Cellulitis – Causes, Symptoms and Treatments

Introduction

Cellulitis is a condition that is quite common and at times, painful. Cellulitis is an outcome of skin infection caused by bacteria. Cellulitis, in other words, is known as “inflammation on the skin.”

Though many kinds of bacteria result in the condition, mostly the type of bacteria that results in Cellulitis are Staphylococcus and Streptococcus.

Initially, the affected area turns red, and the area gets swollen, which on touch gets “hot or warm and tender or hard.” There is a fast growth of “redness and swelling.” This condition majorly affects the lower leg skin, but the occurrence of infection is anywhere on the individual’s face or body. As per the American Academy of Dermatology (AAD), Cellulitis in children affects mostly the neck and face. Every year in the United States (US), 14.5 million individuals are affected by Cellulitis.

Cellulitis mostly occurs on the skin surface, but might also affect the tissues beneath the skin. There is an extension of infection even to the lymph nodes and bloodstream. Many times Cellulitis occurs in parts of broken skin like the skin around the ulcers or surgical wounds.

It is a life-threatening condition, if not treated on time or correctly. If the symptoms are visible, do get medical help.

Individuals at a higher risk of cellulitis development consist of trauma or harm to the skin or other medical conditions such as:

• High blood glucose levels, i.e. Diabetes
• No proper flow of blood to the limbs due to circulatory issues, i.e. Peripheral Arterial Disease
• Inadequate “venous or lymphatic circulation, i.e. lymphedema.” Mostly post-surgical vein harvesting or varicose veins
• The disease of the liver, i.e. long-term hepatitis or liver cirrhosis
• Conditions in which there is an excess of iron deposition in the body, i.e. hemochromatosis or illnesses that need blood transfer very often.
• Diseases of the skin such as eczema, psoriasis. Infection causing illnesses that result in scratches on the skin like chicken-pox, athlete’s foot or excess acne, i.e. pimples.

Symptoms for Cellulitis

• In the areas which are affected, there is pain and tenderness
• Skin gets red and inflamed
• The rapid development of skin sore or rash
• Skin gets swollen, hard and shiny
• In the affected areas there is a warm feeling
• Presence of pus in the abscess
• Fever

Extreme symptoms of Cellulitis

• Shaky sensations
• Fever and chills, i.e. feeling cold
• Feeling sick
• Tiredness
• Dizzy Feeling
• Pain in the head
• Pain in the muscles
• Skin becomes warm
• Too much sweat

If symptoms like the below occur, it means the Cellulitis is proliferating:

• Drowsy feeling
• Tired
• Blisters (a small bubble on the skin filled with fluid when something rubs or burns the skin)
• Red Streaks
• If having any of the below-mentioned symptoms, do reach out to your doctor immediately.

Causes of Cellulitis

There are various reasons due to which the bacteria may enter the skin and result in infection. The following are the risk factors:

• The skin breaks and causes injuries or puncture wound
• Surgical wound results in infections
• Invasion of bacteria via the breaks in the skin. For example long-term skin problems like eczema
• The entrance of foreign objects in the skin
• Some individuals are resistant to certain antibiotics such as methicillin-resistant Staphylococcus aureus, or MSRA are at high risk of resulting in abscesses or pus collection in the skin.
• Beneath the skin occurrence of infection in the bone. Long-ongoing open wound, which is quite intense for exposure of bacteria to the bone. It occurs in individuals who have Diabetes (neuropathy), i.e. lost sensations or reduced flow of blood in the feet.
• As a result of Pasteurella or Capnocytophagia, there is extreme Cellulitis due to biting of cats or dogs. This condition is observed in diabetic individuals with improper immunity or removal of the spleen, i.e. splenectomy.
• Cellulitis results in individuals with a liver disorder or excess deposition of iron due to exposure to mud, soil, or water. The common bacteria in such conditions are vibrio vulnificus, pseudomonas and aeromonas.
• In short, there are various ways through which the Cellulitis inducing bacteria can enter the body, like:
• Surgical incisions
• Burns
• Puncture wounds
• Rashes on the skin, like eczema
• Bites of animals

How can Cellulitis be identified?

It is essential to identify Cellulitis at an early age to avoid the proliferation of Cellulitis. Initially, there might be a feeling of pain and tenderness.

Over time, the noticeable symptoms are:

• On touch the skin is warm
• Blisters
• Skin dimpling
• The red area starts to grow

The analysis of the progression of infection is by circling the red area with a pen. That helps to identify the growth over time. If there is spreading, it is essential to visit a physician. In case of development of any symptoms like fever or cold, immediately run for proper and timely treatment.

Treatment

The treatment includes the involvement of oral antibiotics for approximately 5 to 14 days. The physician might prescribe pain killers.

To reduce the swelling issues, elevate your leg more than the level of the heart.

After starting with antibiotics, the Cellulitis should disappear within 7 to 10 days. In case of a long-term condition or suppressed immunity, prolonged treatment needed. To continue with the antibiotics, as mentioned by the physician post improvement in the symptoms. It sees to it that all the bacteria get disappear.

Do consult the physician if:

• Post-starting the antibiotic, there is no improvement
• The symptoms get worse
• Fever gets developed

IV antibiotics might be required in a hospital if the condition is severe:

• The temperature of the body increases
• Blood pressure drops down
• With antibiotics, the infection does not improve
• Due to other circumstances, the immune system gets weak

Diagnosis

Just by the physical appearance, the physician will be able to diagnose Cellulitis. The physician might recommend a physical examination, such as:

• Skin gets swollen
• The affected area gets red and warm
• Glands get swollen
• A physician might want to analyze the fields for a few days whether the swelling or redness proliferates, which depends on the “severity of the condition.”
• In a few cases, the physician might collect the sample of blood or wound for testing the bacteria that is causing Cellulitis.

