Overview
Impetigo (im-puh-TIE-go) is a common, highly contagious skin infection that primarily affects infants and young children. It manifests as reddish sores on the face, especially around the nose and mouth, and on the hands and feet. These sores eventually burst, ooze for a few days, and form honey-colored crusts. Treatment with antibiotics can limit the spread of impetigo and help the infection heal faster. Children with impetigo should stay home from school or daycare until they are no longer contagious, which is usually 24 hours after beginning antibiotic treatment.
Causes
Impetigo is caused by bacteria, most commonly Staphylococcus aureus (staph) and Group A Streptococcus (strep). These bacteria can enter the body through a cut, scrape, or insect bite, leading to infection. However, impetigo can also infect intact skin. The bacteria thrive in warm, humid conditions, making the infection more common in warmer months. Risk factors include poor hygiene, crowded living conditions, and existing skin conditions such as eczema or insect bites.
How Contagious is Impetigo?
Impetigo is highly contagious and can spread through direct skin-to-skin contact or by touching items contaminated with the bacteria, such as towels, clothing, or bedding. It can also spread through contact with sores, mucus, or nasal discharge from an infected person. Without treatment, impetigo can remain contagious for weeks. After starting antibiotic treatment, the condition is contagious until the rash disappears, scabs fall off, or after completing at least two days of antibiotics.
Symptoms
Symptoms typically develop within three days of infection. The main symptoms include:
- Reddish sores or blisters: Often around the nose and mouth, which quickly burst and form honey-colored crusts.
- Itchy skin: The affected areas may itch and be mildly painful.
- Blisters and lesions: Fluid-filled blisters that burst easily, leaving raw, shiny areas that scab over.
- Rashes and swollen lymph nodes: Red, raw skin around the sores, and swollen glands near the infected areas.
Types of Impetigo
There are three main types of impetigo:
- Non-Bullous Impetigo: The most common form, characterized by sores that burst quickly and form honey-colored crusts. Symptoms include itchy sores, red or raw skin, and swollen glands.
- Bullous Impetigo: A rarer form, more common in infants, marked by large, fluid-filled blisters that burst and leave crusty sores. It typically affects children under the age of 2.
- Ecthyma: A more serious form of impetigo that penetrates deeper into the skin, causing painful fluid or pus-filled sores that turn into deep ulcers, often leaving scars.
- Diagnosis
Diagnosis is usually based on the appearance of the sores. A healthcare provider may examine the affected skin and might take a sample of the liquid from a sore to test in a laboratory, especially if the infection is recurrent or doesn’t respond to initial treatment. This helps determine the most effective antibiotic for treatment.
Treatment
- Impetigo is treated with antibiotics, which can be topical (applied directly to the skin) or oral (taken by mouth) depending on the severity and extent of the infection.
- Topical Antibiotics: Mupirocin (Bactroban®) and retapamulin (Altabax®) are commonly prescribed. These are usually applied two to three times a day for five to ten days.
- Oral Antibiotics: Cephalexin, clindamycin, or doxycycline may be prescribed for more widespread or severe infections. Treatment typically lasts for seven to ten days.
In addition to medication, it is important to keep the affected area clean and dry. Soaking the area in warm water or applying a wet cloth compress can help remove crusts, allowing the antibiotic to penetrate the skin better. Covering the sores with a nonstick bandage can help prevent the infection from spreading.
Complications
Complications from impetigo are rare but can include:
- Cellulitis: A potentially serious infection that affects the tissues beneath the skin, which can spread to the lymph nodes and bloodstream.
- Kidney Problems: Post-streptococcal glomerulonephritis, a condition that can damage the kidneys, is a rare complication.
- Scarring: Sores, especially those from ecthyma, can leave scars.
- Staphylococcal Scalded Skin Syndrome: A serious condition caused by staph bacteria, more common in infants and young children.
Prevention
Preventing impetigo involves maintaining good personal hygiene and taking precautions to avoid spreading the infection. Recommendations include:
- Washing Hands: Regular and thorough handwashing with soap and water.
- Keeping Skin Clean: Cleaning cuts, scrapes, and insect bites promptly with soap and water.
- Avoiding Sharing Personal Items: Do not share towels, clothing, or bedding with an infected person.
- Covering Sores: Use nonstick bandages to cover sores and prevent the spread of bacteria.
- Good Hygiene Practices: Keep fingernails short to prevent damage from scratching, and encourage regular handwashing.
Living with Impetigo
When to See a Doctor
Consult a healthcare provider if you or your child have symptoms of impetigo. It’s important to seek medical advice if the infection does not improve with initial treatment or if it recurs frequently. A doctor can provide appropriate treatment and advice on preventing the spread of the infection.
Self-Care Measures
For minor infections, over-the-counter antibiotic ointments can be tried, although prescription medication is usually more effective. Keeping the affected area clean, applying prescribed medication as directed, and covering the area with a bandage can help manage symptoms and prevent the spread of the infection.
Impetigo vs. Other Conditions
Both impetigo and cold sores cause blisters, but they are caused by different pathogens. Impetigo is bacterial, while cold sores are viral (caused by the herpes simplex virus). Cold sores usually occur around the mouth and consist of small blisters, whereas impetigo can form larger blisters and spread to various parts of the face and body.
Impetigo vs. Weeping Eczema
Impetigo is a bacterial infection, while weeping eczema is a type of dermatitis. Impetigo causes crusty, honey-colored sores and blisters, while weeping eczema causes blisters filled with clear or straw-colored fluid. Eczema blisters can be red or purple and may ooze fluid, while impetigo sores are more likely to be yellowish and crusty.
Risk Factors
Who is at Risk for Impetigo?
- Age: Most common in children aged 2 to 5 years, but can occur at any age.
- Close Contact: Spread easily in crowded settings such as schools, daycare centers, and sports involving skin-to-skin contact.
- Climate: More common in warm, humid weather.
- Skin Conditions: Children with eczema, chickenpox, or other skin conditions are more susceptible.
- Compromised Immunity: Individuals with weakened immune systems, including those with diabetes or undergoing chemotherapy, are at higher risk.
Conclusion
Impetigo is a common and treatable skin infection that primarily affects children but can occur at any age. Understanding the causes, symptoms, and treatment options is essential for managing the infection effectively. Preventive measures, such as maintaining good personal hygiene and avoiding contact with infected individuals, can help reduce the risk of impetigo. If you suspect impetigo, consult a healthcare provider for appropriate diagnosis and treatment.
References
Cleveland Clinic. (n.d.). Impetigo. Retrieved from https://my.clevelandclinic.org/health/diseases/12232-impetigo
DermNet. (n.d.). Impetigo. Retrieved from https://dermnetnz.org/topics/impetigo
Mayo Clinic. (n.d.). Impetigo. Retrieved from https://www.mayoclinic.org/diseases-conditions/impetigo/symptoms-causes/syc-20352352
National Health Service (NHS). (n.d.). Impetigo. Retrieved from https://www.nhs.uk/conditions/impetigo/
