Skin is the largest organ of the body. Skin infections are common – especially in those who have weak immune system. Understanding the most commonly occurring skin infection – Cellulitis is important because its treatment is simple but left ignored, it can potentially cause serious problems. Let’s learn more about it!
Podcast: Cellulitis & Erysipelas – Deep Dive
What is Cellulitis?
Cellulitis is an inflammation and infection of the deeper layers of skin and the tissue directly underneath it (subcutaneous tissue).
What are is Erysipelas and how is it different from Cellulitis?
Both Cellulitis and erysipelas are bacterial skin infections. They both cause redness, pain, and swelling. The difference lies in the involvement of extent skin thickness.
• Erysipelas is a bacterial infection that affects the upper layers of the skin, including the dermis and the very top part of the subcutaneous tissue.
• Cellulitis is the inflammation and infection of the deeper layers of skin and the tissue directly underneath it (subcutaneous tissue).
While there are differences, it can sometimes be hard for doctors to tell them apart just by looking.
Who is more likely to get cellulitis or erysipelas?
Certain conditions can increase your chance of getting these infections:
• Having any cut in the skin, even a tiny one.
• Other existing skin infections or long-term skin conditions.
• Swelling of the skin or body.
• Excess body weight.
• Conditions like diabetes and a weakened immune system (immunosuppression) are also predisposing factors.
• Sometimes, an existing source of infection like an ear infection, varicose eczema/ulcer, or athlete’s foot (tinea pedis) can be an entry point for the bacteria.
What are the symptoms?
Both cellulitis and erysipelas cause very similar symptoms:
• The infected area will typically be painful, red, swollen, and warm.
• Some people may also experience fever or chills.
• Other common symptoms can include a general feeling of being unwell (malaise), a high white blood cell count (leucocytosis), and sometimes blistering, which can be bloody.
• Swollen lymph nodes in the region of the infection are also common.
• Interestingly, some people might not have any symptoms at all.
Where do these infections usually appear on the body?
Cellulitis and erysipelas can appear in various places, but they are most common on the legs or arms. Erysipelas often affects the face, while cellulitis is frequently found on the legs. They can also occur in other areas like the belly, in the mouth, or around the anus.
How are these infections diagnosed?
In most cases, you won’t need specific tests. Your doctor or nurse will typically perform an examination and look at your skin. It’s important for them to figure out the type of infection you have to ensure you get the right treatment. Sometimes, tests might be needed to identify the exact cause of your infection. Swabs from the affected site are often taken, but can be negative; swabs from potential entry sites like ear infections or athlete’s foot may also be taken.
Why is it important to get treated?
It is very important to get treatment for cellulitis or erysipelas because they can spread to the entire body and become very serious if left untreated. Untreated cases can lead to severe complications such as persistent swelling (lymphoedema), blood clots in the brain (cavernous sinus thrombosis), widespread body infection (sepsis), and kidney inflammation (glomerulonephritis).
How are cellulitis and erysipelas treated?
The main treatment involves antibiotics.
• For most cases, antibiotic pills are prescribed. It’s crucial to finish all the prescribed pills, even if you start to feel better, because if you stop early, the infection can return worse.
• For more severe infections, people might need to be treated in a hospital and receive antibiotics directly into a vein through an “IV” (intravenous line).
• Common intravenous antibiotics include flucloxacillin, with clarithromycin, clindomycin, and vancomycin being alternatives for those allergic to penicillin. Milder cases may be treated with oral antibiotics.
What can I do at home to help with the infection?
You can do a few things to help manage the infection:
• Raise the infected area to help reduce swelling. Prop it up on pillows, for example, so it’s above the level of your heart for about 30 minutes, 3 or 4 times a day.
• Keep the infected area clean and dry. You can shower or bathe, but make sure to gently pat the area dry with a towel afterward.
• Antibiotic ointments or creams do not work for treating cellulitis and erysipelas.
When should I call my doctor or nurse? You should contact your doctor or nurse if:
• Your symptoms do not start to get better within 3 days of starting your treatment.
• The affected area gets bigger, more swollen, or more painful. If this happens, your doctor or nurse might do another exam or tests to see if you need different medicines.
Can these skin infections be prevented?
Sometimes, yes.
• If you get a cut on your skin, wash the area thoroughly with soap and water. This helps prevent germs from getting in and causing an infection.
• If you have a long-term skin condition, talk to your doctor or nurse about what you can do to help prevent infections.
Take Home Message
Cellulitis and erysipelas are bacterial skin infections that require prompt treatment with antibiotics. It’s crucial to finish all prescribed medication and contact your doctor if symptoms worsen or don’t improve within 3 days, as untreated infections can become very serious. Early treatment is key to prevent complications.