Prevalence of Cellulitis in Lymphoedema and Lipoedema

Cellulitis is a common bacterial skin infection that can spread rapidly throughout the body. If not treated promptly, it can become serious and, in rare cases, life-threatening. It is usually caused by bacteria entering through a break in the skin, such as a cut, scratch, crack, or even an insect bite.

The skin plays a vital mechanical role in the body’s immune defence by acting as a barrier against bacteria. When the integrity of this barrier is compromised, bacteria can enter and multiply, leading to infection — most commonly cellulitis.

Cellulitis is generally easy to recognise. Typical signs include swelling, redness, warmth, and tenderness in the affected area, often in a limb. These local symptoms may be accompanied by fever, chills, and a general feeling of unwellness.

There is strong evidence that cellulitis is more prevalent in people living with lymphoedema. In lymphoedema, fluid accumulates in the spaces between tissues due to a compromised lymphatic system. This fluid is rich in proteins that have leaked from the capillaries during normal fluid exchange and are no longer adequately cleared. Because these proteins are hydrophilic (water-attracting), their presence in the tissues does not simply lead to stagnation — they increase interstitial oncotic pressure, drawing additional water into the area. This contributes to persistent or progressive swelling. Lymphoedema is therefore described as a chronic high-protein, low-flow oedema.

The combination of fluid accumulation, protein concentration, and reduced immune surveillance creates an environment in which bacteria can more easily thrive. Furthermore, lymphoedema can predispose individuals to recurrent episodes of cellulitis, creating a challenging cycle of infection and further lymphatic damage.

While cellulitis is not a direct symptom of lipoedema, the two conditions can coexist. Because cellulitis is a bacterial skin infection, it may occur as a complication in individuals with lipoedema, particularly where there is poor circulation, chronic oedema, impaired lymphatic drainage, or increased skin fragility.

Prevention strategies are crucial in both lymphoedema and lipoedema management. These include maintaining meticulous skin care, practising good hygiene, and promptly cleaning and protecting any break in the skin. For individuals with recurrent cellulitis, having a clear medical plan — which may include starting antibiotics at the first signs of infection — is essential and should be developed in consultation with a healthcare professional.

Lymphatic drainage therapy and appropriate compression garments are central components in the management of lymphoedema and lipoedema. By supporting lymphatic and venous circulation, these approaches help reduce fluid stagnation and support immune function, which is intrinsically linked to the lymphatic system.

Cellulitis is a serious but largely preventable risk for those living with lymphoedema or lipoedema. Protecting the skin, recognising early signs of infection, and supporting healthy lymphatic flow are essential steps in reducing complications.

If you would like professional support with lymphatic drainage therapy or compression guidance, I am here to help. Early, consistent care can make a significant difference in protecting your lymphatic health and overall wellbeing.

“Where lymph flows, health follows. Support the flow, and the body regains its strength.”

References

Al-Niaimi, F. C. (2009). Cellulitis and lymphoedema:. Journal of Lymphoedema, 4(2). Retrieved February 21, 2026, from https://www.researchgate.net/profile/Firas-Al-Niaimi/publication/285876339_Cellulitis_and_lymphoedema/links/5975b9630f7e9b4016a081d8/Cellulitis-and-lymphoedema.pdf

O'Fallon, M. (n.d.). Lipedema and Cellulitis: Understanding the Relationship and Prevention Strategies. Retrieved February 24, 2026, from Lipoedema Surgical Solution: https://lipedema.net/lipedema-and-cellulitis-understanding-the-relationship-and-prevention-strategies/

Stéphane Vignes MD, F. P. (January, 2022). Cellulitis risk factors for patients with primary or secondary lymphedema. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 10(1), 179-185. doi:https://doi.org/10.1016/j.jvsv.2021.04.00

I am the author of this blog with the assistance of ChatGPT to proofread and polish

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