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Cellulitis (Skin Infection)

A common bacterial infection of the deeper layers of the skin that makes an area red or discolored, swollen, warm and painful — most often on the lower leg. Antibiotics usually clear it, but it can spread quickly, so it needs prompt care, and it often comes back unless the cracked skin or swelling that let it in is looked after.

Call 911 or go to the nearest emergency room if you have cellulitis and:

Don’t drive yourself — ask someone to take you, or call for an ambulance (NHS).

Get medical care right away — the same day, at urgent care, your doctor or the ER — if:

What is cellulitis?

Cellulitis is a common bacterial infection of the deeper layers of the skin and the tissue beneath it (CDC, MedlinePlus). Most cases are caused by Streptococcus (strep, including group A strep) or Staphylococcus (staph) bacteria (Cleveland Clinic, CDC). Our skin normally carries many bacteria; when the skin is broken, they can get in and cause an infection (MedlinePlus). Sometimes the break is too small to notice (NHS).

It is very common: Cleveland Clinic puts it at more than 14 million cases a year in the United States (Cleveland Clinic). It can happen anywhere on the body but is most common on the feet and lower legs (CDC, NHS). It usually isn’t passed from person to person, because it is in the deeper layers of the skin (NHS, CDC).

What does it look like?

Who is more likely to get it?

Is it cellulitis, or something else?

A red, swollen leg isn’t always an infection. Before diagnosing cellulitis, clinicians are advised to consider other causes such as venous stasis dermatitis (skin irritation from poor blood flow in the leg veins) and deep vein thrombosis (American Family Physician, 2026). Cellulitis in both legs at once is rare, so redness and warmth in both legs often has another cause (American Family Physician, 2026). Mix-ups are common: in one U.S. hospital study, about 3 in 10 people admitted from the emergency department for leg cellulitis turned out to have something else, and most of them got antibiotics they didn’t need (Weng et al., 2017).

A blood clot can look similar. A deep vein thrombosis (DVT) can cause swelling, pain or tenderness, warmth, and redness or discoloration of the leg or arm, and needs medical care right away (CDC) — see our Blood Clots guide. This is one more reason to have a red, swollen limb checked rather than guess.

How is it diagnosed?

Usually by a physical exam of the skin; blood or lab tests often aren’t needed (CDC, Cleveland Clinic). In a more severe case, a clinician may order blood tests, a blood culture, or a culture of fluid from the area to check whether the infection has spread and which bacteria are involved (MedlinePlus, Cleveland Clinic). A bedside ultrasound can show whether there is a pocket of pus (an abscess) under the redness (American Family Physician, 2026).

Complications

Untreated, or if treatment doesn’t work, cellulitis can spread to the blood (sepsis), bones, lymph vessels, heart or the lining of the brain, and can cause shock or tissue death (MedlinePlus, Cleveland Clinic). The CDC describes these complications as uncommon (CDC). Rarely, a skin infection becomes necrotizing fasciitis, which can destroy skin and muscle, needs hospital care with antibiotics through a vein and surgery, and can be fatal even with treatment (CDC, MedlinePlus).

Outlook

With early diagnosis and treatment the outlook is good, and most people feel better within 7 to 10 days (Cleveland Clinic, NHS). It often comes back, though, so looking after your skin and any swelling matters (see When cellulitis keeps coming back and Wellness coaching below).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Antibiotics, usually by mouth (penicillin-type or cephalosporin antibiotics for most cases), finishing the whole course; raising the limb; marking the edge of the redness; draining any abscess; hospital and IV antibiotics for severe infections; and treating athlete’s foot and swelling to prevent repeats. Cost estimate being researched. It may look worse in the first 2 days, then improve; most people feel better within 7 to 10 days. Call your clinician if you aren’t improving after 2 to 3 days. It often comes back, so prevention matters.
Chiropractic No role in treating cellulitis, a bacterial infection that needs antibiotics. Not a treatment for cellulitis, so no cost is listed. Avoid hands-on treatment on or near infected, red or swollen skin.
Acupuncture No role in treating cellulitis, a bacterial infection that needs antibiotics. Not a treatment for cellulitis, so no cost is listed. Never have needles on or near infected skin; improper needling can itself cause infection.
Herbal medicine No herb or supplement treats cellulitis — it needs antibiotics. Tea tree oil, honey and colloidal silver are not substitutes. Cost estimate being researched. Trying home remedies instead of antibiotics can let the infection spread to the blood or deeper tissue. Some products, such as colloidal silver, can also interfere with how some antibiotics are absorbed.
Massage therapy Not a treatment for cellulitis. Never massage or rub infected, red or swollen skin. Manual lymphatic drainage for lymphedema is only for after the infection has cleared, by a trained therapist, with your clinician’s OK. Cost estimate being researched. Massage won’t clear an infection, and lymphatic drainage massage should be avoided while you have cellulitis, a fever or an infection.
MBHA Wellness Coach Everyday skin care: moisturize to prevent cracks, clean and cover cuts, wear well-fitting shoes, check feet daily with diabetes, treat athlete’s foot, manage swelling (compression as advised), work toward a healthy weight, wash hands, and don’t share razors or towels. Cost estimate being researched. Good habits lower the chance of cellulitis and of it coming back. They work alongside medical care, never instead of antibiotics for an active infection.

