Rare Complications of Cellulitis: How You Can Prevent Them

Cellulitis is a bacterial infection of the dermis, a thick inner layer of skin. Cellulitis symptoms include redness, inflammation, and fever.

If you don’t take antibiotics for cellulitis treatment, you may experience complications, including a cellulitis abscess or perianal cellulitis, an infection around the anus. In rare cases, complications can be very severe, leading to necrotizing fasciitis, septicemia, and other life-threatening infections. 

Learn more about cellulitis complications, including how to recognize symptoms and treatment options to avoid serious illness.

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Cellulitis Symptoms

Cellulitis occurs when bacteria enter the middle layer of skin, known as the dermis. Soon after an infection takes hold, you’ll notice cellulitis symptoms, including:

  • A red and inflamed area on the skin
  • Skin that is warmer than normal to the touch
  • Skin that’s painful to touch
  • Red lines coming to and from the infected area, spreading toward the heart
  • A cobblestone or patchy appearance on the skin
  • A pitted appearance, like the skin of an orange
  • Blisters 

Complications 

Cellulitis complications are rare. However, they can occur without prompt treatment. This especially is true if you also have underlying health conditions. The complications of cellulitis are most dangerous when they spread throughout your body.

Recurrent Cellulitis

Sometimes, a cellulitis infection will appear to clear up, only to reappear in another area soon after. This is not only frustrating, but it can be dangerous. If you have more than one cellulitis infection in a short period of time, talk to your healthcare provider about taking a low-dose antibiotic to prevent recurrent cellulitis. 

Cellulitis Abscess 

An abscess is a pus-filled area of skin. Like cellulitis, an abscess is often caused by bacteria that normally exist on the skin of healthy individuals. While abscesses can usually be treated at home, you’ll need to see a healthcare provider if you have an abscess caused by cellulitis. For this, you will need to take prescription antibiotics. 

Never try to drain an abscess at home. This can make the infection worse. Instead, see your healthcare provider. 

Lymphedema

Lymphedema is the painful swelling of tissue, most often in the arms or legs. It happens when fluid builds up in your tissue because the lymph nodes are not functioning properly. There are many causes of lymphedema, including infections like cellulitis. Although it can be treated, lymphedema becomes a chronic condition for many people.

This is why it’s important to get help quickly if you notice symptoms of lymphedema such as:

  • Swelling in the arms or legs
  • Skin that feels tight
  • Aching, numbness, or tingling in the arms or legs
  • Loss of mobility

Septicemia

Septicemia is blood poisoning. It’s most often caused by an underlying bacterial infection, like cellulitis, that has gone untreated. When that happens, the infection can spread to the blood and even trigger a potentially deadly immune response called sepsis. Septicemia and sepsis are medical emergencies.

Call your healthcare provider or 911 immediately if you notice symptoms that include:

  • Fever, chills, or sweating
  • Widespread pain or discomfort
  • Fast breathing or heart rate
  • Confusion, light-headedness, or dizziness 

Gangrene

Gangrene is a life-threatening condition in which tissue begins to die. It can be caused by a lack of blood flow or other situations, including infections like cellulitis. It’s hard to diagnose because the symptoms include a loss of sensation, so there’s no pain or discomfort that draws your attention to it. However, it’s very serious.

Call your healthcare provider if you notice symptoms that include:

  • Very dry or peeling skin
  • Skin color changes, including red-, blue-, or green-tinged hues
  • Pain, swelling, or inflammation
  • Bruising or bleeding
  • A wounded area that is warm or pus-filled

Necrotizing Fasciitis

Necrotizing fasciitis is a bacterial infection also known as flesh-eating bacteria. It’s very rare, but very serious and can even be fatal. Having a recent infection like cellulitis may increase your risk of necrotizing fasciitis.

Call your healthcare provider immediately if you have symptoms that include:

  • Severe pain that feels worse than it should based on how your skin looks
  • A rapidly expanding area of red, inflamed skin
  • Skin that’s very warm to the touch
  • Fever

It can be hard to tell the complications of cellulitis apart. When in doubt, call your healthcare provider.

