Facial cellulitis

Background: Facial cellulitis falls between several different specialties.

Referral guidance:

If the cellulitis has originated from the ear (otitis externa, pinna cellulitis, pinna perichondritis) or sinus (potts puffy tumour) then it should be managed by ENT

If the cellulitis involves the eye, it should be referred to ENT if it is thought to originate from the sinuses (history of recent sinusitis). If it is thought to originate from the lacrimal gland (upper outer aspect of eye) or a stye, it should be referred to Ophthalmology

Any facial cellulitis from a dental source should be managed by the maxillofacial team

Any other facial cellulitis should be managed as a primary skin condition under general medicine

Cautions:

Very rarely, necrotising fasciitis can occur. If the patient has pain out of proportion to the visible changes, rapidly progressive symptoms/signs or evidence of skin necrosis, consider necrotising fasciitis and send immediately to their nearest Emergency Department.