Bathing with Lower Extremity Cellulitis
Regular bathing is recommended for patients with lower extremity cellulitis as part of maintaining good personal hygiene, which helps prevent recurrent skin infections. 1
Bathing Recommendations for Cellulitis
Bathing benefits:
- Helps maintain good personal hygiene, which is explicitly recommended by the Infectious Diseases Society of America (IDSA) for preventing recurrent skin and soft tissue infections 1
- Assists in keeping the affected area clean, potentially reducing bacterial load on the skin surface
- May help manage symptoms like itching and discomfort
Bathing precautions:
- Use warm water instead of hot water to avoid excessive vasodilatation that could worsen swelling 1
- Gently clean the affected area without aggressive scrubbing that might damage the skin
- Thoroughly dry the skin after bathing, especially between toes and in skin folds 1
- Apply moisturizers after bathing to prevent skin dryness and cracking
Additional Hygiene Measures
- Keep the infected area covered with clean, dry bandages when not bathing 1
- Change bandages regularly and whenever they become wet or soiled
- Wash hands thoroughly with soap and water or use alcohol-based hand sanitizer before and after touching the affected area 1
- Use separate towels for the affected area to prevent spreading infection to other body parts 1
- Dry skin thoroughly, especially between toes and in skin folds, as moisture can promote bacterial growth 1
Management of Predisposing Factors
The IDSA guidelines strongly recommend identifying and treating predisposing conditions that contribute to cellulitis recurrence 1:
- Carefully examine interdigital toe spaces for fissuring, scaling, or maceration that may harbor pathogens 1
- Treat underlying skin conditions like eczema or venous insufficiency 1
- Address edema with elevation of the affected extremity 1
- Apply emollients to prevent skin dryness and cracking, especially in patients with lymphedema 2
When to Seek Medical Attention
While bathing is generally safe with cellulitis, contact your healthcare provider if:
- The infection worsens despite treatment
- Redness, swelling, or pain increases after bathing
- You develop fever, chills, or other systemic symptoms
- The affected area develops new drainage or pus
- Red streaks appear extending from the infected area
Prevention of Recurrent Infections
For patients with recurrent cellulitis, the IDSA recommends 1:
- Maintaining good personal hygiene, including regular bathing
- Treating predisposing factors like edema, obesity, and toe web abnormalities
- Considering prophylactic antibiotics for patients with 3-4 episodes per year despite addressing predisposing factors
Common Pitfalls to Avoid
- Don't soak in very hot water, which can increase inflammation and swelling
- Don't share towels or washcloths with others to prevent spreading infection
- Don't aggressively scrub the affected area, which may damage the skin barrier
- Don't neglect drying between toes and in skin folds after bathing
- Don't stop prescribed antibiotics early, even if symptoms improve after bathing
By following these guidelines, patients with lower extremity cellulitis can safely incorporate bathing into their hygiene routine while supporting their recovery and preventing recurrence.