Gout and cellulitis can both cause inflammation and pain in your lower body. Gout is the buildup of uric acid crystals in a joint, while cellulitis is a bacterial infection in the deep layer of your skin.

Cellulitis and gout are two conditions that can cause pain and inflammation, especially in your feet or lower body.

Cellulitis is a bacterial infection of the deep layer of your skin called the dermis. Gout is a form of inflammatory arthritis involving the development of crystals in a joint due to the buildup of a substance called uric acid.

This article examines the differences between these two conditions.

Prevalencemore than 14 million cases each year in the United Statesoccurs in 1–4% of people
Symptomsskin redness, painsevere joint pain
Locationusually arms and legsmost commonly big toe
Causeusually bacterial infectionbuildup of uric acid

Cellulitis and gout both cause pain and inflammation. Here’s how their symptoms compare.

Cellulitis symptoms

Cellulitis typically causes areas of your skin that are:

  • red, which may appear purple or gray on darker skin tones
  • swollen
  • warm
  • painful
  • pitted like the peel of an orange

You may also develop a fever and chills.

Symptoms typically always occur on one side of your body.

Gout symptoms

Gout flare-ups tend to occur suddenly. They typically cause severe pain in one joint, most often in one of your big toes. Your joint may be:

  • hot
  • swollen
  • red

Flare-ups can last days to weeks and are followed by periods of remission that last weeks, months, or years.

If left untreated, gout can lead to the buildup of needle-shaped crystals called tophi that can cause progressive pain and joint misshapenness.

Other joints commonly affected include:

  • other toes
  • ankles
  • knees

Here’s a look at the causes of gout and cellulitis.

Cellulitis causes

Cellulitis is usually due to a bacterial infection. It typically occurs after bacteria enter a break in your skin through:

  • cuts
  • ulcers
  • bites
  • tattoos
  • piercings
  • surgical wounds

Risk factors for cellulitis include:

Gout causes

Gout is caused by hyperuricemia, which is the buildup of uric acid. Your body produces this substance when it breaks down chemical compounds called purines that are found in some foods.

Hyperuricemia causes the buildup of uric acid crystals in the joints of people who develop gout.

Half or slightly less than half of people with gout have a family history of the condition. Other risk factors include:

  • male sex
  • experiencing menopause, in females
  • drinking alcohol
  • drinking sugary drinks
  • eating an unhealthy diet or foods high in purines
  • older age

Gout flare-up triggers

Common gout triggers include

The National Health Service (NHS) in the United Kingdom recommends getting medical attention if you have potential symptoms of cellulitis, such as your skin feeling:

  • swollen
  • hot
  • painful

They also recommend contacting your doctor again if your symptoms don’t improve 2–3 days after starting antibiotics.

The NHS also recommends speaking with a doctor if you:

  • develop symptoms of gout for the first time
  • your usual gout treatments aren’t working

Doctors can typically diagnose cellulitis by looking at your skin. Additional testing usually isn’t needed.

Doctors can only diagnose gout during a flare-up. They may make the diagnosis by:

  • performing a physical exam
  • ordering blood tests to look for high levels of uric acid
  • taking a sample of your joint fluid to look for uric acid crystals
  • ordering X-rays

Here’s how cellulitis and gout are treated.

Cellulitis treatment

Doctors treat mild cellulitis with oral antibiotics. You’ll usually receive a prescription for about a week. Symptoms often continue to get worse for the first 48 hours before they improve.

More severe infections might require antibiotics administered intravenously.

Gout treatment

Doctors usually treat gout with nonsteroidal anti-inflammatory drugs (NSAIDs), such as:

  • ibuprofen
  • colchicine
  • indomethacin

If these medications aren’t effective, your doctor may recommend steroid injections or tablets.

Learn more about gout treatment.

You may be able to prevent cellulitis by:

  • disinfecting any wounds you may have
  • wearing gloves when working with your hands
  • preventing wounds with proper clothing and footwear
  • keeping your skin clean
  • avoiding hot hubs, swimming pools, and freshwater ponds or lakes when you have an open wound

Gout flare-ups may be preventable with lifestyle factors such as:

  • exercising regularly
  • maintaining a healthy body weight
  • drinking plenty of fluids
  • lowering your calorie intake
  • avoiding sugary drinks
  • getting protein from low fat dairy instead of meat and seafood
  • avoiding alcohol (if you drink)

Learn more about reducing uric acid levels in your body.

Here are some frequently asked questions people have about cellulitis.

Can cellulitis be confused with gout?

Cellulitis may be confused with gout if it occurs around a joint. It’s particularly likely to be misdiagnosed if it occurs around your big toe.

Can you have gout and cellulitis at the same time?

Gout and cellulitis develop independently of each other. Gout is due to the buildup of uric acid crystals in a joint, while cellulitis results from a bacterial infection. It’s possible to develop both conditions separately.

What other conditions are misdiagnosed as gout or cellulitis?

Cellulitis is misdiagnosed in as many as 30% of cases. It may be misdiagnosed as:

Gout may be misdiagnosed as:

It’s important to get medical attention if you suspect you might have cellulitis or if you develop gout symptoms for the first time.