Impetigo (im-peh-TY-go) is a very common skin infection among kids, especially
preschoolers and school-age kids. It can cause blisters or sores on the face, hands,
legs, and diaper area.
What Causes Impetigo?
Kids can be more likely to develop impetigo when their skin is already irritated
by another problem, such as eczema,
poison ivy, insect bites,
and cuts or scrapes.
Scratching a sore or a rash is a common cause — for example, poison ivy can
get infected and turn into impetigo. It also happens more often in warm, humid environments.
Making sure that kids wash
their hands and faces well can help prevent it.
What Are the Signs & Symptoms of Impetigo?
Impetigo may affect skin anywhere on the body, but is most common around the nose
and mouth, hands, and forearms, and in young children, the diaper area.
The three types of impetigo are non-bullous (crusted), bullous
(large blisters), and ecthyma (ulcers):
Non-bullous or crusted impetigo is most common. It begins as tiny blisters that
eventually burst and leave small wet patches of red skin that may weep fluid. Gradually,
a yellowish-brown or tan crust covers the area, making it look like it has been coated
with honey or brown sugar.
Bullous impetigo causes larger fluid-containing blisters that look clear, then
cloudy. These blisters are more likely to stay longer on the skin without bursting.
Ecthyma impetigo looks like "punched out" ulcers with yellow crust and red edges.
Is Impetigo Contagious?
Impetigo is contagious, and can spread from one person to another. It's usually
caused by one of two bacteria: Staphylococcus aureus or Streptococcus
pyogenes (also called group A streptococcus, which also causes strep
throat). Methicillin-resistant Staphylococcus aureus (MRSA)
is also becoming an important cause of impetigo.
Impetigo can spread to anyone who touches infected skin or items that have been
touched by infected skin (such as clothing, towels, and bed linens). It can be itchy,
so kids also can spread the infection when they scratch it and then touch other parts
of their body.
How Is Impetigo Diagnosed?
In most cases, doctors can diagnose impetigo based on how the rash looks. Occasionally,
they may need to take a sample of fluid from blisters for testing.
How Is Impetigo Treated?
Impetigo is typically treated with antibiotics, either as an ointment or a medicine
taken by mouth:
When it just affects a small area of the skin (and especially if it's the non-bullous
form), impetigo is treated with antibiotic ointment for 5 days.
If the infection has spread to other areas of the body or the ointment isn't working,
the doctor may prescribe an antibiotic pill or liquid to be taken for 7–10 days.
After antibiotic treatment begins, healing should start within a few days. It's
important to make sure that your child takes the medicine as prescribed. Otherwise,
a deeper and more serious skin infection could develop.
While the infection is healing, gently wash the skin with clean gauze and antiseptic
soap every day. Soak any areas of crusted skin with warm soapy water to help remove
the layers of crust (you don't have to remove all of it).
To keep impetigo from spreading to other parts of the body, the doctor or nurse
will probably recommend covering infected areas with gauze and tape or a loose plastic
bandage. Keep your child's fingernails short and clean to prevent scratching that
could lead to a worse infection.
Can Impetigo Be Prevented?
Keeping skin clean can help prevent impetigo. Kids should wash their hands well
and often and take baths or showers regularly. Pay special attention to skin injuries
(cuts, scrapes, bug bites, etc.), areas of eczema, and rashes such as poison ivy.
Keep these areas clean and covered.
Anyone in your family with impetigo should keep their fingernails cut short and
the impetigo sores covered with gauze and tape.
To prevent impetigo from spreading among family members, make sure everyone uses
their own clothing, sheets, razors, soaps, and towels. Separate the bed linens, towels,
and clothing of anyone with impetigo, and wash them in hot water. Keep the surfaces
of your kitchen and household clean.
When Should I Call the Doctor?
Call the doctor if any of your kids have signs of impetigo, especially if they've
been around a family member or classmate with the infection.
If your child is already being treated for impetigo, keep an eye on the sores and
call the doctor if the skin doesn't begin to heal after 3 days of treatment or if
a fever develops. If the area around the rash becomes red, warm, or tender to the
touch, call the doctor right away.