What Is Impetigo?
Impetigo is a common and highly contagious bacterial skin infection that primarily affects children, though adults can contract it as well. Characterized by red sores or blisters that rupture and form honey-colored crusts, impetigo most often appears on the face—particularly around the nose and mouth—but can also develop on the arms and legs.
This infection spreads easily through skin-to-skin contact or by touching contaminated objects, making it prevalent in settings like schools and daycares. While usually mild, impetigo requires proper treatment to prevent complications and further transmission.
Types of Impetigo
1. Non-Bullous Impetigo (Most Common)
- Begins as small red sores that quickly burst
- Oozes fluid and forms a distinctive golden-brown crust
- Often appears around the nose, mouth, and hands
- Accounts for about 70% of cases
2. Bullous Impetigo
- Causes larger, fluid-filled blisters (bullae)
- Blisters are more fragile and rupture easily
- Primarily affects infants and young children
- Commonly appears on the torso, arms, and legs
3. Ecthyma (Severe Form)
- A deeper, more serious infection
- Forms painful ulcers with thick crusts
- May lead to scarring
- Typically occurs in people with weakened immune systems
Causes and Risk Factors
Bacteria Responsible
- Staphylococcus aureus (including MRSA strains)
- Streptococcus pyogenes (Group A strep)
How It Spreads
- Direct contact with infected skin
- Touching contaminated items (towels, clothing, toys)
- Scratching existing sores spreads bacteria to other body parts
Who’s Most at Risk?
- Children aged 2-5 years
- People in crowded environments (schools, sports teams)
- Individuals with:
- Cuts, insect bites, or skin conditions like eczema
- Poor hygiene habits
- Weakened immune systems
Recognizing Impetigo: Signs and Symptoms
Common Indicators
- Red sores that quickly rupture and crust over
- Itchy, sometimes painful lesions
- Swollen lymph nodes near infected areas
- Mild fever (in some cases)
Appearance by Type
| Type | Characteristics |
|---|---|
| Non-bullous | Small blisters → honey-colored crusts |
| Bullous | Larger, fluid-filled blisters → shiny crusts |
| Ecthyma | Deep ulcers with thick, dark scabs |
Note: Symptoms typically appear 1-3 days after exposure.
Diagnosis and Medical Testing
Most cases are diagnosed through visual examination, but doctors may recommend:
- Bacterial Culture
- Identifies specific bacteria causing infection
- Helps determine antibiotic sensitivity
- Gram Stain
- Distinguishes between staph and strep bacteria
- PCR Testing
- Detects antibiotic-resistant strains like MRSA
Effective Treatment Approaches
Medical Treatments
- Topical Antibiotics (for mild cases):
- Mupirocin ointment (Bactroban)
- Retapamulin (Altabax)
- Oral Antibiotics (for severe or widespread cases):
- Cephalexin
- Dicloxacillin
- Clindamycin (for MRSA)
Home Care Essentials
✔ Gently wash sores with soap and water
✔ Apply prescribed ointments as directed
✔ Cover lesions with bandages
✔ Wash bedding and towels daily in hot water
✔ Keep fingernails short to prevent scratching
Healing Time: Most cases clear within 7-10 days with treatment.
Prevention Strategies
- Hygiene Practices
- Frequent handwashing with soap
- Avoid sharing personal items
- Regular bathing (especially after sports/sweating)
- Infection Control
- Stay home until 24 hours after starting antibiotics
- Disinfect surfaces in shared spaces
- Treat underlying skin conditions
- Wound Protection
- Clean and cover all cuts/scrapes
- Use antibiotic ointment on minor injuries
Potential Complications
While rare, untreated impetigo may lead to:
- Cellulitis (deeper skin infection)
- Scarring (especially with ecthyma)
- Post-streptococcal glomerulonephritis (kidney inflammation)
- Sepsis (bloodstream infection)
High-risk groups: Newborns, elderly, and immunocompromised individuals require close monitoring.
Special Considerations
For Parents
- Children can return to school 24 hours after starting treatment
- Watch for signs of spreading infection
- Ensure completion of antibiotic course
For Athletes
- Avoid contact sports until healed
- Disinfect shared equipment
- Shower immediately after practices/games
For Recurrent Cases
- Investigate possible MRSA infection
- Check household members for carriers
- Address underlying skin conditions
When to Seek Medical Help
Consult a doctor if:
- Sores spread despite treatment
- Fever develops or worsens
- Lesions become increasingly painful
- Signs of dehydration appear (in children)
- Symptoms don’t improve after 3 days of treatment