a secondary infection somewhere else in the body, such as in the blood (septicaemia). Such cases usually require hospital admission for treatment with intravenous antibiotics (antibiotics given directly into a vein).

In 2010, there were 917 deaths as a result of cellulitis in England and Wales. Most of these deaths occurred in elderly people.

Learn more in complications of cellulitis.

  • show glossary terms
Antibiotics
Antibiotics are medicines that can be used to treat infections caused by microorganisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.
Bacteria
Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some others are good for you.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Last reviewed: 30/07/2012

Next review due: 30/07/2014

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28 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

Clemettr said on 07 April 2013

I had an ingrown toe-nail which caused the cellulitis in my leg!! I was admitted to a&e with pain in my leg from the groin down, redness and swelling developed while I was in hospital and within 12 hours I was told I could lose my life or at best my leg!! I was operated on, (two fasciotomies) they saved my leg. It spread so fast due to my MS and immuno-supression. I had the staples out two weeks ago but cellulitis is back and i'm scared i'll need to be re-admitted for more surgery - how long does this ting take to go away because it's been a month now and it's still infected!

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bobbyd2 said on 01 April 2013

Im 17, and developed facial Cellulitis, from a scratch when drunk. I was diagnosed about a month ago and my life has sucked since. I woke up with a completely swollen face, had to go to the doctors where they prescribed me a week long course of co-amoxiclav. The infection went down slightly, but one week later it was back. By now I had developed acne from it which became incredibly inflammed, it hurt and made my face red. As well as this rashes occured.

I was then prescribed a 12 day course of flucloxacillin and penicillin (maximum dosage) This worked well, but now I am 3 days off it, my face is beggining to hurt again, and am 90% sure I will wake up with a swollen face again.

In summary, even if you are young and healthy, cellulitis is so annoying. It just keeps coming back until you have to go to A&E. You can't drink alcohol, concentrate on work, and look ugly (If you have facial cellulitis). This causes loss of all self-esteem, and evertime you think it's getting better, it's not.

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wivany said on 08 January 2013

I suffered from an episode of Cellulitis while on holiday in south wales in August this year & was admitted to Aberswyth hospital for 2 weeks. I was aware of the cellulitis as a side effect of my current condition of Lympodema. I was diagnosed with primary lymphodema in both legs (after 19 years of fighting with NHS doctors) March 2011. I wasn't aware of the condition being serious and I have now had my eyes wide open. However its now 5 1/2 months since and I am in terrible pain at the top of my leg - I have been told this is my lymp gland working over time, I also suffer greatly from pins and needles in my leg (where the infect was) if I stand more than 10 seconds is one spot. As I have been told I am at risk of re-occurance this is now that the forefront of my mind and I am constantly checking my legs and if I have a told and start shivering I panic...... its stupid! To put my mind at ease I would like to know if the pains I am experiencing are normal and will they subside? I cannot seem to get a traight answer from either my GP or my Lymph nurse...... Feeling very frustrated!

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Goatee53 said on 11 August 2012

i'm a 58 yr old male, and have had cellulitis around 5 times in last 8 years. It's always been in the same place, lower leg. I've noticed that I have athletes foot in the same leg, and wonder if that has been the cause of the infection now and in the past.

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User703602 said on 10 August 2012

I've been bitten twice by a mosquito or something else on my wrist or lower arm (not sure as not seen), on separate occasions that resulted in cellulitis.

At first it seemed like a typical bit, itch, raised wheal, but then massive swelling and reddening that spreads despite antihistamines and throbbing pain that resulted in one GP walk in visit and the most recent - A&E as late - unfortunately NHS direct did not help and were way off track on this instance.

So, if you have massive swelling, reddening and heat etc as article above says- go to the docs! And do it before it gets to the point I leave it - as then it cuts the circulation and hurts!

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ccmacleod said on 25 June 2012

can someone please help....my husbands been diagnosed as having cellulitis in his foot yesterday and attended the A&E department and was given antibiotics.

