What is cellulitis?
Cellulitis is a non contagious infection of the skin. It can be sudden and cause pain, heat and swelling. People with Lymphoedema are particularly susceptible to cellulitis. The lymphatic system drains fluid away from tissues and helps to control infection and for that reason a cellulitis attack may not be dealt with properly in the area affected by Lymphoedema.
What causes cellulitis?
The cause is nearly always bacterial. The infection can enter via a break in the skin – a scratch/insect bite/wound/ulcer/athlete’s foot/eczema or dermatitis. Sometimes it is not possible to identify a cause of cellulitis and it can happen suddenly and without warning.
How to recognise cellulitis?
People often feel unwell with flu like symptoms – fever/shivers/muscular aches and pains/ vomiting etc. The swollen area usually develops a rash and/or becomes red, hot and tender. Swelling may also increase and become painful.
If you suspect you have cellulitis you must see a Doctor immediately to avoid further damage to the affected area and possible recurrent attacks.
Antibiotics should be prescribed straight away and continued for not less than 14 days. If there is no response i.e. a recognisable improvement within 48 hours of taking the antibiotics there may be a need to have the prescription changed or in acute cases admission to hospital.
Any compression garments should be removed as soon as a cellulitis attack is apparent and MLD therapy and exercise should stop.
Bed rest and elevation of the affected part is essential, plenty of water should be drunk and painkillers taken as necessary.
If patients have experienced a cellulitis attack it is recommended that they have a course of antibiotics to hand ‘ in case’ so they can start the course at the first sign of another attack prior to seeing a Doctor.
If patients have had 2 or more attacks of cellulitis in a year they should be offered Penicillin V 250mg twice a day ( or erythromycin if allergic to penicillin) or 500mg twice a day if the body weight is more than 100kg. This may need to be a life long treatment.
For some tips on how to reduce the risk of a cellulitis infection – please refer to the Dos and don’ts pages.