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Eczema and Cellulitis

Medically Reviewed by Stephanie S. Gardner, MD on March 07, 2022

Eczema and cellulitis are two separate conditions, but they share some of the same symptoms. And people with eczema sometimes also develop cellulitis.

Correct treatment is key for each of these conditions -- especially cellulitis, which can have life-threatening complications. That’s why it’s important to know the difference between the two, as well as how they’re connected.

What Is Eczema?

Eczema is a chronic inflammatory skin condition in which your immune system overreacts to allergens or irritants. There’s no one cause, but lots of things can contribute to it, including your genes and things in your environment.

The most common symptom is dry, itchy skin. You may want to scratch it a lot, which can lead to bleeding, blisters, and skin infections like cellulitis.

Not everyone with eczema has the same symptoms. But symptoms may include:

  • Flaky skin
  • Sensitive skin
  • Inflamed skin
  • Discolored skin
  • Rashes
  • Scaly patches
  • Swelling
  • Oozing or crusting
  • Blisters and skin infections

Eczema is common in infants, children, and adults. It may be mild or severe. You may have flare-ups when your symptoms are worse and times when they go away completely.

If you have eczema, your doctor may recommend moisturizer, ointments, special baths, wet-wrap therapy, topical steroid creams, corticosteroids, or other treatments to ease your symptoms.

What Is Cellulitis?

Cellulitis is a skin and soft tissue infection. It happens when bacteria get into your body through a break or crack in your skin, including those that can result from eczema. It’s deeper than eczema, and may develop in your skin or just beneath it.

Cellulitis is often painful. Your skin may feel tender to the touch. Skin in the infected area may look red and swollen and feel warm.

Other symptoms may include:

  • Blisters
  • Fever
  • Red spots
  • Skin that looks dimpled, like an orange peel

Cellulitis most often appears on your legs, but can also show up in other areas. And it can spread quickly. If it’s not treated, it can move to your bloodstream and lymph nodes and become very serious.

If you have cellulitis, your doctor may recommend antibiotics to treat the infection. If it gets worse, you could develop a fever and your white blood cell count may go up. You might need to be hospitalized if the infection spreads and causes complications.

If you have a rash that’s red, swollen, tender, and warm, and it’s expanding, see a doctor right away. If you also have a fever, go to urgent care or the emergency room.

How Are They Different?

Eczema and cellulitis may look similar. Both lead to inflamed or swollen skin.

But your symptoms may be different.

If you have crusting or scaling, that’s a sign of eczema, but not cellulitis. With cellulitis, your skin usually looks smooth and shiny.

Small blisters are another symptom of eczema that’s not common with cellulitis. If you get blisters with cellulitis, they’ll probably be large ones.

With cellulitis, you can develop a fever. With eczema, you probably won’t.

Your skin may feel tender when you have cellulitis, but this isn’t likely with eczema.

Location is another key difference. Cellulitis usually shows up on your lower leg. It may also appear on your face, arms, and other areas, but that’s less common. Eczema can appear anywhere. Common places include:

  • Hands
  • Neck
  • Inner elbows
  • Ankles
  • Knees
  • Feet
  • Near your eyes

Certain Types of Eczema Look Like Cellulitis

Varicose eczema, also called venous eczema, can look similar to cellulitis. This type of eczema affects your lower legs, which is where cellulitis often appears.

With varicose eczema, your skin may be itchy, swollen, dry, flaky, scaly, or crusty. If you have light skin, it could look red or brown. If you have darker skin, it could look dark brown, purple, or gray.

Like cellulitis, varicose eczema sometimes causes swelling in your legs. It’s more likely to happen at the end of the day or after you stand for a long time. You might also notice swollen, enlarged veins in your legs, which are also called varicose veins.

This type of eczema can cause pain and tenderness, which are also symptoms of cellulitis. You may also notice discolored skin, tight skin, hardened skin, or small, white scars.

How Are Eczema and Cellulitis Linked?

If you have eczema, you’re more likely to develop cellulitis.

Eczema can cause breaks in your skin, especially if you scratch it. This gives bacteria an easy way to enter your body. Eczema makes you more prone to skin infections from bacteria, viruses, and other germs, like staph or herpes.

Some eczema treatments could make cellulitis worse. If you use eczema treatment but your skin gets worse, you might have cellulitis.

What to Do if You Have Eczema and Develop Cellulitis

If you have eczema and notice symptoms of cellulitis, talk to your doctor. It’s important to treat it before it turns into a more serious condition.

Antibiotics are the most common treatment. But your doctor will decide what’s best depending on how serious your infection is. They may try draining the abscess. If it’s more serious, you may need to go to the hospital and get intravenous (IV) antibiotics.

Once you’ve had cellulitis you’re at higher risk of getting it again, even if you treat it and it goes away.

If you get cellulitis three to four times a year, your doctor may recommend taking a daily low-dose antibiotic.

If you keep getting it even when you’re on antibiotics, that could mean it’s not cellulitis, but another skin condition. A dermatologist can help you find out what’s causing your symptoms.

Can You Prevent Cellulitis?

The most important way to prevent cellulitis is to keep your skin clean and protect wounds.

Try to:

  • Clean your hands often during the day. Wash with soap and water or use hand sanitizer.
  • Cover cuts, scrapes, and wounds with petroleum jelly and a bandage. Change the bandage at least once a day.
  • Moisturize your skin often.
  • Keep your nails short and well-manicured.
  • Avoid sharing items that may carry bacteria, like towels and razors.
  • Treat infections and other skin conditions right away.
  • Look for symptoms of infection, like redness, pain, or drainage. Check for foot injuries or infections every day. If you notice any signs, talk to your doctor.

Healthy lifestyle choices may help you prevent cellulitis from coming back:

  • If you smoke, quit. Smoking might increase your risk of cellulitis.
  • If you’re overweight or obese, you may lower your risk of cellulitis by losing weight.
  • If you drink, cut back. Heavy drinking is thought to increase your risk of cellulitis, though we need more research on this.

Show Sources

SOURCES:

British Medical Journal: “Importance of distinguishing between cellulitis and varicose eczema of the leg.”

American Academy of Dermatology Association: “Cellulitis: How to Prevent it From Returning.”

American Academy of Pediatrics: “Boils, Abscess & Cellulitis.”

Arnold Palmer Hospital for Children: “3 Ways to Tell if It’s Eczema or a Skin Infection.”

Cleveland Clinic: “Eczema.”

Mayo Clinic: “Cellulitis.”

National Eczema Association: “Cellulitis,” “Conditions Related to Eczema,” “What is Eczema?”

NHS: “Varicose Eczema.”

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