Adult Cellulitis Treatment (Cellulitis)
Fast MD-only cellulitis care by secure online video visit, $49 flat-fee, no insurance required.
Cellulitis is a bacterial infection of the skin and underlying soft tissue that can cause redness, warmth, swelling, and pain. Our board-certified MDs use guideline-based evaluation to distinguish mild infections that can be treated with oral antibiotics from more serious cases that need urgent in-person or emergency care.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Cellulitis Care
- Adult-only evaluation of localized skin redness and swelling
- Screening for abscess, diabetic foot infection, and sepsis
- Oral antibiotic prescriptions for appropriate mild cases
- Clear criteria for when in-person or ER care is required
Adults 18+ only. TeleDirectMD does not provide IV antibiotics, wound procedures, or hospital-level sepsis care by telehealth and does not prescribe controlled substances for pain control.
What Is Adult Cellulitis?
Cellulitis is an acute bacterial infection of the deeper layers of the skin and soft tissue. It typically presents with an area of redness, warmth, swelling, and tenderness that may spread over hours to days. The infection often starts when bacteria enter through a break in the skin such as a cut, insect bite, ulcer, or athlete’s foot.
In otherwise healthy adults, mild localized cellulitis without systemic symptoms can sometimes be managed with oral antibiotics and close follow-up. However, rapidly spreading redness, high fever, systemic illness, or involvement of certain high-risk areas like the face, hands, or genitals requires urgent in-person evaluation and often IV antibiotics. A core role of telehealth is to distinguish which category you fall into and direct you to the safest setting for care.
Symptoms and Red Flags in Adult Cellulitis
Many adults with mild, early cellulitis can be triaged and treated through a virtual visit. Certain symptoms, however, suggest deeper infection, sepsis, or special locations that require in-person or hospital-level care instead of telehealth alone.
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Localized redness, warmth, and tenderness of skin | Typical early cellulitis or local skin infection | Often appropriate if limited area and patient well-appearing | Not a red flag alone if small, stable, and without systemic symptoms |
| Redness surrounding a small cut, scratch, or insect bite | Entry site for bacteria causing mild cellulitis | Yes, if area is small and not rapidly spreading | Rapid expansion of redness or severe pain over a few hours |
| Low-grade fever with localized leg or arm infection | Moderate cellulitis needing careful assessment | Telehealth may be appropriate for initial evaluation | High fever, rigors, or signs of sepsis |
| Fluctuant lump or pocket of pus (abscess) | Likely abscess that may need drainage | Telehealth can help diagnose and direct care | Large or deep abscesses often require in-person drainage |
| Red streaks tracking up the limb from the infected area | Possible lymphangitis and more advanced infection | Telehealth may triage but is limited | Associated fever, chills, or feeling very ill |
| Red, swollen skin on face, around eyes, or on hands or genitals | Higher-risk sites with potential for serious complications | Telehealth may help identify concern | Orbital involvement, trouble seeing, or difficulty moving fingers |
| Severe pain out of proportion to skin findings | Possible deeper infection such as necrotizing fasciitis | No | Requires emergency department evaluation |
| Fever, chills, confusion, rapid heart rate, or rapid breathing | Possible sepsis from skin infection | No | Emergency evaluation is required, not telehealth-only care |
| Open ulcers or wounds on a person with diabetes or poor circulation | Higher risk of deep infection, osteomyelitis, or poor healing | Telehealth may triage but cannot fully evaluate | Deep ulcers, foul odor, or inability to bear weight |
Differential Diagnosis: Cellulitis vs Other Red, Swollen Skin Conditions
Not every red, warm area on the skin is true cellulitis. During your TeleDirectMD visit, the MD will assess onset, location, pain, systemic symptoms, and any trauma or bites to differentiate uncomplicated cellulitis from other conditions that may require different treatment or in-person testing.
Typical Cellulitis
- Ill-defined redness, warmth, swelling, and tenderness in 1 region
- Often follows a break in the skin, athlete’s foot, or bite
- May cause low-grade fever and feeling unwell
- Improves with appropriate antibiotics and limb elevation
Other Conditions That Mimic Cellulitis
- Stasis dermatitis: Chronic reddish-brown changes and swelling in lower legs from venous disease, usually less tender and more long-standing.
- Contact dermatitis: Itchy rash with clear trigger such as new cream or bandage; often sharply demarcated and less painful.
- Gout or inflammatory arthritis: Red, hot, swollen joint with intense pain, often at big toe, ankle, or knee.