Is Cellulitis contagious?

Cellulitis is not transmissible. Then too, it is a possibility to get Cellulitis if the cut is open on the skin that comes in touch with the skin of an infected person.

If an individual is suffering from conditions like eczema or athlete’s foot, there are higher chances of them suffering from Cellulitis? The entrance of bacteria happens via the cracks of the skin.

With a weak immune system, the chances of being infected with Cellulitis is high because the protection against infection is not that good.

Cellulitis is life-threatening if proper and timely treatment not there. So it is essential to inform the doctor.

Home-Remedies for Cellulitis

Antibiotics help in the treatment of Cellulitis. If the procedure not done correctly, it can result in dangerous conditions. At home, certain things can be done by you for pain killer and other symptoms.

Areas affected by Cellulitis requires proper cleaning. Take advice and help from the doctor for learning ways to clean and covering the wound properly.

Reducing swelling and pain by raising your leg above the level of the heart (raising the affected limb).

The appliance of cool compress. A clean cloth in cool water to be applied, if the skin becomes hot and extremely painful. There is further irritation to the damaged skin if using chemical ice-packs.

Can take over-the-counter reliever (OTC) drugs: There are chances of reduction in pain and inflammation by taking OTC medications like ibuprofen or naproxen.

Treating the underlying condition: Conditions like athlete’s foot or eczema i.e. affects the infected wound needs treatment.

Surgery for Cellulitis

To use antibiotics initially, which helps in significant clearance of the infection. If there is a presence of an abscess, it needs to be removed by surgery.

Initially, the medicine is given for numbing the area. A tiny cut is made in the abscess by the surgeon that results in removal of the pus.

For healing, later, the surgeon protects the wound by covering it. Then there is a scar observed.

Prevention

If there is the presence of a skin break on your body, immediately essential to apply an antibiotic cream. The bandage is needed for covering the wound. Keep on changing the dressing until required.

To check the wounds regularly if the red, presence of drainage or pain sensations. Presence of all these symptoms results in infections.

If improper circulation or something is putting at risk of Cellulitis:

To avoid cracking, keep the skin moist

In case of skin cracks or athlete’s foot, immediately treat the condition while playing work or any sports essential to wear protective equipment’s for signs of injury or infection, analyze your feet regularly daily.

Recovery

There could be worsening of the symptoms in the initial one or two days. The improvement in the condition starts once taking antibiotics.

Even though an improvement in the condition and symptoms, complete the entire course as prescribed by the physician. It will help in showing full removal of the bacteria.

Essential to keep the wound clean while recovering. Necessary to go as the doctor’s instructions to wash and protect the skin part, which is affected.

Prognosis

Post 7-10 days of the cellulitis condition, majority of the individuals get recovered. But there are chances of recurrence of infection again in the upcoming years.

If the chances are higher of recurrence of Cellulitis, the physician might prescribe a higher dose of antibiotic. It avoids cellulitis condition to come again in the future.

In case of an open wound or a cut, one can protect it from infections by covering or keeping the skin clean. If an individual is not aware post-injury care of the skin, kindly consult a physician for the same.

Cellulitis vs DVT

Deep Vein Thrombosis (DVT): In one of the deep vein legs, there is the presence of blood clot. DVT condition can occur after prolonged periods of sitting or lying down on the bed. For example, extended trip on plane or post-surgery

Symptoms of DVT include:

• Leg pain
• Redness
• Warm feeling

Get proper medical care. In-case of a clot breaking and travelling to the lungs, results in a life-threatening or harmful condition. There is a requirement of blood thinner. These medicines avoid in getting big and prevents getting any further or new clots.

Cellulitis and Diabetes

Individuals with uncontrolled blood glucose levels affect the immunity of an individual and results in infections like Cellulitis. There is a decreased flow of blood to the legs.

There is the development of sores on legs and feet. The entrance of Cellulitis causing bacteria is possible through the wounds and results in an infection.

Essential to keep the feet clean if diagnosed or not with Diabetes. To avoid skin cracks, use a moisturizer or appropriate creams. Do keep a check for signs of infection on a regular or daily basis.

Cellulitis vs Abscess

An abscess is a “swollen pocket of pus” present below or beneath the skin. Majorly it is Staphylococcus that enters the body via a cut or wound is open. The immune system is sent by white blood cells (WBC) to fight against the bacteria. The attack can result in the formation of the hole below or beneath the skin and filled with pus. The pus consists of dead tissue, bacteria and white blood cells (WBC).

An abscess is similar, looking like a lump below the skin. There are chances of symptoms like fever and cold.

Without treatment, some of the abscess shrink or decrease in the size. Other individuals need treatment via antibiotics or removal.

Conclusion

The condition cellulitis is a “severe infection” that occurs in the deep layers of your skin and below the surface. It can result in excess problems and can be dangerous or harmful. There are increased chances of effective treatment if the person is treated immediately for the condition.

There are chances of returning of the condition cellulitis. Steps need to be taken by an individual to avoid this.

References

1. https://www.rcpjournals.org/content/clinmedicine/18/2/160
2. https://www.ncbi.nlm.nih.gov/books/NBK549770/
3. https://www.ncbi.nlm.nih.gov/pubmed/27434444