Types of Cellulitis

In addition to the complications of cellulitis, there are certain types of cellulitis that are especially serious and require medical care. 

Orbital Cellulitis

Orbital cellulitis is a bacterial infection of the tissue around the eye. It’s very rare, but very serious since it can lead to blindness. Orbital cellulitis happens most often in children but can affect anyone.

Call your healthcare provider if you notice symptoms like:

  • Pain and swelling in the eyebrow, eyelid, or cheek
  • A red, purple or shiny-looking eyelid
  • Double vision or any other vision changes
  • Trouble moving the eye
  • Bulging eyes

Perianal Cellulitis

Perianal cellulitis is a bacterial infection of the skin around the anus. It’s most common in children who have just had another infection like strep throat or impetigo.

You should call a healthcare provider if you notice symptoms such as:

  • Itching or pain, especially with bowel movements
  • Bleeding from the anus
  • Redness around the anus
  • Fever

Ways to Treat Cellulitis 

All complications and types of cellulitis need to be treated with antibiotics. In most cases, a minor infection will be treated with oral antibiotics taken for about 10 days. Your healthcare provider might also dress the affected area to keep it clean while it heals, and advise you to rest while it heals.

If you experience complications of cellulitis, you’ll need more intensive treatment, including intravenous (IV, within a vein) antibiotics and possibly surgery. Some of the complications of cellulitis, like gangrene, can require amputation.

When to See a Healthcare Provider

Cellulitis needs to be treated with antibiotics, so call your healthcare provider even if you think the infection is minor. After you’ve seen a healthcare provider and started antibiotics, call your provider if your symptoms begin to worsen or do not get better. Anytime you experience changes to your breathing pattern, heart rate, or cognition, seek emergency medical care immediately. 

How to Prevent Complications 

The best way to prevent cellulitis complications is to get treatment for cellulitis right away. In addition, try to:

  • Avoid scrapes and cuts: Scrapes and cuts provide an opening in the skin where bacteria can enter the dermis and cause infection. 
  • Wash and treat wounds right away: If you do get a wound, clean it immediately to reduce the risk of infection.
  • Keep your skin clean and moisturized: Regular hygiene and moisturizing can keep your skin healthy, which makes it easier to keep bacteria out. 
  • Treat underlying medical conditions: Underlying medical conditions like diabetes or other skin infections can weaken your immune system, leaving you more likely to experience complications from cellulitis.

Summary

Cellulitis is a bacterial skin infection. It can occur anywhere on the body and needs to be treated with antibiotics. It’s especially important to treat orbital cellulitis, which occurs around the eyes, and perianal cellulitis, which develops around the anus. If you don’t treat cellulitis promptly the infection can spread, leading to serious and even deadly complications including lymphedema, gangrene, necrotizing fasciitis and blood poisoning.

A Word From Verywell 

Cellulitis may seem minor at first, but it’s a condition that needs to be taken seriously. Complications can be deadly and hard to identify, so always reach out to your healthcare provider if you’re concerned. 

Frequently Asked Questions

  • Is cellulitis contagious?

    No, cellulitis is not contagious. It's caused when bacteria that naturally occur on the surface of your skin reach the dermis, the middle layer of skin.

  • What should I do if my cellulitis is still red after taking antibiotics?

    If your cellulitis doesn’t improve within a day or two after starting antibiotics, call your healthcare provider. 

  • Is cellulitis an emergency?

    No, cellulitis is not an emergency. However, it does require antibiotics. If you don’t treat cellulitis promptly, it can lead to emergencies such as blood poisoning and necrotizing fasciitis. 

  • How can you know if cellulitis is getting worse?

    Monitor yourself for symptoms. If you notice more redness, swelling, pain, or heat around the infected area, call your healthcare provider. You might also see red lines emerging from the infected area, spreading toward your heart. Fever, increased breathing rate and a racing heart are all signs of serious infection and require immediate medical attention. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Cellulitis: Everything you need to know.

  2. Johns Hopkins Medicine. Cellulitis.

  3. American Academy of Dermatology Association. Cellulitis: Diagnosis and treatment.

  4. MedlinePlus. Perianal streptococcal cellulitis.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.