close up of mans foot with red rash

What is cellulitis?

Cellulitis is a common, potentially serious bacterial skin infection. The affected skin is swollen and inflamed and is typically painful and warm to the touch. Cellulitis usually affects the lower legs, but it can occur on the face, arms and other areas. The infection happens when a break in the skin allows bacteria to enter. If severe or if left untreated, it can spread into the lymph nodes and bloodstream.

How does cellulitis develop in lymphedema patients?

Lymphedema dramatically increases one’s chances of developing cellulitis. Similarly, cellulitis raises the risk for lymphedema. Lymphedema is a chronic, but treatable condition marked by an accumulation of lymph fluid (i.e., swelling) in parts of the body where lymph nodes or lymphatic vessels are damaged or inadequate.

Lymphedema thins skin due to the stretching from the accumulated fluid, making it easier for bacteria to enter. Bacteria flourish in the swollen tissue caused by lymphedema. Although lymphedema doesn’t always result in cellulitis, having either condition can worsen the other. For instance, a severe bout of cellulitis can damage the lymphatic system, resulting in secondary lymphedema. Similarly, lymphedema can raise the risk of developing cellulitis because it hinders one’s ability to fight off infection.

What happens if cellulitis is left untreated?

Cellulitis has definite symptoms that you shouldn’t ignore. As with other serious infections, if cellulitis is left untreated, it can spread throughout the entire body and require hospitalization. It can even lead to a bone infection or gangrene. In short, untreated cellulitis can be life-threatening; bacteria can spread through your bloodstream quickly.

Here are a few common signs of a cellulitis infection:

  • Red or swollen skin
  • A fast-growing rash or sore
  • An abscess containing pus
  • Skin that’s tender to the touch
  • Skin that’s warmer than surrounding areas
  • A dizzy or lightheaded feeling
  • Fever/chills
cellulitis close up foot

How to treat cellulitis for patients with lymphedema?

Most of the time, cellulitis can be treated with oral antibiotics. If cellulitis worsens, intravenous antibiotics may be introduced. Topical antibacterial ointments cannot treat cellulitis because they do not penetrate deeply enough, however, if open wounds develop, it is important to take proper external care to ensure that no further bacterial organisms are introduced. In the case of lymphedema-related recurrent cellulitis (two or more infections annually), a prophylactic oral antibiotic may be used.

Daily use of compression garments on the leg has been recommended to prevent the recurrence of cellulitis. Edema may be more severe than usual when cellulitis is present, and compression stockings and sleeves can help alleviate the swelling. Compression garments for lymphedema can lead to infections if not cleaned properly. Make sure you’re always using clean compression garments and bandages.

Scientists have not studied the way individual nutrients may treat cellulitis, however, flavonoids, ie., chemicals in fruits, such as citrus, blueberries, grapes; in vegetables, including onions; and in tea and red wine, when added to nutrition seem to help reduce lymphedema, and the risk for cellulitis. In addition, the following supplements may strengthen the immune system and help skin heal: Vitamin C, Vitamin E and Zinc.

Gentle movement via exercise will help the muscles pump lymph fluid (the fluid that causes edema) more effectively through your body. Movement and exercise help you improve and maintain flexibility and also keeps your bones strong. Being more active helps you achieve and maintain a healthy weight and it may improve your emotional wellbeing. Pacing yourself is important. Set yourself personal and achievable goals.

Unfortunately, the relationship between lymphedema and cellulitis has been described as a “vicious cycle,” in recognition of the fact that one often precipitates the other. Careful attention to lymphedema management is among the best strategies for preventing cellulitis or its recurrence.

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