Cellulitis: How to prevent it from returning

If you’ve had cellulitis, you have a higher risk of getting it again. Even after successful treatment, some people get cellulitis again and again. For most people, the cellulitis develops in the same place every time.

Clean and bandage wounds immediately

This can help reduce your risk of getting cellulitis again.

The following can help decrease your risk of getting cellulitis again:

1. Avoid injuring your skin. Skin injuries include cuts, scrapes, burns, sunburns, frostbite, stings from bees and other insects, and abrasions. Being careful when you’re doing any activity, including working out, gardening, or cooking can help avoid an injury.

2. Treat wounds right away. If you injure your skin, immediately:

   • Wash the wound with soap and water.
   • Apply an antibiotic ointment.
   • Cover the wound with a bandage.
   • Clean and change the bandage every day (or as often as your doctor recommends) until the wound heals.

3. Keep your skin clean and moisturized. Keeping your skin clean washes away bacteria that cause cellulitis. Moisturizing helps prevent cracks in your skin, which can let bacteria into your body.
   
   An effective way to prevent or reduce dry skin is to apply moisturizer within three minutes of taking showers or baths. If your hands are dry, applying moisturizer after you wash your hands and frequently throughout the day can relieve the dryness.

4. Keep your nails well-manicured. You could accidentally scratch yourself with a broken nail. When cutting your fingernails and toenails, you want to take care not to injure the surrounding skin.

5. If you had cellulitis in an arm, have blood drawn from the arm that has not had cellulitis. Be sure to ask the person drawing the blood to take it from a part of your body that has not had cellulitis.

6. Treat infections promptly. An infection like athlete’s foot or impetigo can lead to cellulitis, so you want to treat it as soon as you notice signs. Dry, itchy skin between your toes can mean athlete’s foot. Sores, red and swollen skin, or blisters can be a sign of an infection.

7. Treat other medical conditions. Having another medical condition can increase your risk of getting cellulitis again. Working with your doctor to manage conditions like diabetes, eczema, leg ulcers, or periphery artery disease (PAD) can greatly reduce your cellulitis risk.

8. Treat lymphedema (excessive fluid buildup that causes swelling, usually in an arm or leg). Of all the medical conditions that increase your risk of getting cellulitis again, lymphedema ranks highest. While there is no cure for lymphedema, it can be treated with exercise, compression bandages, elevation, and drainage.

9. Lose weight. Research shows that if you are overweight or obese and lose weight, you reduce your risk of getting cellulitis again.

10. Stop smoking. While more research is needed to know whether smoking increases your risk of getting cellulitis again, research suggests it might.

11. If you drink alcohol, drink in moderation. More research is also needed to know whether alcohol increases your risk of getting cellulitis again. Current research suggests that heavy drinking increases the risk.
    
    Drinking in moderation means that women have no more than one drink a day and men two.

12. Check your feet every day to see if you have an injury or infection. Some people fail to notice when they injure a foot.

Repeat flares of cellulitis can be reduced with daily antibiotics

If you continue to get cellulitis after doing what you can to reduce your risk, research shows that taking a low-dose antibiotic can help. This treatment may be recommended for someone who has had cellulitis three or four times in one year.

If you continue to get cellulitis while on an antibiotic, it’s possible that what’s looks like cellulitis may actually be another skin condition. Seeing a dermatologist can help you find out whether you have cellulitis or another condition.

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References
Al-Niaimi F, Neil Cox N. “Cellulitis and lymphedema: A vicious cycle.” J of Lymphoedema.” 2009;4(2):38-42.

Oh CC, Ko HC, et al. “Antibiotic prophylaxis for preventing recurrent cellulitis: a systematic review and meta-analysis.” J Infect. 2014 Jul;69(1):26-34.

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.