The problem is we are due to fly out to Florida on Tuesday morning!! Can any one tell me if he will be allowed to fly? or if there is any reason that he shouldnt fly? He is a 37yr old, generally healthy man, who has never had this before.

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G Matthews said on 17 June 2012

I am going to Lanzarote in September. This is the first time in years that I am going abroad. I have had to take out travel insurance that covers lymphodeama cellulitis in case I get an attack and have to have IV. I am worried about this happening as I get very sick, very quickly. I understand that I need to get a course of antibiotics before I go and take a prescription.with me Can anyone confirm this is so and any tips for me.

Also, I am borderline diabetic and I think this has something to do with why I get this condition but the doctors always say they do not know why it has happened. I have had it four times in a number of years and I really dread the next episode.

Always get medical treatment as soon as you know you have it. Never ever leave it. It is so dangerous. I wish more money would be spent on finding the cause as it is on the increase.

Much appreciated for any tips.

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yvek said on 23 May 2012

Have had cellulitis for one week so far in leg, on antibiotic and penicillin for 5 days. Cousin also diagnosed with it in same place and at same time as myself! Another family member also had it in same place, developed sepsis and died 2 months ago. Is this contageous? I`ve been told it`s not but it seems such a coincidence. Redness, swelling, sweats, painful...not much fun...and no sign of improvement yet. According to comments here, it seems that when you have had it once you are likely to get it again. Docs just give standard answers. Can anyone help?

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ballard said on 14 April 2012

I have just been discharged from hosptial for the third time in 4 weeks with cellulitis. I have lumphoedema following cancer surgery. Initially I had a few attacks so my GP put me on penicillin on a long term basis. I was free from cellulitis for about 2 years then all of a sudden, for no apparent reason, I get these latest 3 attacks. I wish I knew what had caused them and what do I do now to try and decrease the amounts of attacks? Any advice would be welcome.
Ballard

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bz1236 said on 14 March 2012

I stood on a nail 4pm friday 9th march 2012, by 6.30pm couldnt walk on my right foot went to a+e right away and was diagnosed with cellulitis and put on flucloxacillin take one four times a day, told to keep foot up and use cold compresses to help with the swelling did all this but it still got worse, by the sunday went back to a+e and was admitted right away and given intrevenus drips, discharged on tuesday, my foot is still painful and the pressure when you try to put your foot down is unbearable but the redness seems to be getting better, have to take two pills 4 times a day now, anyone who happens to stand on or cut thereself with anything suspect dont wait fort something to happen go straight to your doctors or nearest hospital and get it sorted right away.

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mary47 said on 07 February 2012

feel like i have a bad case of the flu now. falling asleep a lot., although ankle isnt as red.is this usual.

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mary47 said on 06 February 2012

I have just been given antibiotics for cellulitis. I too keep catnapping then wake up with a start. I am also taking low dose iron tablets for previous anaemia. Ice cube bags make handy cold compresses.

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mary47 said on 06 February 2012

I have just started taking antibiotics for cellulitis in my right ankle. I agree with pobble7 I too keep catnapping and having strange dreams, also turnanog and munjojerrie I am still taking low iron tablets for anaemia. I fill ice cube bags to make handy cold compresses.

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joda50 said on 15 January 2012

I first contracted cellulitis in july 2009 while on holidays to Canada, it started with shivering and my left lower leg became hot and started to turn red. As I did not know what it was I did not go to the hospital for about 9 hours, by this time my leg was in pain very swollen and well infected. I was lucky as all they did was give me an antibiotic injection in my rear flank and a 1 week course of oral antibiotics and it went away. I had no idea I was going to get it again but I did two and a half years later while on holidays in Canada. When it started this time I knew what it was and headed for the hospital right away but this time I was on an IV drip for 3 days and it got way worse before it got better, almost did not make my flight home. Because of the reoccurance of cellulitis I am forced to rethink my holiday plans, in 2013 I was hoping to go to China on a 3 week guided tour but if cellulitis breaks out I could be left behind and have a find them further into the tour not ideal. I will still travel but will have a permanent base if trouble happens far less hassle. If you suffer from cellulitis don't let it stop you from seeing the world just make sure you have good travel insurance.
Happy travels

