Facial Cellulitis: Symptoms, Causes, and Treatment

Some 14 million people a year in the United States are diagnosed with cellulitis, an acute bacterial infection of the skin, each year. There are no hard figures detailing how many people get facial cellulitis.

When it strikes the face, the condition can stem from a dental infection. The situation grows serious when bacteria migrate deeper into skin tissues.

Initial treatment is a round of antibiotics, followed by surgery.

What Is Facial Cellulitis?

Cellulitis is a disease caused by bacterial infection in your skin tissues. Facial cellulitis is a form of cellulitis that occurs on the face, typically striking only one side of the face.

About 14 million Americans are diagnosed with cellulitis each year, although the level of misdiagnosis is high. There are no hard statistics about how many people are diagnosed with facial cellulitis.

The condition can grow serious in a hurry, especially if the bacteria gets in deeper tissues. If this happens, the tissues may develop gangrene and start to die. Eventually, parts of your skin may need to be removed.

Facial Cellulitis and Your Dental Health

One way to develop facial cellulitis is through a dental infection. A severe tooth infection can lead to a bacterial build-up called dental abscess.

If you don’t get treatment for an abscess, the bacteria can spread to the neighboring tissues on your face. As a result, you can get facial cellulitis on your cheeks and around your eyes.

Symptoms

Symptoms of facial cellulitis include:

• Swelling of the infected area

• Difficulty opening the eyes due to swelling 

• Redness 

• Abnormal warmth in the face

• Presence of an abscess 

• Tight, tender skin 

• Facial pain

• Fever 

• Headache 

• Weakness

You should see your doctor immediately if:

• You have diabetes or a weak immune system 

• Your eyelids swell 

• Your skin darkens 

• You experience swelling behind your ear 

• You are shaking or sweating from fever 

• You feel drowsy

Is facial cellulitis serious?

Researchers say it’s critical to get prompt treatment for cellulitis. Several complications can take hold in people who don’t get the help they need. 

Cellulitis is an infection of the skin, but it can penetrate deeper into the bloodstream. Infected blood is called bacteremia, which can lead to infections around the heart. Blood tests can help your doctor spot this condition. 

People who have cellulitis sometimes have the following serious symptoms:

• High fever (over 100.4 degrees) 

• Fast breathing 

• Fast heart rate

• Abnormal white blood cell count 

These symptoms point to sepsis, an unusual reaction to an infection in which the immune system turns on the body instead of against the bacterial invaders. This complication can be life-threatening and requires immediate treatment.

If the infection keeps moving into deeper tissues, you can develop osteomyelitis—infections within the bone. People with this condition typically need surgeries to remove the dead bone left behind. 

If you have cellulitis, it’s important to get help from a treatment professional immediately. People with immune system issues or diabetes are particularly prone to complications, so it’s vital that they take cellulitis seriously. 

What causes facial cellulitis?

Facial cellulitis occurs when bacteria enter your body through a cut or open sore on your skin. Three bacteria that commonly cause this infection:

• Streptococcus pneumoniae 

• Hemolytic streptococcus 

• Staphylococcus aureus 

These bacteria are present on the top layers of most people’s skin. They are harmless when the skin is intact. If the skin cracks or breaks, bacteria can get beyond the top layer of skin and start to cause an infection. 

You can also get infected with facial cellulitis if you: 

• Get injured in water 

• Are bitten by an animal or human

• Have an infected tooth

A cellulitis infection can also transmit from person to person through wound-to-skin contact, but it is rare.

Among the factors that increase your risk of infection are:

• Skin conditions that make skin wounds more common, such as eczema or psoriasis

• A weak immune system from a condition such as diabetes or HIV

• A history of cellulitis infection 

• Bacterial infection in a tooth

• Obesity 

Having a wound on your skin does not mean you will get facial cellulitis. Most people have strong immune systems that can fight bacteria and prevent infection. The condition only occurs in rare cases.

How is facial cellulitis diagnosed? 

The American Academy of Dermatology explains that there’s no standardized medical test that can diagnose cellulitis. However, doctors can use several tools to determine if your skin condition is cellulitis. Doctors can use secondary tests to determine the best course of treatment. 

Your diagnosis might involve the following steps:

• Interview: Your doctor will ask if you’ve traveled recently, experienced an injury, have a history of intravenous drug use, or have been bitten by an insect or animal.

• Inspection: Your doctor will look closely at your skin, looking for evidence of warmth, swelling, redness, or tenderness. You must have at least two of these four issues before you can be diagnosed with cellulitis. 

• Marking: Your doctor will draw a circle around the swollen area and check that often. If the swelling continues, it will move beyond that circle. 

Once you’ve been diagnosed with cellulitis, your doctor might take a small sample of your infected skin or the fluid below it. Testing that sample could tell your doctor what kind of bacteria is causing your cellulitis. 

If your cellulitis impacts more than just your face or you have other symptoms that impact your whole body, your doctor might check your blood for underlying problems or illnesses. 

How is facial cellulitis treated?

Skin doctors treat cellulitis in two ways, with antibiotics and with surgery.

How to recover from facial cellulitis 

Your medical team will give you antibiotics to help your cellulitis heal, and you should feel better within 24 to 48 hours of taking your first dose. 

Contact your doctor if you experience any of the following after facial cellulitis treatment:

• Your redness moves outside the line your doctor marked.

• Your pain gets worse. 

• You develop a fever.

• You develop a bullae (a fluid-filled lesion just below the skin). 

While you’re healing, keep your skin clean and dry. Keep your head elevated, as it may help to reduce swelling and pain. 

Importance of oral care

Taking care of your oral health can reduce your chances of developing facial cellulitis.

One way you can avoid dental problems is through preventive care. Getting regular checkups and cleanings from your dentist can prevent most oral problems. Your dentist can identify dental problems before they become severe. This can help you avoid tooth infections, tooth loss and facial cellulitis.

How to keep facial cellulitis from returning 

If you have recurring facial cellulitis, your doctor may prescribe preventive antibiotics. You can also take some precautions to help prevent infection:

• Maintain good oral hygiene. Brushing and flossing your teeth regularly can help avoid a tooth abscess that can lead to facial cellulitis. 

• Avoid skin injuries such as burns, cuts, bug bites and bee stings.

• Take good care of wounds. If you have an open wound on your skin, wash it, apply an antibiotic cream and keep it covered to prevent bacteria from entering.   

• Apply ointments or creams to your skin. These can also protect your skin from cracking and prevent bacteria entry. 

• Maintain good overall hygiene. Wash your face regularly to keep bacteria levels low.

• Treat other medical conditions such as diabetes. Also, try to lose weight through exercise.

Is cellulitis covered by insurance?

Cellulitis is a bacterial infection of the skin. Your medical insurance should cover issues that happen to your skin, which is the largest organ in the human body. If you have medical insurance, you can use your coverage to pay for things like antibiotics and bacterial testing. 

If your facial cellulitis started with an oral problem (like an abscess), you will need dental insurance for things like dental extractions or root canals. Your health insurance likely won’t help with that problem.

These are general guidelines, and your results may vary. Always contact your insurance provider to verify your benefits and get answers to your specific plan questions. 

Frequently Asked Questions