Cellulitis: Diagnosis and treatment

How is cellulitis diagnosed?

We don’t have a medical test that can diagnose cellulitis. Doctors diagnose it by examining the infected skin and asking questions.

Be sure to tell your doctor about:

• A recent injury to your skin

• All medical conditions you have

• All medications you take

This information can help make sure you get the treatment you need and prevent problems.

To get an accurate diagnosis, some patients need:

Medical tests: While a test cannot tell whether you have cellulitis, testing can tell what germs are causing an infection.

A referral to a dermatologist: If you are seeing a doctor other than a dermatologist, you may be sent to a dermatologist. Cellulitis can look like other skin conditions and infections.

Dermatologists have extensive training in diagnosing the many conditions that can look like cellulitis. An accurate diagnosis is essential to clear your skin condition.

How is cellulitis treated?

If you are diagnosed with cellulitis, treatment is important. It can prevent cellulitis from worsening. It can help you avoid serious medical problems like blood poisoning and severe pain.

To treat cellulitis, doctors prescribe:

Antibiotics: An oral (you take by swallowing) antibiotic can effectively clear cellulitis.

The type of antibiotic you need and how long you’ll need to take it will vary. Most people take an antibiotic for 7 to 14 days. If you have a weakened immune system, you may need to take the antibiotic for longer.

If you stop taking the antibiotic early, there is a risk the antibiotic won’t kill all the bacteria that made you sick. Taking all of the antibiotic exactly as prescribed helps clear cellulitis.

Some people need to take more than one type of antibiotic.

Sometimes, the antibiotic is given through an IV. When this is necessary, a hospital stay is often prescribed. This can help clear severe cellulitis or cellulitis on the face. Most people are hospitalized for just over one week.

Wound care: This is an important part of treating cellulitis. Covering your skin will help it heal. If you need special wound coverings or dressings, you’ll be shown how to apply and change them.

Rest: This can help prevent cellulitis from becoming serious and help your body heal.

Elevation: If you have cellulitis in your leg, keeping your leg elevated can help reduce the swelling and help you heal.

Treatment for another medical condition: If the bacteria got into your body because you have another skin condition like athlete’s foot, it’s important to treat that condition, too.

What is the outcome for someone who gets cellulitis?

With treatment, you should quickly start to see less redness, swelling, pain, and warmth.

If you fail to notice improvement after 24 – 48 hours, let your doctor know.

While cellulitis will clear with treatment, anyone who has had it has a higher risk of getting cellulitis again.

You can find out what helps to prevent this at Cellulitis: How to prevent it from returning.

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References
Habif TP, Campbell, JL, et al. “Cellulitis.” In: Dermatology DDxDeck. Mosby Elsevier, China, 2006: Card#47.

Hapern AV and Heymann WR. ““Bacterial diseases.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:1084.

Raff AB, Kroshinsky D. “Cellulitis: A review.” JAMA. 2016;316(3):325-337.

Stevens DL, Bisno AL, et al. “Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America.” Clin Infect Dis. 2014;59(2):e10-52.

Strazzula L, Cotliar J, et al. “Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: A multi-institutional analysis.” J Am Acad Dermatol. 2015;73(1):70-5.

Weng, QY, Raff AB, et al. JAMA Dermatol. 2016 Nov 2. doi: 10.1001/jamadermatol.2016.3816. [Epub ahead of print].