Facial Cellulitis: Symptoms, Causes, and Treatment

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Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. What is Facial Cellulitis?
  2. Affects on Dental Health
  3. Symptoms
  4. Complications
  5. Causes
  6. Diagnosis
  7. Treatment
  8. Importance of Oral Care
  9. Prevention
  10. Frequently Asked Questions
  11. References

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

Complications

Facial cellulitis can spread from one part of the body to another. If it gets deeper into the tissues, it can cause tissue damage and tissue death. 

The infection can also spread to the blood, heart, bones and lymph system. Severe cases can lead to extreme fever and low blood pressure. If the infection starts in the mouth, it can lead to gum swelling.

Causes

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.

Diagnosis

Diagnosing cellulitis is tricky, and studies have shown that about 30 percent of people who develop the condition are misdiagnosed. Of that group, almost all of them (92 percent) received unneeded antibiotics, and 85 percent were hospitalized unnecessarily.

Instead of cellulitis, many of the 92 percent had eczema, lymphoedema or lipodermatosclerosis.

Doctors diagnose facial cellulitis through a physical examination and through testing. Visible symptoms such as swelling and redness are indicators of facial cellulitis.

If the doctor suspects a case of cellulitis, you can expect to take a blood test. Results can confirm an infection and also determine what kind of bacteria that is affecting you. 

Once the bacteria are identified, doctors usually prescribe appropriate antibiotics as the initial state of treatment.

Treatment

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

Most cases of facial cellulitis are treated with oral antibiotics and pain medication. If you have a severe infection or have additional risk factors like low blood pressure or a high temperature, your doctor might give you intravenous antibiotics instead.

Most people recover from facial cellulitis within seven to 10 days. Rest will help you speed up your healing time. However, be sure to complete the antibiotics dosage prescribed by your doctor even if you start feeling much better.

If your infection is caused by bacteria in your mouth, you will need surgery to treat it. Your dentist will cut a small part of your gums and drain the pus that has collected there. After disinfecting the area, the dentist may perform a root canal on your tooth. If there’s too much decay, tooth extraction may be necessary. 

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

  • Your symptoms get worse

  • You’ve taken antibiotics for three days without any improvement 

  • You get a fever

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.

Prevention

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.

Frequently Asked Questions

Facial cellulitis infection occurs when bacteria enter the skin on your face through a wound or open sore. Sometimes, the bacteria from an infected tooth can spread to your facial skin tissue.

Doctors treat facial cellulitis using antibiotics. If the infection is the result of a tooth abscess, the tooth may need to be extracted.

Facial cellulitis requires immediate treatment. If you delay treatment, it can spread to other body parts, damage body tissues and infect the blood and other vital organs.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.