Cellulitis is a common and highly treatable bacterial skin infection. It begins as a painful, discolored, swelling skin patch. It’s important to get medical attention quickly if you suspect cellulitis. Untreated, the bacteria can spread and cause complications.

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Many cellulitis infections occur from common skin bacteria. Usually, people can manage them at home with oral antibiotics. Sometimes, emergency room (ER) or hospital care is necessary. Cellulitis is common in adults and children. Often, symptoms begin abruptly without an obvious cause.

If you suspect your child has cellulitis, contact a doctor’s office right away. Early diagnosis and treatment can help prevent the infection from spreading to the bloodstream and other body parts.

Cellulitis is a common bacterial skin infection. It usually involves a painful skin area with discoloration, warmth, and swelling that enlarges rapidly.

In adults, cellulitis is most common on the lower legs. But in children, cellulitis can appear on the head, neck, limbs, or trunk. Sometimes, it can cause complications like skin abscesses.

Rarely the bacteria can spread to the surrounding tissues or bloodstream. But once a doctor identifies cellulitis and starts providing treatment, many children can recover quickly.

Cellulitis begins as a slightly swollen, discolored, and warm skin area that’s tender to the touch. It can be anywhere on the body.

The discoloration often expands rapidly. Sometimes, you can see discolored streaks extending from the infection site. You can draw a line around the discolored area’s edge with a ballpoint pen to help monitor the spread.

As cellulitis progresses, you might notice symptoms like:

  • fever
  • discoloration involving spreading and streaking
  • pain and swelling that both worsen
  • skin breakdown or blistering
  • pus discharge
  • abscess formation
  • swollen lymph nodes

Cellulitis isn’t usually itchy.

When to get emergency care

Sometimes, cellulitis can be serious. Talk immediately with your child’s doctor or get ER care if your child has any of the following:

  • signs of serious illness
    • fever/chills
    • lethargy/confusion
    • high heart rate or low blood pressure
    • severe pain
  • a weakened immune system (such as from a recent transplant or chemotherapy)
  • cellulitis near an implanted medical device (such as a surgical rod, catheter, or shunt)
  • cellulitis around the eyes
  • rapid symptom worsening
    • rapidly spreading discoloration/swelling
    • , tan, brown, blackened or blistered skin
    • severe pain
  • numbness, tingling, or weakness
  • an inability to tolerate oral antibiotics
  • no improvement after 48 hours of treatment
  • other medical conditions (such as diabetes, cancer, or newborn infancy)

Cellulitis is an infection that occurs from common bacteria, such as Streptococcus or Staphylococcus species. We all have these bacteria living on our skin periodically.

But in cellulitis, the bacteria penetrate through tiny breaks in our protective skin barrier. Sometimes, you can see the breaks, such as cuts, scrapes, or bites. Other times, the break in the skin barrier is too small to see. Once inside, the bacteria cause a cellulitis infection in the deeper skin layers.

Your child’s doctor can usually diagnose cellulitis by talking with you and examining your child’s skin.

Children with serious cellulitis or other underlying medical conditions may need additional testing. This could include wound or blood cultures or imaging tests.

Let your child’s doctor know if you think there have been unusual circumstances, such as exposure to water sources (hot tubs, salt water, or freshwater), bites or puncture wounds, or people at home with similar rashes.

Since cellulitis is a bacterial infection, your child’s doctor can prescribe antibiotics to treat it.

People usually take oral antibiotics by mouth for at least 5 days – or as prescribed by a doctor. Occasionally, two antibiotics may be necessary to treat cellulitis.

Your doctor can choose the best medication regimen based on your circumstances and your area’s bacterial resistance patterns. They may recommend intravenous (IV) antibiotics in more severe cellulitis cases.

If the cellulitis forms an abscess (pus collection), your doctor may cut and drain the area.

Breaks in the skin barrier can increase your cellulitis risk. This happens in common skin conditions like:

People with illnesses like the following, which can affect their immune systems or wound healing, may also have a higher chance of getting cellulitis:

Medications like corticosteroids, immunosuppressants, or chemotherapy can also affect the immune system and increase your skin infection risk.

To help prevent cellulitis in children, try the following:

  • Treat chronic skin conditions as your doctor directs.
  • Promptly wash new wounds well with soap and water, apply over-the-counter antibiotic ointment, and cover with a bandage. Monitor cuts and scrapes for a few days, watching for infection signs.
  • If you have open wounds, do not swim in hot tubs or open freshwater or saltwater bodies.
  • Keep your child’s nails short and discourage scratching or skin picking.

With prompt recognition and treatment, the outlook for children with cellulitis is usually excellent.

Once your child starts antibiotics, you can expect your child to improve significantly within about 48 hours. Be sure that your child finishes the full course of antibiotics, even after they look much better.

Many children with cellulitis can safely get treatment at home and can fully recover by the time they complete their course of medication.

For severe or high risk cellulitis cases requiring hospitalization, the average hospital stay lasts about 3 days, and many children can go on to recover fully.

How serious is cellulitis in children?

Cellulitis is a potentially serious bacterial skin infection. Untreated, it can spread to the bloodstream or nearby tissues and cause complications.

But with a prompt diagnosis and starting antibiotics, many children with cellulitis can fully recover at home.

What are the 3 indicators of cellulitis?

In cellulitis, you might notice a skin patch with rapidly spreading:

  • discoloration
  • swelling
  • tenderness

You might also notice swollen glands or lymph nodes near the affected area. Some children may also have a fever or be unusually tired or irritable.

When should you take a child to the emergency room for cellulitis?

Many cellulitis cases don’t require ER or hospital care. But if your child has a serious underlying medical condition (such as cancer, diabetes, immunodeficiency, or recent surgery), immediately talk with your doctor or go to the ER.

Similarly, if your child appears very ill (high fever, fast heart rate, confusion), or their cellulitis seems severe (affecting the face/eyes, rapidly worsening, blistering, extremely painful), get immediate care.

Finally, if your child has difficulty tolerating their medication or doesn’t improve after 48 hours of treatment, your doctor may direct you to the ER.

Should kids go to school with cellulitis?

In general, cellulitis isn’t particularly contagious. Your child can usually return to school once they’re fever-free, responding well to antibiotics, and their open wounds heal.

If your child doesn’t clearly improve, has a fever, or has open skin or wound discharge areas, keep them home until you talk more with your doctor.

Your doctor can help you decide when your child can return to school.

Cellulitis is a common bacterial skin infection that’s highly treatable.

Talk with your child’s doctor as soon as you notice cellulitis signs, such as an area of discolored, warm, painful, and swollen skin. Draw a line around the discolored area with a ballpoint pen so you and your doctor can monitor progression.

Without treatment, cellulitis can spread and cause serious complications. But many children with cellulitis can take oral antibiotics at home and improve significantly within 48 hours after starting treatment.

Contact your doctor right away if your child’s symptoms worsen rapidly, your child seems seriously ill, or your child doesn’t improve within 48 hours of starting prescribed antibiotic treatment.