Swelling? Leg it to the doctor

Cellulitis is an infection of the skin and deeper underlying tissues, usually caused by either streptococcal or staphylococcal bacteria. It is common, and if detected and managed promptly, it shouldn’t cause too many problems.

However, for some unlucky people, it can turn into something of a nightmare – recurring frequently, not healing up, and potentially impacting hugely on quality of life.

We don’t know exactly how many people will get cellulitis in their lifetime, but we do know that some groups are far more likely to suffer from it.

This includes:

■ Anyone who has had cellulitis before.

■ People who are obese or have very swollen legs (for example, from oedema or poor circulation).

■ People with lowered immunity, including people with poorly controlled diabetes and those receiving chemotherapy or other ‘‘immune suppressing’’ drugs.

■ People with ongoing skin issues, such as eczema or psoriasis. This is because the inflammation and subsequent scratching that occurs in these conditions compromises the function of the skin ‘‘barrier’’, increasing the risk of infection.

■ People with athlete’s foot or tinea. Again this is because the cracks in the skin that occur with this condition effectively create a portal for bacteria to enter.

■ Anyone who has had either an animal or an insect bite, as the puncture site compromises the skin’s surface, making infection more likely.

■ People who have recently had surgery or a wound stitched up.

■ Intravenous drug users.

Despite the fact that there are these known risk factors, anyone at all, no matter how young or healthy, can get cellulitis, and it can go from minor to potentially very serious really rapidly, so if you or someone you know is concerned, it’s a really good idea to get it checked out before things deteriorate. The main symptoms that indicate cellulitis include:

■ Redness, swelling and heat in the skin, often spreading very rapidly to surrounding areas. The line between the area of cellulitis and the healthy surrounding skin isn’t always clearly demarcated, so it can be hard to tell how extensive it is.

■ Pain – this can be quite severe, and is due to swelling creating pressure under the skin.

■ Blisters or red ‘‘spots’’ may form over the affected area or just outside the periphery.

■ There may be an obvious ‘‘entry point’’, for example an insect bite that has been scratched, a recent wound, or a patch of athlete’s foot, but this isn’t always the case.

■ Fever and malaise, including feeling headachey, sick or shivery as though you have the flu.

The lower leg is by far the most common site, but other parts of the body can be affected, too. If the area around the eye is involved, it is called periorbital cellulitis and needs urgent treatment.

If picked up early, most cases of cellulitis can be effectively managed by your GP. Your doctor will usually be able to make the diagnosis with a simple examination, but occasionally they will want to make sure something else (for example, gout or an underlying abscess) isn’t the issue so may request some blood tests.

As long as you aren’t really unwell, and the area of cellulitis isn’t too big, a course of oral antibiotics is the mainstay of treatment and will start to take effect within 48 hours.

Important things to remember in terms of selfcare include:

■ Rest with the affected limb elevated – this helps to reduce the swelling in the area, and the less swollen an area is, the quicker it will heal.

■ Take adequate analgesia – cellulitis is painful, so make sure you have good supplies of paracetamol and something like ibuprofen to keep yourself