What you need to know about: Impetigo
Eroded expanding superficial bullae with yellow crusts
Grouped flaccid vesicles, bullae, and crusts
|Images © Dermatlas
What is Impetigo?
Impetigo is a skin infection that can spread from one person to another. Impetigo causes one or more "sores" on the skin that are often covered by a thick dry honey-colored crust. The sores don't hurt, but may be tender if touched. They may also be itchy. Any skin area can be affected, but sores are usually on arms or legs, the face (mainly around the mouth, nose, or ears), and sometimes on the scalp. Anyone can get impetigo, but it most often occurs in children 2 to 6 years old. The disease is most common during summer and fall, but can occur anytime.
What Causes Impetigo?
Impetigo is usually caused by a group of bacteria ("germs") called group A streptococci ("strep"), or by other bacteria called staphylococci ("staph"). These bacteria are normally found on the skin and in the nose. When small cuts, scratches, or insect bites occur, these bacteria can get under the skin surface and cause infection. Infected areas are often reddish and puffy. Fluid or pus oozes from the sore for a few days. The fluid dries to form honey-colored crusts. As the bacteria multiply, the sores increase in number and size.
How is Impetigo Spread?
Impetigo is very contagious. Sores have large numbers of the bacteria. The bacteria are easily passed to new areas of the skin by scratching or touching the sores or to other people by unwashed hands, dirty fingernails, and clothing or other objects that have touched the sores. To help prevent spread of impetigo:
- Bathe or shower daily.
- Keep fingernails clean and short.
- Wash with hot water and soap clothing, sheets, towels, and other items that come in contact with impetigo sores or crusts. Do not share these items with anyone else.
- Keep sores covered with clean bandages. Wash your hands after changing the bandage.
- Throw away used bandages in a trash bag.
Children who may have impetigo should not attend school or daycare. They should not sleep, play, or have close contact, with other children until after they have been seen by a doctor.
How Can Impetigo Be Treated?
While rarely serious, impetigo can sometimes lead to complications. See a doctor if small breaks in the skin do not heal quickly or if the sores get bigger and honey-colored crusts appear. The doctor can decide if the skin problem is impetigo and what type of treatment is needed. Oral antibiotics may be prescribed to treat impetigo infections. Be sure to finish all of the medication given, even if your child seems better. This helps prevent the infection from reoccurring. Antibiotic creams or ointments are also used on the surface of the skin and sores. The crusts must be removed before using the ointment. The best way to remove the crusts is to soak them in warm, soapy water until they soften and can be wiped away. After the crusts have been removed, gentle scrubbing of the sore will help wash away more bacteria. After washing, dry the area and apply a thin layer of antibiotic ointment. Repeat this process three or four times a day until several days after new crusts have stopped forming. If already being treated for impetigo, see a doctor if a fever, diarrhea, or painful pus-filled sores develop or if the skin doesn't begin to heal after three days of treatment.
What Happens if Impetigo Is Not Treated?
If impetigo is not treated promptly, it can spread to other areas of the body or to other people. Severe or untreated impetigo can cause kidney damage.
How Can Impetigo Be Prevented?
- Bathe or shower daily with soap and water.
- Wash face, hands, and hair regularly. If you are caring for someone with impetigo, be sure to wash your hands after each contact.
- Keep fingernails short and clean.
- Change and wash clothing frequently.
- Do not let your children play, or have other close contact, with someone who may have impetigo (look for the sores with honey-colored crusts).
- If you or your child get a cut, scratch, or insect bite, wash the wound with soap and water. You can then apply a small amount of an antibiotic ointment and cover the wound with a bandage or gauze and tape to larger breaks in the skin.
REMEMBER: See a doctor if a cut, scratch, or insect bite fails to heal properly, gets larger, or develops a honey-colored crust. It may be impetigo.