- Deep vein thrombosis (DVT): Swollen, painful limb with risk factors for clot; may have minimal skin redness but requires urgent imaging.
Telehealth can often distinguish these based on detailed history and photos. When the diagnosis is uncertain, the area is extensive, or systemic symptoms are present, in-person evaluation is recommended both to confirm the cause and to choose the safest treatment setting.
When Is a Video Visit Appropriate for Cellulitis?
When a Video Visit Is Appropriate
- Localized redness and warmth of a small area of skin
- Mild to moderate pain that is manageable without strong narcotics
- No high fever, chills, or confusion
- No rapidly spreading redness or severe pain in the last few hours
- No deep ulcers, exposed bone, or foul-smelling wounds
- Patient can show the affected area clearly on camera
- Adult 18+ who can obtain oral antibiotics and follow safety instructions
Red Flags Requiring In-Person or ER Care
- High fever, rigors, rapid heart rate, or rapid breathing
- Severe pain out of proportion to the appearance of the skin
- Rapidly expanding redness or swelling over hours
- Infection around the eye, on the face, or on the genitals
- Deep diabetic foot ulcers, foul odor, or inability to walk
- History of immune suppression, chemotherapy, or advanced liver or kidney disease with new infection
- Recent surgery at the affected site with increasing pain and redness
If any red-flag symptoms are present, seek in-person or emergency care immediately. TeleDirectMD is not an emergency service and does not manage sepsis, necrotizing infections, or other life-threatening conditions by telehealth.
Treatment Options for Adult Cellulitis
Management of cellulitis focuses on early recognition, appropriate antibiotics, and supportive measures. Our MDs follow evidence-based guidelines to choose oral antibiotics when it is safe and to direct you to urgent in-person or emergency care when higher-level treatment is required.
Supportive Measures and Skin Care
- Mark the border of redness with a pen to help track whether it is spreading.
- Elevate the affected limb when possible to reduce swelling and discomfort.
- Keep the area clean and dry; avoid aggressive scrubbing or home incision attempts.
- Use over-the-counter pain relievers such as acetaminophen or ibuprofen if appropriate.
- Monitor for worsening pain, spreading redness, fevers, or new systemic symptoms.
Antibiotic Therapy (When Appropriate)
- For mild nonpurulent cellulitis, beta-lactam antibiotics covering streptococci are typically used first-line.
- For purulent infections or suspected MRSA, regimens that include MRSA-active agents may be considered.
- Antibiotic choice is adjusted based on allergy history, local resistance patterns, and comorbidities.
- Telehealth is not appropriate for IV antibiotic initiation; those cases require in-person or hospital care.
TeleDirectMD emphasizes antibiotic stewardship: using the narrowest effective regimen at an appropriate dose and duration, avoiding unnecessary dual coverage, and clearly explaining when in-person evaluation or imaging is safer than continuing outpatient telehealth management.
Common Medications Used for Adult Cellulitis
The exact regimen is individualized based on infection location, severity, allergy history, local resistance patterns, and other medical conditions. The table below shows typical oral options your MD may consider for mild to moderate cases that are appropriate for outpatient telehealth management.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Cephalexin 500 mg | 500 mg by mouth 4 times daily | Typically 5–7 days, longer if slow response | First-line for mild nonpurulent cellulitis in adults without severe beta-lactam allergy |
| Dicloxacillin 500 mg | 500 mg by mouth 4 times daily | Typically 5–7 days | Alternative for nonpurulent cellulitis when penicillinase-resistant agent preferred and no allergy |
| Clindamycin 300 mg | 300 mg by mouth 3–4 times daily | Typically 5–7 days | Adults with beta-lactam allergy or when MRSA and streptococcal coverage are both desired |
| Trimethoprim–sulfamethoxazole DS | 1–2 DS tablets by mouth 2 times daily | Typically 5–10 days | Suspected MRSA skin infection, usually combined with a beta-lactam when streptococcal coverage is also needed |
| Doxycycline 100 mg | 100 mg by mouth 2 times daily | Typically 5–10 days | Alternative MRSA-active oral agent when appropriate and no contraindications |
These are example regimens only. Actual medications, doses, and durations are determined by the MD after reviewing your history, allergies, infection severity, and concurrent medications. TeleDirectMD does not prescribe IV antibiotics or controlled substances by telehealth and will refer you for in-person evaluation if your infection requires higher-level care.
