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Cellulitis

Date issued: December 2022

Review date: December 2024

Ref: A-517/NB/ED/Cellulitis

PDF:  Cellulitis final December 2022.pdf [pdf] 110KB

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 (even a scratch) is all that is needed to allow bacteria in.

  • The bacteria may then multiply and spread along under the skin surface to form an infection. Sometimes the infection occurs for no apparent reason with no break in the skin found.

What are the symptoms of cellulitis?

  • The lower leg is the most common site for cellulitis to develop but it can affect any area of the skin.

  • 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.

  • You may feel generally unwell and have a fever. Indeed, the first symptom is often to feel feverish and shivery for up to 24 hours before any changes to the skin appear.

Is cellulitis serious?

  • Cellulitis can range from a small area to a large, spreading infection affecting a large area of skin. Treatment is usually advised as soon as cellulitis is diagnosed to make sure it does not spread and become serious

  • Most people with cellulitis make a full recovery without any complications developing.

What is the treatment for cellulitis?

  • Antibiotics: a course of antibiotic tablets will usually clear cellulitis.

  • Tell a doctor if the area of infection continues to spread or you become worse after you start antibiotics (they may take up to 24 hrs to begin working).

  • People with severe cellulitis or those not improving with antibiotic tablets may need antibiotic injections. Some people with severe cellulitis become quite unwell and need to be treated in hospital with antibiotics given straight into a vein. This can sometimes be done at home by your district nurse.

Other things that may help include

  • Keeping the affected limb raised

  • Paracetamol is useful to ease pain and reduce fever. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may prescribe additional painkillers such as codeine if the pain is more severe.  If you are prescribed a combination of paracetamol and codeine (e.g., co-codamol or co-dydramol) then it is important not to take additional paracetamol as you will accidentally overdose

  • Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them

  • Use a moisturiser cream and soap substitute on the affected area of skin until it heals. This prevents the skin from becoming dry and helps to prevent damage to the skin.

 

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