Approach 1 of 6

Conventional medicine (AMA)

Cellulitis is treated with antibiotics, and it can be serious if it isn’t treated quickly (NHS, CDC). If you think you have it, contact a clinician promptly (MedlinePlus).

1. Antibiotics — and finishing the course

2. Tracking the edge of the redness

Your clinician may draw around the edge of the redness with a pen, to see whether it spreads past the line over the next few days (MedlinePlus). Redness that keeps spreading beyond the mark while you are on antibiotics is one reason a hospital stay may be needed (MedlinePlus). Symptoms can get a little worse in the first 48 hours of treatment before they improve; contact your clinician if you aren’t starting to feel better 2 to 3 days after starting antibiotics (NHS).

3. Comfort and healing at home

4. When a hospital stay is needed

You may need to be admitted — usually for IV antibiotics — if you are very sick (very high temperature, low blood pressure, or vomiting that won’t stop), if the infection is spreading despite antibiotics, if your immune system is weakened, or if the infection is around your eye (MedlinePlus). Most cases of orbital cellulitis need a hospital stay (MedlinePlus).

5. MRSA and abscesses

MRSA is a type of staph that resists several antibiotics. You can’t tell by looking whether an infection is MRSA — it is often mistaken for a spider bite — and a lab test of a sample is needed to confirm it (CDC). Skin infections with pus are more likely to involve MRSA (American Family Physician, 2026). If there is an abscess, it is usually opened and drained, followed by antibiotics; severe cellulitis may be treated with antibiotics that also cover MRSA (American Family Physician, 2026, CDC). Never try to pop or drain a bump yourself (CDC).

6. Treating what let the infection in

People who are prone to cellulitis should treat athlete’s foot promptly (NHS), and repeated cellulitis below the knee is a reason to check for a fungal foot infection (CDC). Cracked skin between the toes, dermatitis, open wounds and leg ulcers should all be treated, and swelling brought under control (British Lymphology Society guideline, 2022). If cellulitis keeps coming back, some people are offered a long-term antibiotic to prevent repeat infections (NHS) — see When cellulitis keeps coming back below.

Who to see

A primary care provider or urgent care clinic can usually diagnose and treat cellulitis; use the emergency room for the warning signs at the top of this page. If it keeps coming back, ask about a dermatologist, a podiatrist, or a lymphedema service.

What it costs

MBHA cost estimate being researched (antibiotics, urgent care and doctor visits).

How well it works — what to expect

With prompt treatment the outlook is good, and most people feel better after 7 to 10 days (Cleveland Clinic, NHS). Longer treatment may be needed if the infection is severe or your immune system isn’t working well (MedlinePlus).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating cellulitis, which is a bacterial infection that needs antibiotics. We found no research suggesting otherwise. Never have adjustments or other hands-on treatment on or near infected, red or swollen skin, and don’t let any treatment put off seeing a health care provider.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture has no role in treating cellulitis. Never have needles placed on or near infected, red or swollen skin. Acupuncture done improperly or with non-sterile needles can itself cause infections, and it shouldn’t be used to put off seeing a health care provider (NCCIH).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Cellulitis needs antibiotics. We found no herb, essential oil or supplement shown to treat it. Delaying antibiotics to try a home remedy can be dangerous: untreated, cellulitis can spread and cause serious problems, including infection of the blood (CDC, NHS). Products that haven’t been proven safe and effective should never be a reason to put off seeing a health care provider (NCCIH).

Tea tree oil

Tea tree oil has a little research for acne and athlete’s foot, but for other conditions there isn’t enough evidence to say whether it helps (NCCIH). We found no research on tea tree oil for cellulitis. If you use it for athlete’s foot to help protect your skin, never swallow it, and stop if your skin becomes red or irritated (NCCIH) — see our Athlete’s Foot guide.

Honey

Manuka honey has antibacterial effects and is used in some medical wound dressings, but Memorial Sloan Kettering advises patients not to treat themselves with honey products: any infection should be examined by a physician or other qualified professional (Memorial Sloan Kettering).

