Signs That Cellulitis Is Healing

What to Expect Once You Start Oral Antibiotics

Medically reviewed by Leah Ansell, MD

Cellulitis treatment usually includes oral antibiotics used to kill the bacteria causing the skin infection. Most cellulitis symptoms will decrease after three to five days with most infections clearing up in about 10 days.

The signs that cellulitis is healing include:

• Swelling decreases

• Pain lessens

• Redness fades

• Skin becomes less sensitive
  

This article will review the different stages of healing and what to do if antibiotics don't work.

Brief Overview of Cellulitis Infection

Cellulitis is a skin infection caused by bacteria that enter through a cut, bite, or other type of wound, or through cracked, dry skin. It's most often caused by group A Streptococcus and Staphylococcus aureus bacteria. Cellulitis is usually red, swollen, painful, and warm to the touch.

People with weakened immune systems, venous insufficiency, lymphedema, poor healing from chronic conditions like diabetes, or inflammatory skin conditions such as eczema or psoriasis are at an increased risk of developing cellulitis.

Symptoms of Cellulitis

Cellulitis typically causes redness, pain, swelling, and heat. You may notice pitting on your skin (known as orange peel skin) or blisters, and you may also have a fever or chills.

Signs Cellulitis Is Healing

Antibiotic medication, either delivered orally or intravenously, is the main form of treatment used to treat cellulitis.

Once you begin antibiotics, you can expect cellulitis to progress through several stages as the infection starts to heal. Most infections heal within 10 days.

The First 48 Hours

Following the first 24 hours of treatment with antibiotics, the infection may look worse. Don't assume that the medication is not working or that you need to switch the antibiotic. While the bacteria will die off, they still create inflammation. Wait at least 48 hours for signs of improvement.

After Three Days

After the first three days of antibiotic treatment, your pain will typically decrease. You may also start to notice that your swelling is starting to go down and that the infected area no longer feels very warm.

After Five Days

After five days of antibiotic treatment, most people will notice a significant decrease in pain, swelling, and redness. At this point, the affected area of skin may no longer be tender to the touch.

After Ten Days

Assuming your body has responded well to antibiotic treatment, most if not all of your cellulitis symptoms should subside within 10 days of antibiotic treatment. The standard practice when treating uncomplicated cellulitis is to prescribe a 10-day course of oral antibiotics, although research has shown that a five-day course can be just as effective.

If Antibiotics Aren’t Working

If your cellulitis symptoms do not begin to improve within a few days after starting oral antibiotic treatment, or if your fever worsens and/or you experience nausea or vomiting, seek immediate medical attention to stop the spread of your infection. Severe pain is typically also a sign that the infection is worsening.

Take Your Medication as Prescribed

It is important that you take your oral antibiotics exactly as prescribed by your healthcare provider. Failure to do so could delay the amount of time it takes for your cellulitis to heal.

Symptoms Requiring Urgent Care

When your initial dose of oral antibiotics prescribed by your healthcare provider does not improve your symptoms, or if you start to develop new symptoms such as fever, chills, nausea, and/or vomiting, you will need immediate medical attention. Most likely, you'll receive intravenous (IV) antibiotics, which circulate throughout your bloodstream and are more powerful than oral antibiotics for treating an infection.

Potential Complications

Cellulitis can cause permanent skin changes if the infection worsens and spreads to underlying tissues such as your muscles and bones. These conditions may require surgical treatment to remove the infected tissue. Without removal of the infected tissue, life-threatening sepsis can occur in which the infection rapidly spreads through the bloodstream and throughout the body.

Surgical debridement in which portions of your infected skin and muscle are removed is attempted first for severe infections. If debridement fails to help the infection heal, limb amputation is the last resort for lifesaving treatment.

Recurring Cellulitis

An estimated 8% to 20% of people who have had cellulitis will deal with recurring cellulitis. If you're one of them, talk with your healthcare provider about prophylactic oral antibiotics. Research has shown that they can help reduce the risk of recurrence.

Skin Care and Prevention

If you have a wound on your skin, keeping it clean and well cared for can help reduce your risk of cellulitis. And if you're prone to skin cracks, either due to a condition such as eczema or because you have dry skin, applying a thick moisturizer can help create a barrier against bacteria and protect against infection.

Summary

Cellulitis is a bacterial skin infection that causes pain, warmth, redness, and swelling to the affected area of the body, most commonly the legs and feet. Oral antibiotic treatment will typically clear symptoms within ten days. If your infection doesn't respond to oral antibiotics, you'll likely be given IV antibiotics. Should your cellulitis progress and result in complications, surgery may be required to prevent sepsis.