Cellulitis and erysipelas

What are cellulitis and erysipelas?

Cellulitis and erysipelas happen when germs called bacteria infect your skin. Bacteria can infect your skin if you have a cut or scrape, an open sore (ulcer), a cut during surgery or an insect bite.

Cellulitis and erysipelas are so similar that doctors can't always tell them apart. The main difference is that cellulitis affects a deep layer of your skin. Erysipelas affects your skin nearer the surface. Both conditions are treated the same way.

What are the symptoms?

Cellulitis and erysipelas make a patch of your skin turn red and feel sore. You're most likely to get cellulitis on your legs or arms, but it can appear anywhere. Erysipelas often affects the skin on the face. The affected area may get bigger and the skin may blister. You may also get swollen glands near the infection, or feel generally ill, as if you have flu.

What treatments work?

Antibiotics cure almost everyone with cellulitis or erysipelas. They kill the bacteriathat are causing the skin infection. If you don't get treatment, the infection could spread to other parts of your body. So it's best to see a doctor as soon as possible.

You may need to go to hospital and have antibiotics as a drip (also called an intravenous infusion or IV). You'll switch to tablets when you start to get better. But if your cellulitis is mild, you'll probably just take tablets. You'll probably need to take antibiotics for one or two weeks.

Some of the antibiotics normally given (and their brand names) are: benzylpenicillin (Penicillin G), clindamycin (Dalacin C) and erythromycin (Erythrocin).

Between 7 and 8 out of 10 people who take antibiotics are cured after a week or so. If you're not cured by the first antibiotic you take, your doctor will switch you to a different type, or give you antibiotic tablets as well as a drip. Or you could have blood tests to find out which bacteria are causing your symptoms. You can then be given an antibiotic that's especially good at killing those bacteria.

Antibiotics can have side effects, but they're usually mild. They include diarrhoea, nausea, tummy pain, headaches, dizziness and a rash.

You may be given a painkiller, such as paracetamol. This can make you more comfortable while you're waiting for the antibiotics to work. If your cellulitis is on your leg or arm, you might be told to keep that limb higher than the rest of your body. This may help the swelling go down. If your skin starts to blister, you may be given a dressing to put on it.

If you have athlete's foot (a foot condition caused by a fungus) near the infection, it will need to be treated. This will help to stop the cellulitis coming back.

What will happen to me?

With treatment, most people who have cellulitis or erysipelas recover completely in about two weeks. If you're usually healthy, you may be treated at home. But lots of people need hospital treatment. You may be able to go home after a day or two if you're feeling better, but on average people stay in hospital for about 10 days.

Sometimes cellulitis can spread and cause other problems (complications). It can cause blood poisoning, which is a severe infection that affects your whole body. This is rare, but it may happen if the cellulitis isn't treated in time or if the antibiotics don't work.

Cellulitis can also come back. About a third of people who have had cellulitis get it again within three years.

Some people get swelling in the arm or leg where they get cellulitis. This is called lymphoedema. Treatment usually gets rid of the inflamed patch of skin, but in some people the swelling doesn't go away. This happens to 7 in 100 people who get cellulitis in their leg.

If you get cellulitis around your eye, you need to get treatment as quickly as possible. The infection could spread and affect your eyes or your brain.