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Nannynessa said on 14 January 2012

Diagnosed for first time yesterday, i had bad case of athletes foot about a month or two ago, though on the my right foot maybe that was the cause? i had very high temp tues night, body was on fire, next day just had hot swollen left upper leg not painful as such, suffer from arthritis so can put up with most pain. rang NHS early hours of weds and was in A&E within an hour, DVT was ruled out as had one previously, but i had also suffered a great blood loss since a band ligation Dec 21 last 2 weeks very heavy, was very anaemic as i have myelodysplasic too! I am now on antibiotics the swelling and heat is going down, now very itchy and bruised around the bullseye! noticed this expression can see what you mean, now my lower leg feels bit tight, but keeping it raised and feel ok in myself just wondered is it best to keep rested or to carry on as usual?

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Budweiser said on 10 January 2012

On my 5th day now. Very painful ( in the groin area and fanning out over leg). Paracetamol helps a bit. Was given fluxocillin but hasn't worked, now been given co-amoxiclav started yesterday no sign yet of improvement. Spent half a day waiting for a scan yesterday only to be told to come back today(frustrating). If another doctor/nurse prods,pokes or kneads me today I think I'll scream(6 so far, all with different opinions). No wonder I'm in pain! I dont blame the staff, it's a tough job but surlely it would be better to get the results from a scan rather than poking and prodding an infected area( one didn't even wear his gloves) and giving their own opinion, which clearly differs from doctor to doctor..started a new job in nov already missed two shifts and no sign of me improving yet..don't fancy my chances of being kept on...

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Pobble7 said on 10 January 2012

I'm a 55 year old guy with both diabetes and lyphoedema, so I'm doubly prone to leg infections. I've now had 5 in the last 3 months and never experienced anything like them before. Fortunately I have a wonderful GP who comes out very quickly to issue me a script for antibiotics. Some infections have been worse than the others, but they all have the same symptoms. I sometimes feel a 'click' in my head, like someone switching on a light, and I immediately become light headed and muzzy - it's that quick ! Soon after, I feel cold and get shivers although these don't often last more than an hour or two. I usually (but not always) have a temperature up to 38 or 39C but again this doesn't last long and responds to paracetamol, which also helps with the aches, (especially in the neck). The problem is, many infections begin like this but with cellulitis, the charateristic rash does not appear until the second day.
That said, the first day is always the worst because you feel almost delirious.I normally spend it cat-napping with strange dreams and visions floating around my head. Don't know if anyone else has had this experience too, but there's also a strange kind of time dilation effect. The day seems to last for ages !
It worries me how quickly these episodes come upon you and I wondered if there were anything I could do to minimise them, but my GP told me they usually do occur 'just like that' (reason unknown) and did not think there was much I could do to ward them off. I suggested boosting my immune system, but he seemed very sceptical about this, and more or less implied that these infections were now part of my life and I'd have to get used to them. That said, I think I'm going to have to start moisturising my legs daily as the dry skin caused by the lymphoedema is very liable to crack and admit bacteria. Hope it works because I don't think I could face the rest of my life with episodes as often as I've been getting them lately !

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kim2011 said on 28 November 2011

My just turned 3 year old boy, had cellulitis about 3months ago which i think came just after he had a cut on his face, the cut healed and left a scar which turned really red then a couple of days later one side of his face and ear was bright red, went to the docs and got giving anti biotics and it all went until 3days ago he got scrammed by someone at play group on his face again, the scram healed fine and left a bit of a scar but now the same side of his face has swelled and gone red, this time he is also being sick, will this ever go away or will my poor baby have to deal with this throughout his whole life????

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GARY55 said on 18 November 2011

First attack was last Xmas, took days to get medical treatment. I spent two weeks in bed.

It started (always starts) with shivering, then fever, loss of balance, loss of control urinating, and if you don't drink lots of water, kidney pains and slipping in and out of dreadful halucinations.

