Facial Cellulitis (Child)

Cellulitis is an infection of the deep layers of skin. A break in the skin, such as a cut or scratch, can let bacteria under the skin. It may also occur from an infected pimple (oil gland) or hair follicle. Cellulitis is more common in children with a weak immune system, such as from cancer or an organ transplant.

Facial cellulitis is an infection of facial tissues. It often occurs on the cheeks. It can also occur behind or around the eyes, on the neck, or behind the ears. Cellulitis causes the affected skin to become red, swollen, warm, and sore. The reddened areas have a visible border. An open sore may leak fluid (pus). Your child may have a fever, chills, and pain. A young child may be fussy, cry, and be hard to soothe.

Cellulitis is treated with antibiotics. Symptoms should get better 1 to 2 days after treatment is started. In some cases, symptoms can come back.

If not treated, cellulitis can get into the eyes, bloodstream, and lymph nodes. The infection can then spread throughout the body. This causes serious illness.

Home care

Your child's healthcare provider will give you an antibiotic to treat the infection. Make sure to give all of this medicine for the full number of days until it's gone. Keep giving the antibiotic even if your child is better. Your child's provider may also tell you to use medicine to reduce fever and swelling. Follow the provider’s instructions for giving these medicines to your child. Don't give aspirin to a child under 18 years of age who has a fever. It may cause a serious illness called Reye syndrome.

General care

  • Have your child rest as much as possible until the infection starts to get better.

  • Hold infants upright. Have an older child sit upright as much as possible. This can help reduce swelling in the face.

  • Follow the healthcare provider’s instructions to care for an open wound and change any dressings.

  • Keep your child’s fingernails short to reduce scratching.

  • Wash your hands with soap and clean, running water before and after caring for your child. This is to prevent spreading the infection.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to get medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see "Fever and children" below)

  • Symptoms that don’t get better with treatment

  • Swollen lymph nodes on the neck or under the arm

  • Swelling around the eyes or behind the ears

  • Excessive drooling, neck swelling, or muffled voice

  • Redness or swelling that gets worse

  • Pain that gets worse

  • Bad-smelling fluid coming from the affected area

  • Blackened skin

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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