According to Andrey Malvestiti, dermatologist at Hospital Israelita Albert Einstein, the skin is made up of three layers: epidermis (outermost), dermis (intermediate) and subcutaneous fatty tissue. And the classification of infections occurs according to the layer affected: erysipelas (when it occurs only in the most superficial part), cellulitis (occurs in the deepest part and also affects the dermis and subcutaneous tissue) and abscesses (which are collections of pus, usually below the dermis, such as boils).
Treatment is with antibiotics
Both erysipelas and cellulitis are more common on the lower limbs, but they can also affect other areas, including the face, perineal and genital regions. The basic difference between cellulitis and erysipelas, explains Malvestiti, is the extent of the infection. Because it is more superficial, erysipelas usually presents an area with clearer edges, while cellulite, because it is deeper, does not have such precise limits. Both are treated with antibiotics – they can be administered orally, intramuscularly or intravenously. The length of time you use the medication will depend on the severity of the problem.
According to the dermatologist, what will define the type of antibiotic and the method of administration is the location of the cellulite and the clinical assessment of the patient, at which point the doctor will try to identify the possible gateway for the bacteria to settle.
“There are different antibiotics for different bacteria. We need to know if the patient has had contact with salt water, fresh water, if he was bitten by an insect, if he was bitten by another person, if he was bitten by a cat or dog. There are countless possibilities , which require varied medication approaches. In general, we direct the treatment to combat the most common bacteria, which are streptococci and staphylococci”, explains the doctor.??
Malvestiti points out that, when it is identified and treated early, cellulite is unlikely to evolve into something more serious. But complications can arise, especially if the disease occurs on the face, close to the eyes, and progresses to periorbital cellulitis (which increases the risk of vision loss), or in the cavernous sinuses of the face, which can cause thrombosis. “Most of the time, treatment with the use of antibiotics is very effective and the condition tends to resolve within two weeks”, adds the dermatologist.