Home Care, Expectations, and Return to Work
With appropriate antibiotics and supportive care, many mild cellulitis cases start to improve within 24–48 hours, although full resolution of redness and swelling can take several days. The goal is to stop progression, relieve pain, and prevent complications such as abscess, deep infection, or sepsis.
- Take antibiotics exactly as prescribed and complete the full course, even if symptoms improve early.
- Check the marked outline of redness at least twice daily to ensure it is not expanding.
- Elevate the affected limb and limit excessive use until pain and swelling decrease.
- Call for care or seek in-person evaluation if redness spreads beyond the marked line, fever develops, or pain worsens.
- Arrange follow-up if you have diabetes, immune suppression, or recurrent cellulitis episodes.
Many adults with mild cellulitis can continue working or return to work once antibiotics are started and they feel well enough, depending on job duties and infection location. If a work note is needed, TeleDirectMD can generally provide documentation of evaluation and treatment rather than extended time off, unless there are complicating medical issues.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions like cellulitis. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidelines, clarify what can be safely managed via telehealth, and explain when in-person primary care, urgent care, wound care, or emergency evaluation is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Adult Cellulitis Treatment FAQs
Cellulitis is a true bacterial infection of the deeper skin and soft tissue, causing redness, warmth, swelling, and pain that often worsens over hours to days. Simple irritation or dermatitis is usually more itchy than painful, may be linked to a product or contact, and does not typically cause spreading warmth or systemic symptoms such as fever or chills.
Many mild, localized cellulitis cases in otherwise stable adults can be safely evaluated via secure video. We review photos, your symptoms, and your medical history to decide whether oral antibiotics and home care are appropriate. If we see signs of severe infection, deep abscess, or sepsis, we will direct you to urgent in-person or emergency care instead of managing it fully online.
Many people notice less pain and spreading within 24–48 hours of starting appropriate antibiotics, although the redness and swelling can take several days to fully resolve. If the redness is expanding beyond the marked area, pain is getting worse, or you develop fever or chills after starting treatment, you should seek in-person care promptly to reassess the infection and treatment plan.
Depending on your allergy history, infection severity, and other conditions, we may consider oral agents such as cephalexin, dicloxacillin, clindamycin, trimethoprim–sulfamethoxazole, or doxycycline. The choice is tailored to whether we suspect typical streptococcal cellulitis, MRSA involvement, or a mixed picture and will be explained during your visit, including expected dose and duration.
Many mild cellulitis cases in otherwise healthy adults can be diagnosed clinically without immediate imaging or blood work. However, if you are very ill, have diabetes or poor circulation, have deep ulcers or foreign bodies, or are not improving on appropriate antibiotics, in-person evaluation with labs or imaging may be needed. Telehealth can help determine when those tests are appropriate and where to obtain them locally.
Cellulitis becomes an emergency when it is associated with high fever, chills, confusion, rapid heart rate, rapid breathing, severe pain out of proportion to the skin findings, or rapidly spreading redness. Infection around the eye, deep ulcers in people with diabetes, or signs of necrotizing infection also require urgent in-person or hospital care, not telehealth-only management or watchful waiting at home.
Many adults with mild cellulitis can continue working or return to work once antibiotics are started and they feel well enough, especially if the affected area can be protected and elevated during breaks. Jobs that require heavy physical activity or prolonged standing on an infected leg may need temporary adjustment. Your TeleDirectMD physician can provide a work note describing evaluation and treatment if needed, while avoiding unnecessary prolonged time off when it is safe to work.
Preventing recurrence involves protecting the skin barrier and addressing risk factors. That includes treating athlete’s foot or other chronic skin conditions, moisturizing dry cracked skin, promptly cleaning and covering cuts or scrapes, managing swelling in the legs if you have venous disease, and supporting glucose control if you have diabetes. During your visit, we can review your specific risk factors and outline practical prevention steps tailored to your situation.
TeleDirectMD can help with triage, antibiotic decisions, and education for many mild episodes, but recurrent cellulitis may signal underlying issues such as venous disease, lymphedema, or poorly controlled diabetes that need in-person evaluation. We encourage you to maintain a relationship with a local primary care clinician or specialist, and we can provide visit summaries that you may share to support coordinated, long-term care.
TeleDirectMD offers MD-only, guideline-based cellulitis care through secure video visits with a transparent $49 flat-fee model and no insurance required in 25+ states. We focus on early recognition, appropriate oral antibiotic selection, antibiotic stewardship, and explicit instructions about red-flag symptoms and when to escalate to in-person urgent care, wound care, or emergency evaluation for your safety.