Cellulitis in older adults: what to know

Cellulitis is an infection of deeper skin and soft tissue. It may cause warmth, redness, swelling, and tenderness, often on a leg or arm. In an older person, the skin can be thinner, sensation may be reduced, and mobility or memory changes may make a new sore area harder to notice. Fever may be absent even when the person is unwell. Look for a new change in behaviour, appetite, alertness, walking, or ability to manage usual activities as well as visible skin changes. Cracked skin, pressure areas, wounds, Athlete's Foot, and Type 2 Diabetes can increase concern.

Check the skin gently in good light and compare both sides. Record when the change began, where it is, and whether the redness or swelling is enlarging. Arrange prompt medical advice and provide a complete list of medicines, allergies, medical conditions, and recent wounds. Follow prescribed treatment and hydration advice, and help the person avoid scratching or walking on a painful area. Do not use leftover antibiotics or delay care because the person has no fever.

Seek emergency care for new confusion, unusual sleepiness, faintness, breathing difficulty, severe weakness, rapidly spreading redness, severe pain, or a sudden decline in function. Fever or chills with a worsening skin infection also need urgent attention. Sepsis can develop from an infection and is an emergency. If the person cannot reliably describe symptoms, a caregiver's observation should be shared with the clinician.

Ask how the infection will be monitored, whether a wound or fungal problem is contributing, how medicines fit with kidney or other health conditions, and which changes require emergency help. Ask for a clear follow-up plan that a family member or caregiver can follow.