Cellulitis is one of the most common and serious complications faced by people living with lymphoedema. It is a bacterial skin infection that can spread rapidly and, if left untreated, can cause further damage to the lymphatic system. Understanding how to prevent it — and recognise it early — is essential knowledge for every lymphoedema patient.
What is Cellulitis?
Cellulitis occurs when bacteria (usually Streptococcus or Staphylococcus) enter through a break in the skin and infect the deeper layers. In lymphoedema patients, the impaired immune function in the affected area makes infection more likely and harder to fight.
Recognising the Signs
Cellulitis can develop very quickly. Look out for:
- Sudden increase in swelling
- Redness that spreads (draw around the edge with a pen to track it)
- The area feels hot to the touch
- Pain or tenderness
- Flu-like symptoms: fever, chills, nausea, feeling unwell
- Red streaks running along the skin
What to Do if You Suspect Cellulitis
- Seek medical help immediately — cellulitis needs antibiotic treatment as soon as possible
- Do not delay — early treatment prevents complications
- Stop MLD and compression on the affected area until the acute infection has settled
- Rest and elevate the affected limb
- Take the full course of antibiotics, even if you start feeling better
- Ask your GP about standby antibiotics — many lymphoedema patients keep a course at home so they can start treatment immediately if symptoms occur outside GP hours
Prevention Strategies
- Daily skin care — keep skin clean, moisturised, and intact
- Protect against injury — wear gloves for gardening and cleaning, use thimbles for sewing, wear shoes outdoors
- Insect bite prevention — use repellent, especially in summer
- Nail care — keep nails short and filed. Avoid cutting cuticles
- Avoid injections, blood pressure, and blood tests on the affected limb where possible
- Treat athlete's foot promptly — fungal infections between toes are a common entry point for bacteria
- Maintain your compression routine — well-managed lymphoedema has lower infection risk
If you experience recurrent episodes of cellulitis (two or more per year), your GP may recommend long-term prophylactic antibiotics. This has been shown to significantly reduce the frequency of infections.