Colloidal silver

Colloidal silver was used for infections before antibiotics existed, but the FDA has warned that it isn’t safe or effective for treating any disease. It can permanently turn the skin bluish-gray, and it can interfere with how some antibiotics are absorbed (NCCIH).

In short: take the antibiotic you are prescribed, finish the course, and tell your clinician about any herb or supplement you use. We don’t list doses here.

Approach 5 of 6

Massage therapy

Don’t massage or rub skin that has cellulitis. Cleveland Clinic advises not touching or rubbing the affected area (Cleveland Clinic), and lymphatic drainage massage should be avoided by anyone who has cellulitis, a fever, an infection or a blood clot (Cleveland Clinic).

Massage doesn’t treat an infection, and it shouldn’t be used to put off seeing a health care provider (NCCIH). Cancer Research UK also advises against massage where the skin is broken, and against general massage on an arm or leg swollen with lymphedema (Cancer Research UK).

Lymphedema: after the infection has cleared

For people whose cellulitis is linked to lymphedema, controlling the swelling is part of preventing the next infection (British Lymphology Society guideline, 2022). Manual lymphatic drainage (MLD) is a gentle, specialized massage that moves lymph fluid out of a swollen area. It is one part of a lymphedema treatment program, alongside compression, exercise and skin care, and is given by a specialist therapist such as a certified lymphedema therapist (National Cancer Institute, NHS). It isn’t meant to be the only treatment, and anyone who wears compression garments should keep wearing them (Cleveland Clinic).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Most cellulitis starts at a break in the skin, and it often comes back. An MBHA Wellness Coach can help you build the small daily habits that protect your skin and keep swelling down — especially if you have diabetes, lymphedema or have had cellulitis before.

Keep skin healthy and unbroken

Look after cuts and scrapes promptly

If you have diabetes

Check your feet every day for wounds, redness, swelling and blisters (a mirror helps); wash them daily in warm, not hot, water and dry them well; moisturize the tops and bottoms but not between the toes; and never go barefoot, even indoors. Don’t wait for your next appointment if you notice a fungal infection between your toes, dry cracked skin, or a sore or blister (CDC). Keeping chronic conditions such as diabetes well managed also lowers the risk of sepsis (CDC).

Manage swelling

Work toward a healthy weight

Being overweight is a risk factor for cellulitis (CDC), and obesity is linked with repeat episodes and reduces lymph drainage. Lymphedema specialists recommend weight management alongside treating swelling (British Lymphology Society guideline, 2022). A coach can help with realistic, step-by-step changes to eating and activity.

Clean hands, and don’t share personal items (MRSA prevention)

A coach is never a substitute for medical care. If you notice the warning signs at the top of this page, get help right away.

Another approach

When cellulitis keeps coming back

Cellulitis often comes back — in as many as 29% of cases, according to one review, and especially in people with lymphedema, long-lasting leg swelling, or cancer (American Family Physician, 2026). Cleveland Clinic estimates about a third of people get it again (Cleveland Clinic). Many people who get it again have a skin problem that hasn’t been treated, such as athlete’s foot, or diabetes that isn’t well controlled (Cleveland Clinic, MedlinePlus). The first step is always to treat the “way in”: the skin between the toes, wounds, ulcers and swelling (British Lymphology Society guideline, 2022). Two other approaches have been tested in trials:

Compression for leg swelling

  • In an Australian trial of 84 adults with chronic leg swelling and repeated cellulitis, those given compression garments plus education had fewer repeat infections than those given education alone (15% vs. 40%), and the trial was stopped early because the difference was clear. It was small, single-center and not blinded (Webb et al., 2020).
  • Longer follow-up of the same trial, to 18 months, found cellulitis in 20% of the compression group and 47% of the control group (Webb et al., 2026). A compression-garment maker supplied the garments free of charge for that follow-up.
  • A 2026 review recommends compression stockings for people who have had two or more episodes of leg cellulitis in the same area within two years (American Family Physician, 2026).

Long-term preventive antibiotics

  • In the PATCH I trial of 274 people with two or more episodes of leg cellulitis, a year of daily penicillin cut repeat infections while people were taking it (22% vs. 37% on a dummy pill), but the protection faded after it was stopped (Thomas et al., 2013).
  • A Cochrane review of six trials reached the same conclusion: preventive antibiotics probably reduce repeat leg cellulitis while they are being taken (moderate-certainty evidence), the benefit seems to fade once they stop, and side effects were mostly minor, such as nausea and rash (Cochrane review, 2017).

Whether preventive antibiotics or compression make sense for you depends on how often you get cellulitis and why. Talk it through with your clinician; never start or stop an antibiotic on your own.

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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