Impetigo

Written by Janelle Martel | Published on June 25, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Impetigo

Impetigo is a highly contagious skin condition. It usually occurs on the face, neck, and hands of young children and infants. Children who wear diapers also tend to get it around the diaper area. Impetigo occurs more rarely in adults, usually following another skin condition or an infection.

Impetigo is caused by two bacteria - streptococcus pyogenes and staphylococcus aureus. Recommended treatment often depends on which bacteria are causing your impetigo. Outlook for this condition is good and it usually goes away within two to three weeks.

Types of Impetigo

There are several different types of impetigo. The symptoms and causes are what set each type apart from the others.

Impetigo Contagiosa

This may also be called nonbullous impetigo, and is the most common type of impetigo in children. It is very contagious. This type of impetigo usually begins with red sores around the nose and mouth.

These blisters burst, leaving a weeping, red rash that becomes crusted. This rash may be itchy but is not painful. Swollen lymph nodes (bean shaped glands that help your body fight infection) may also occur with impetigo contagiosa.

Bullous Impetigo

This form of impetigo is most common in children under age two. Blisters usually appear first on the torso, arms, and legs. These blisters may initially appear clear and then turn cloudy.

Blisters caused by bullous impetigo tend to last longer than blisters caused by other types of impetigo. The areas around the blisters may be red and itchy.

Ecythma

This is the most serious form of impetigo because it affects the second layer of the skin, rather than just the top layer. Blisters tend to be painful and may turn into ulcers, or aggravated, open sores. Swollen lymph nodes and scars may also occur.

Who Gets Impetigo?

Certain individuals are more likely than others to develop impetigo. Risk factors include:

  • being two to six years of age
  • regularly attending a daycare or school
  • having skin irritated by other conditions
  • poor hygiene
  • warm weather
  • being in a crowded environment where bacteria can spread easily
  • having dermatitis (itchy, inflammation of the skin, sometimes caused by allergic reactions)
  • participating in activities that involve skin-to-skin contact
  • having diabetes
  • having a compromised immune system

Causes of Impetigo

Impetigo occurs when certain types of bacteria infect the skin. This can occur in a few different ways, such as:

  • skin-to-skin contact with an individual who has impetigo
  • touching things an individual with impetigo has had contact with, such as towels, bedding, and toys
  • injury to the skin
  • insect bites
  • animal bites

Symptoms of Impetigo

Impetigo symptoms can be uncomfortable and embarrassing, particularly when they are present on the face. Though the symptoms vary slightly from type to type of impetigo, they are similar and can include:

  • red sores that pop easily and leave a yellow crust
  • fluid-filled blisters
  • itchy rash
  • skin lesions
  • swollen lymph nodes

Diagnosis of Impetigo

Your doctor will examine your sores and ask about any recent injuries to the skin. Most cases of impetigo can be diagnosed through physical examination. However, your doctor may wish to take a culture to determine the type of bacteria that is causing your impetigo.

Taking a culture involves brushing a swab over an affected area. This swab will then be sent to a lab to be tested for bacteria. The information from this test can help your doctor decide whether you need antibiotics, as well as what type of antibiotics to prescribe.

Impetigo Treatment

Treatment for impetigo depends on the severity of the symptoms as well as the type of bacteria causing the impetigo. If you have a mild case of impetigo, your doctor may recommend simple hygiene methods to help the skin heal and to prevent impetigo from spreading.

The affected area should be cleaned several times per day, using either water or an antibacterial wash. It is important not to scrub the area while washing it, as this can further irritate the skin. After washing, pat the skin dry and apply an antibacterial or over-the-counter antibiotic ointment according to your doctor’s recommendation.

If there are many scabs on the skin, you can soak this area to help remove some of the scabbing and promote healing. Affected areas can be soaked in soapy water or a 1:32 solution of vinegar and water.

Try to avoid picking at or touching the areas affected by impetigo. A non-stick dressing can be applied to reduce the spread of impetigo. Always wash your hands thoroughly after touching areas of your skin affected by impetigo.

If at-home treatment does not work or your impetigo is severe, your doctor may prescribe medication. Your doctor may prescribe a topical antibiotic cream to apply directly to your skin. It is important to clean the skin before applying the antibiotic cream, so it can penetrate the sores.

Your doctor may also prescribe oral antibiotics. These come in liquid form for children and pill form for adults. Whether you are prescribed topical or oral antibiotics, it is important to finish your prescription to prevent the infection from returning. Stopping an antibiotic regimen just because symptoms have improved can lead to a recurrence of the infection and antibiotic resistance.

Prevention of Impetigo

Good hygiene can help you prevent impetigo. These methods include:

  • washing hands regularly
  • bathing or showering regularly
  • cleaning and covering any injuries to the skin

If you have impetigo, there are several things you should due to prevent it from spreading to other areas of the body, as well as to other individuals. These include:

  • using antibacterial soap to wash hands
  • using a clean towel or fresh paper towel to dry the body or hands
  • washing linens and clothes in hot water
  • cleaning surface areas in the home with antibacterial products
  • keeping fingernails short
  • avoiding schools and childcare centers while infection is contagious
  • not sharing personal hygiene items
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