It has returned 4 times this year and I have been ready ever since that first attack. It takes over your life. On one occasion the doctor told me to drive to get medicine, not a good idea so don't even think about trying to drive.

I am trying to work out what triggers an attack. I am tracing a pattern based on stress (no proof) but I do know that excessive stress or anxiety can create toxins in the skin. Interested in any feedback.

My advice is get treatment immediately you get the shivers and can't get warm, but don't try to drive yourself. I was lucky not to be involved in one of several traffic accident possibilities on that night.

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Fredw said on 22 October 2011

I have had this 5 times in th last10 years, always at the same spot on my lower left leg so I don't believe it was caused by a scratch or bite - that would be too much of a coincidence.

I agree A&E is hopeless - you could die waiting for the necessary antibiotics. My doctor has given me some antibiotic tablets to take the moment symptom appear again - I will certainly keep taking them while waiting for hospital treatment.

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tirnanog said on 11 October 2011

Funny enough I was fit and healthy until I was put on a course of iron tablets for mild anaemia. Now I have sudden unexplained cellutitis in my lower right leg. It's almost as if my body is toxic and breaking out to get rid of excess (iron) ?

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Mungojerrie said on 25 July 2011

I have just noticed the tell-tale signs of Cellulitis on my lower left leg again, the fourth time since January. Thankfully, I seem to have it quite mildly compared to some, but I am sick of getting this time and time again this year, yet I had never even heard of it before January! The only life changes I have had that could have contributed to this are 1) I have been on Warfarin after a DVT and PE in December, and 2) I was diagnosed with anaemia at the same time, and have been on iron tablets since April. Could one or both of these be a contributary facter? I would love to know. Meanwhile, I will now have to see if I can get an appointment at my local surgery with either a doctor or the Nurse Practioner tomorrow to get yet more antibiotics - I have taken more oral AV's in the last 6 months than I have in the previous 6 years!!!!!!

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tazissocool said on 14 July 2011

I have just returned home from 5 days in hospital with this infection, to be honest i didnt know what it was until i caught it, the hospital reacted very fast to treating this as it was spreading very rapidly from the knee down, and i developed a fever and vomiting during the night, very very painful and still is even after treatment!!
You need very strong interveiness antibiotics to start with and I now take 24-28 tablets a day for another 10 days.

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justlikewatchingbrazil said on 30 June 2011

I have had at least 8 stays in hospital due to cellulitis in the last 16 years and it does take over your life as you never know when it will strike and when it does its painful and i start getting a temp over 39 and i turn up at the hospital it takes hours before they decide to give me a course of antibiotics due to procedures and all the while it spreads fast and means a longer stay in hospital and larger doses which on the last stay in hosiptal 2 weeks ago for 6 days the doctor said i was having enough antibiotics that vets would give to an elephant and they make a mess of the veins and ended up having 5 canular replacements in six days.
Also it is stopping me going abroad on holiday as im scared it will break out while away.

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G Matthews said on 24 April 2011

I have lymphodeama in both my legs and feet and have had cellulitis four times, Due to the seriousness of this illness I have to attend A & E immediately to have IV drugs. It is really awful and the pain is extreme. I never know when the next occurence is going to be. I have to be extremely careful and check for any cracks in the skin etc, although there have been times where there has been no reason for it. Once I was in the cinema when I had an attack and missed the film, having to go straight to hospital. It is inconvenient and annoying.

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vcyorke said on 07 April 2011

My Son who has just turned 4, had his pre school booster for diptheria, tetanus, acellular pertussis & polio 2 days ago and has got cellulitis in the top of his left arm. High dose of antibiotics & cold compress & calpol and fingers crossed.... not much info on small kids & this condition.

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ej358 said on 02 January 2011

My wife also has been getting cellulitis several times in 2010 .
We have to be very vigilant about the needed treatment
She has myelodisplasia which means her blood count is lower than normal and therefore the white cells do not cope very well with infections.
The ususal treatment is a course of antibiotics, usually co-amoxiclav.

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samcraig said on 01 November 2010

I get this yearly somes 2 - 3 in the year

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