Impetigo (im-puh-TIE-go) is a highly contagious skin infection that mainly affects infants and children. Although anyone can develop impetigo, children ages 2 to 6 years and infants are most often infected. In adults, impetigo is usually the result of injury to the skin often by another dermatological condition such as dermatitis.
Staphylococcus aureus (staph) and streptococcus pyogenes (strep) are the two types of bacteria that cause impetigo. Both types of bacteria can live harmlessly on your skin until they enter through a cut or other wound and cause an infection.
Children are especially susceptible to infections because their immune systems are still developing. And because staph and strep bacteria flourish wherever groups of people are in close contact, impetigo spreads easily in schools and child care settings. Also, children are commonly infected through a cut, scrape or insect bite but they can also develop impetigo without having any notable damage to the skin.
Impetigo usually appears as red sores on the face, especially around a child's nose and mouth. Although it commonly occurs when bacteria enter the skin through cuts or insect bites, it can also develop in skin that's perfectly healthy.
Impetigo is seldom serious and usually clears on its own in two to three weeks. But because impetigo can sometimes lead to complications, your child's doctor may choose to treat impetigo with an antibiotic ointment or oral antibiotics. Your child can usually return to school or a child care setting as soon as he or she isn't contagious (often within 24 hours of starting antibiotic therapy).
There are three type of impetigo. Those types include impetigo contagiosa, bullous impetigo and ecthyma.
The most common form of impetigo is impetigo contagiosa which usually starts as a red sore on your child's face (most often around the nose and mouth). The sore ruptures quickly, oozing either fluid or pus that forms a honey-colored crust. Eventually the crust disappears, leaving a red mark that heals without scarring. The sores may be itchy but they aren't painful. Your child isn't likely to have a fever with this type of impetigo but may have swollen lymph nodes in the affected area. And because it's highly contagious, just touching or scratching the sores can spread the infection to other parts of the body.
Bullous impetigo primarily affects infants and children younger than 2 years. It causes painless, fluid-filled blisters (usually on the trunk, arms and legs). The skin around the blister is usually red and itchy but not sore. The blisters, which break and scab over with a yellow-colored crust, may be large or small, and may last longer than sores from other types of impetigo.
Ecthyma is the more serious form of impetigo which penetrates deeper into the skin's second layer (dermis). Signs and symptoms include painful fluid- or pus-filled sores that turn into deep ulcers, usually on the legs and feet. The sores break open and scab over with a hard, thick, gray-yellow crust. Scars can remain after the sores heal. Ecthyma can also cause swollen lymph glands in the affected area.
Impetigo treatment can speed healing of the sores, improve the skin's appearance and limit the spread of the infection. How impetigo is treated depends on several factors, including the type of impetigo and the severity of the infection.
Hygienic measures. Sometimes your doctor may choose to treat minor cases of impetigo with only hygienic measures. Keeping the skin clean can help mild infections heal on their own.
Topical antibiotics. Your doctor may prescribe a prescription antibiotic that you apply to the affected areas (topical antibiotic), such as mupirocin ointment (Bactroban). Before applying the antibiotic, you need to gently remove any scabs so that the antibiotic can penetrate the sore.
Oral antibiotics. Antibiotics you take by mouth (oral antibiotics) may be prescribed for widespread impetigo, ecthyma and severe cases of impetigo contagiosa. The specific antibiotic depends on the severity of the infection and any known allergies or medical conditions. Be sure to finish the entire course of medication even if the sores are healed. This helps prevent the infection from recurring and makes antibiotic resistance less likely.
For minor infections that haven't spread to other areas, try the following:
• Soak the affected areas of skin with a vinegar solution — 1 tablespoon of white vinegar to 1 pint of water — for 20 minutes. This makes it easier to gently remove the scabs.
• After washing the area, apply an over-the-counter antibiotic ointment three or four times daily. Wash the skin before each application, and pat it dry.
• Avoid scratching or touching the sores as much as possible until they heal. Applying a nonstick dressing to the infected area can help keep impetigo from spreading.
• Keeping the skin clean is the best way to keep it healthy. Treat cuts, scrapes, insect bites and other wounds right away by washing the affected areas and applying antibiotic ointment to prevent infection.
If someone in your family already has impetigo, follow these measures to help keep the infection from spreading to others:
• Gently wash the affected areas with mild soap and running water and then cover lightly with gauze.
• Wash an infected person's clothes, linens and towels every day and don't share them with anyone else in your family.
• Wear gloves when applying any antibiotic ointment and wash your hands thoroughly afterward.
• Cut an infected child's nails short to prevent damage from scratching.
• Wash hands frequently.
• Keep your child home until your doctor says he or she isn't contagious.
If you suspect that you or your child has impetigo, consult your family doctor, your child's pediatrician or a dermatologist. Your doctor can recommend a treatment plan based on the type of impetigo and severity of the infection.
MC Ortega is the former publicist for the late Walter Payton, Coca-Cola and Dunkin’ Donuts. Ortega is a senior communications and messaging executive specializing in media relations, social media, program development and crisis communications. Also, Ortega is an avid traveler and international shopper. Ortega resides with her partner, Craig, dog, Fionne and extensive shoe collection. Ortega also enjoys jewelry design/production and flamenco dancing.
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