From the Guidelines
To reduce swelling in cellulitis, elevation of the affected area and treatment of predisposing factors, such as edema or underlying cutaneous disorders, are recommended 1. This approach is based on the strongest and most recent evidence, which prioritizes morbidity, mortality, and quality of life as the outcome.
Key Recommendations
- Elevate the affected area above heart level as much as possible throughout the day and while sleeping to reduce fluid accumulation in the tissues 1.
- Apply cool, moist compresses to the area for 20 minutes several times daily to constrict blood vessels and reduce inflammatory mediators in the area.
- Take prescribed antibiotics exactly as directed, typically for 5 days, but treatment should be extended if the infection has not improved within this time period 1.
- Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce both pain and inflammation.
- Rest the affected area and avoid activities that worsen swelling.
- Stay well-hydrated by drinking plenty of water to help your body fight the infection.
- Avoid tight clothing or bandages that could restrict circulation to the area.
- Monitor the affected area daily - if the redness spreads, swelling worsens, or you develop fever despite these measures, seek immediate medical attention as your antibiotic regimen may need adjustment.
Additional Considerations
- Systemic corticosteroids, such as prednisone 40 mg daily for 7 days, could be considered in nondiabetic adult patients with cellulitis, although the evidence for this is weak and moderate 1.
- It is essential to note that while corticosteroids may help reduce inflammation, they should be used with caution and under the guidance of a healthcare professional, as they can also have adverse effects.
Prioritizing Evidence
The recommendation to elevate the affected area and treat predisposing factors is based on the highest quality study 1, which provides strong and moderate evidence for this approach. This study is the most recent and relevant to the management of cellulitis, and its findings should be prioritized in clinical practice.
From the Research
Reducing Swelling in Cellulitis
To reduce swelling in cellulitis, several methods can be considered:
- Compression therapy: This involves using compression bandages or stockings to reduce swelling and improve blood flow 2, 3, 4.
- Elevating the affected limb: This can help reduce swelling by allowing fluid to drain more easily.
- Managing underlying conditions: Certain conditions, such as chronic edema, venous insufficiency, and eczema, can increase the risk of cellulitis and swelling 5.
- Using anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help reduce inflammation and swelling, although their effectiveness in cellulitis is still being studied 6.
Prevention of Recurrent Cellulitis
Preventing recurrent cellulitis is also crucial in reducing swelling:
- Compression therapy has been shown to be cost-saving in preventing lower limb recurrent cellulitis in patients with chronic edema 4.
- Identifying and managing risk factors, such as sole anomalies, ulceration, and interdigital intertrigo, can help prevent cellulitis and subsequent swelling 5.
- Early detection and treatment of cellulitis can also help reduce the risk of complications and recurrent episodes.
Treatment Options
Treatment options for cellulitis typically involve antibiotics, and in some cases, compression therapy and anti-inflammatory medications may be used as adjunctive treatments: