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Here It Is, Cellulitis In A Nutshell
Cellulitis is an infection that is the "bread and butter" of Infectious Diseases Physicians and other doctors worldwide. While it doesn't evoke the spine-tingling tension of an Ebola outbreak or SARS, cellulitis is an important condition that affects countless numbers of people every year.
What is cellulitis?
First of all, cellulitis has got nothing to do with cellulite. So if you are seeking information on "thunder thighs" and their reduction, read no further! Cellulitis is infection of the tissue under the skin - the "subcutaneous" tissue. The infection tends to spread through special blood vessels in the body known as lymphatics.
Is it rare?
Not at all. Cellulitis would be one of the most common reasons for hospital admission amongst Infectious Diseases units.
Where do you get cellulitis?
By definition, cellulitis can affect any part of the body covered by skin. But, in practice, the most common part of the body affected by cellulitis is the leg; therefore, the emphasis of this article will be cellulitis in that part of the body.
Which bugs cause cellulitis?
Cellulitis is usually caused by bacteria that live on our skin. For the vast majority of our lives, these skin bacteria have been peacefully co-existing on us. But on some occasions, they can stir up trouble and cause cellulitis. Out of all our skin bacteria, the two most frequent culprits are Group A Streptococcus (also known as Streptococcus pyogenes) and Staphylococcus aureus (also known as "golden staph"). There are other causes which will be discussed below (see "Severe forms of cellulitis").
How do you get cellulitis?
Sometimes, patient with cellulitis will recall a break in the skin that has become infected e.G. A cut, a scratch or a surgical wound. But more often than not, there is no history of trauma to the affected part of the body; however, there are a number of risk factors that predispose people to cellulitis.
What are the risk factors for cellulitis?
Tinea pedis
This is a common fungal infection also known as "Athlete's Foot". It causes a break in the skin between the toes but usually causes no symptoms. The fungus itself doesn't cause cellulitis; but, the breach in the skin provides a portal of entry for skin bacteria to wreak their microbial mayhem, causing cellulitis.
Peripheral vascular disease (blocked arteries in the leg)
A healthy blood supply to the extremities is vital to prevent infection. People with blocked arteries in the leg are at higher risk of cellulitis. The two most common groups in which blocked arteries in the leg are seen are chronic smokers and diabetics.
Chronic venous insufficiency
Damaged veins in the leg can increase the risk of cellulitis of the leg. This is often a consequence of aging and other conditions, such as varicose veins. People with chronic venous hypertension usually have thickened skin, dermatitis and small star-like veins over the leg.
Lymphoedema
Lymphatics are vessels that carry a clear liquid to the lymph nodes. The lymphatic system is a vital part of our immune system so any disruption to it increases the risk of infection. When disruption to the lymphatic vessels occurs, it results in swelling of the affected limb called lymphoedema. This can occur spontaneously, be a complication of surgery (e.G. Lymphoedema of the arm following breast cancer surgery) or infection (e.G. Filariasis).
Generalized reduction in the body's immunity Any condition that reduces the body's ability to fight infection increases the risk of cellulitis e.G. In diabetes and in people who take immune-lowering medications.
What happens when you get cellulitis of the leg?
Typically, your foot or leg will start hurting and then become red, hot and swollen - but the order of these symptoms is variable. With time, the affected area of the leg will extend upwards. The infection spreads via the lymphatic vessels which run up the inside thigh and into the lymph nodes at the very top of the thigh; therefore, patients may have a streak of redness and pain on the inside and top of the thigh. Some patients can become generally unwell with fevers, uncontrollable shivering and sweating.
Serious complications of cellulitis Septicaemia Amputation Death
How do you diagnose it?
Cellulitis is purely a clinical diagnosis. Blood and radiological tests are only useful to clarify the severity and extent of the condition.
What is the usual treatment of cellulitis?
Antibiotics (usually penicillin-based) in oral or intravenous form.
Elevation of the affected leg and bed rest Treat the underlying cause e.G. Give antifungal cream for tinea pedis, encourage better control of diabetes and refer to a Vascular Surgeon if there is a history of blocked arteries.
Severe forms of cellulitis Although cellulitis is generally not life-threatening, there are a few exceptions:
Necrotizing skin and soft tissue infections
These are fulminant conditions associated with a very high death rate that include "necrotizing fasciitis", "synergistic gangrene" and "gas gangrene". You may sometimes read in the media of cases described as being caused by "flesh eating bacteria". These are technically not just cellulitis because they end up spreading much deeper than the subcutaneous tissue. People with these conditions have severe pain in the affected areas, often associated with large blisters. They also look very unwell from the end of the bed. The only cure is surgery in conjunction with antibiotics, sometimes involving many operations. Often the operated area will be completely exposed e.G. An open abdomen with the intestines visible or an open leg with the bones on full display.
Dog and cat bites
In Sri Lanka, animal bites, especially from stray dogs, rightly make us worry about rabies. But they also harbour a bacterium called Pasteurella in their mouths. If introduced into our skin through a bite or scratch, they can cause an aggressive form of cellulitis that loves to invade the tendons and joints. These patients often need surgery in addition to antibiotics.
Cellulitis from water
When cellulitis occurs following an injury in water, different bacteria have to be considered. Aeromonas and Vibrio are two bacteria that we worry about, in particular. They can both cause severe blistering infections. Also it is vital to ask the patient about exposure to water as these bacteria require different antibiotics compared to standard cellulitis. For those readers who like the outdoors, it is worth remembering that leech bites complicated by cellulitis are often due to Aeromonas and require special antibiotics.
So there you have it - cellulitis in a nutshell. The take home message is that it is a common condition which has the potential to become very serious if not attended to promptly.
(The writer is an Infectious Diseases Physician and Associate Professor of Medicine at the Australian National University)
How Bad Is It To Pop Your Pimples?
We don't always have the answers, but we have some people on speed dial who do — which is why we present to you our series FYI where we have experts explain if lip balm is actually bad, how often should you wash your hair and more.
When you wake up with a pimple, it can be incredibly tempting to pop it. After all, you want to get rid of that thing as fast as humanly possible. But you may want to think twice before you let your fingers go to town on that zit. According to experts, poking and prodding your acne can make things worse — and may even lead to a potential infection or scarring.
To help you address your blemishes in a more effective way, I spoke to board-certified dermatologists about the dangers of popping your pimples, what to do if you really can't resist popping them, and more effective (and safe!) ways to treat your acne.
SKIP AHEAD Is it bad to pop your pimples?Are some types of pimples better to pop than others?How to safely pop a pimpleThe best way to get rid of pimples4 acne treatments to consider
Every dermatologist we spoke with agreed: Popping your pimples is a bad idea, and it opens you up to a ton of potential issues. "It can lead to more inflammation, possible infection, a bigger chance of scarring and discoloration," says Dr. Jennifer Gordon, a board-certified dermatologist at Westlake Dermatology in Austin, Texas. Not only that, popping your pimples can keep them around for longer. "True acne pimples do not need to be 'popped' and will heal faster if they are left alone," she adds.
There's one exception to the rule: While you shouldn't try to burst your blemishes, a dermatologist may help. It's much safer if they do it, as they can use sterilized tools, clean the wound properly and know exactly the right pressure to exert.
If you really can't resist popping a pimple, you should know that some are better to pop than others. Very superficial pimples and small whiteheads are the types of pimples that are better to pop if you have to, says Gordon. Blemishes you should avoid trying to squeeze? "Deep cystic lesions and small red pimples do not need to be popped," adds Gordon. "Many people think they need to bring these to a head or dig them out — but it's not true!" If you do try to push on them, you may be in for a world of trouble. "Some larger pimples may also be small epidermal cysts under the skin which, when irritated and pressed, can rupture and can cause cellulitis or infection of the skin, which may need systemic antibiotics to calm down," says Dr. Kseniya Kobets, director of cosmetic dermatology at Montefiore Einstein Advanced Care.
"As a dermatologist, I'm supposed to tell you to never pop a pimple and leave it to the professionals. But can anyone really keep their hands off of a big, juicy whitehead?" says Gordon. "Luckily some people can, but others can't resist." If you fall into the latter category, you should at least know how to do it as safely as possible. Avoid an extractor (often called a comedone extractor) at all costs — Gordon says she sees many injuries caused by that tool. Instead, here are the steps Gordon recommends following if you can't resist popping:
Just because you shouldn't pop a pimple doesn't mean you just have to sit back and let it take over your face. Several acne treatments can help speed up the healing process. Here's what our experts suggest:
Based on the guidance from our dermatologists on what type of products to use instead of popping a pimple, we rounded up options that we've featured previously or that are staff favorites.
Murad Retinal ReSculpt Overnight Treatment$105.00
Amazon
$105.00
Sephora
$105.00
Ulta
Murad's overnight treatment made our list of the best retinol products. It has a 4.8-star average from over 600 reviews on Sephora and is formulated to address fine lines, wrinkles and uneven texture, according to the brand. It uses retinal, a type of retinoid that is more powerful than retinol and has similar benefits of smoothing skin texture and clearing breakouts. The retinal in this formula is encapsulated, which allows it to release to limit irritation, according to the brand slowly. It also has olive leaf extracts in its formula to help with hydration.
Neutrogena Rapid Clear Stubborn Acne Spot Treatment Gel$10.48
$13.39
Amazon
$11.39
Target
$10.77
Walmart
Though this spot treatment was on our list of best teen acne products, it works for adults, too. According to the brand, it can reduce the size and redness of acne in just two hours. Experts told us it contains 10% benzoyl peroxide, which inhibits the growth of the bacteria that causes acne.
SkinCeuticals Blemish + Age Defense$110.00
Dermstore
$110.00
Bluemercury
$110.00
SkinCeuticals
Experts recommended this product to treat adult acne and reduce the appearance of fine lines in our guide to salicylic acid. The serum has 1.5% salicylic acid to help with oil and breakouts, but it also has glycolic acid and citric acid to address fine lines and help smooth skin, according to our experts.
Hero Cosmetics Invisible Mighty Patch$17.86
Amazon
$17.99
Ulta
$17.99
Hero Cosmetics
"The patches are very effective at extracting a pimple, but it may take a couple of rounds of patches depending on how deep or large of a pimple it is," says Select's editorial projects associate Rebecca Rodriguez, who tried them for NBC Select's Wellness Awards, who also noted that they blend into her skin and don't broadcast that she has a blemish. Unlike other patches with additional acne-fighting ingredients, these solely rely on the hydrocolloid gel to draw out any sebum or debris from your skin, making them gentle for sensitive skin.
What should you not do with a pimple to make it disappear faster?
Beyond not popping it, you should avoid overly drying your skin around the pimple. While one of the above-listed spot treatments can help dry the pimple out, avoid using harsh treatments on the rest of your face. When your skin feels deprived of moisture, it signals your oil glands to go into overdrive. So, drying out your face can backfire and cause more breakouts to happen.
Is popping pimples in the area between your nose and the corners of your lips actually dangerous?
When it comes to popping pimples, some refer to the area between your nose and the corners of your mouth as the "triangle of death." Why such a scary name? "The area contains a lot of blood vessels that have a direct connection to the brain," says Dr. Amy Huang, a board-certified dermatologist with Medical Offices of Manhattan and contributor at Lab Finder. "An infection that starts in this area has the potential to spread to the brain." However, popping a pimple in this zone doesn't guarantee an infection. It is rare — it's still better to be safe than sorry.
What do pimples on different parts of the face tell you?
Ever heard of face mapping? It's the idea that blemishes on different areas of your face can tell you different things about your health — something Huang says is largely pseudoscience. That said, there are causes for pimples in different areas. "Acne on the forehead can be due to excessive sweating, wearing of headgear, or application of oils and other products to the scalp," she says. "Side sleepers can also have more pimples on the side of the cheek that they sleep on. Jawline acne can be associated with hormonal fluctuations in women."
At NBC Select, we work with experts with specialized knowledge and authority based on relevant training and experience. We also ensure all expert advice and recommendations are made independently and without undisclosed financial conflicts of interest.
Bethany Heitman is a contributor at NBC Select and a journalist who regularly covers beauty, home and lifestyle. For this story, she interviewed dermatologists about popping pimples.
Catch up on NBC Select's in-depth coverage of personal finance, tech and tools, wellness and more, and follow us on Facebook, Instagram, Twitter and TikTok to stay up to date.
This Is Why You Shouldn't Tweeze Or Wax Your Nose Hair
Here's a hairy fact that no one talks about.
Going hairless on your arms, legs and pubic area is perfectly fine, but your nose hair is where you should draw the line, as those pesky little hairs hidden inside your nostrils should go untouched.
"The nose is a delicate area with numerous blood vessels and mucous membranes," Dr. Don J. Beasley, an Idaho-based board-certified otolaryngologist (also known as an ear, nose and throat specialist), told BuzzFeed.
Plucking or waxing out your nose hairs, especially if it's done improperly or without the proper hygiene practices in place, could increase the risk of infection, which will give way to complications such as folliculitis or nasal cellulitis.
You might view body hair as quite a nuisance, but there's a reason your nose comes with those small hairs.
"The primary role of nose hairs is to trap dust, pollen and other airborne particles in the air so that the air you breathe is partially filtered," Dr. Michael Jacobs, a New York-based board-certified dermatologist and associate professor of dermatology at Weill Cornell Medical College, said to BuzzFeed.
The nose hairs also pose as a physical barrier, which prevents harmful allergens from entering the nasal passages and causing irritation or harm to the respiratory system.
Another protective role the nose hairs take on is one many might not expect – it alerts us to potential dangers.
"When something touches the nostril hairs, such as a small insect or other irritants, it triggers a reflexive sneeze, which is the body's way of expelling the intruder or irritant," Jacobs explained to the media outlet.
Jacobs also mentioned that nose hairs maintain high moisture levels in the nasal passages.
"Nose hairs trap moisture from exhaled air, preventing the nasal passages from becoming too dry," Beasley said to the media outlet. "This moisture helps to humidify the air we breathe, making it more comfortable for our respiratory system."
When it comes to waxing your nose hairs and completely removing the hair, you're removing the important filtration system that's designed to keep you healthy and ward off infections such as nasal vestibulitis and nasal abscess, according to Dr. Nicole Aaronson, a Delaware-based board-certified otolaryngologist.
"While waxing doesn't necessarily weaken the immune system, it does breach the skin barrier by creating openings for bacteria to get into the deeper tissues, thus creating the opportunity for infection," she said to Buzzfeed.
Considering all the risk factors that come with waxing nose hairs — such as the side effects, the temporary pain, ingrown hairs, or partial nose hair waxing that comes with the risk of burning — Jacobs warns against doing it at all.
Plucking and tweezing are also bad.
The method can cause buildup of the nasal abscesses. Aaronson recalled having to perform incision and drainage of nasal abscesses due to plucking nose hairs.
"I would not recommend this method of hair removal for the nose," she said to the media outlet.
If you think your nose hairs are out of control and growing out of your nostrils, feel free to carefully trim the hairs that are sitting underneath the nostril with a clean pair of eyebrow scissors or angled scissors with rounded tips.
For a deeper cut inside the nose, opt for an electric trimmer, which is safe and easy to use as well.
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