Impetigo

You might have never heard about this word, maybe you've heard it multiple times, or even heard it said differently such as Infantigo. But what is this skin infection called Impetigo?

 

What is Impetigo?

Impetigo is a very common skin infection seen mainly in children that is usually caused by a bacteria called Staphylococcus Aureus (AKA Staph). It may occur anywhere on the skin, but usually in areas that have received some cut, trauma, bite, or abrasion. The face near the nose is a very common area to see these lesions. Sometimes it can occur after a runny nose causing irritation of the skin, leading to Impetigo.

 

What does it look like? 

It can start as very tiny sores, pustules, or small blisters, and as they rupture they develop a honey-colored crust on top, very characteristic. Impetigo does have a less common variant, called bullous Impetigo. This type has large bullae, like blisters, on the trunk, but can occur anywhere too. 

 

Can it spread? 

It usually starts as one lesion that spreads very easily due to scratching. It may spread from under the nails to other areas nearby or elsewhere on the body. To prevent this spread it is important to keep the nails short and clean, also to avoid scratching and touching the lesions.

 

It can also spread to other children by directly touching them or surfaces they might touch. It is very common in certain sports due to the direct contact, such as wrestling or football.  It is highly contagious!

 

Can it be treated? 

Yes! It is treated with antibiotics. The first line of treatment, unless severe and already expanded, is a topical antibiotic cream or ointment such as Mupirocin 2%. This is used 2-3 times a day on the affected lesions for 7 days. It tends to improve within 48hrs. 

 

In certain cases, where the lesions have already spread, they are resistant to the topical treatment, or it has been diagnosed or treated late, it is recommended to take oral antibiotics, such as Cephalexin. 

 

Can it be resistant to standard antibiotics?

In certain cases, it can be MRSA impetigo. This means it is caused by a Staph strain that is resistant to standard antibiotics and needs to be treated with stronger antibiotics such as Clindamycin. 

 

Is it dangerous?

Most Impetigo is pretty benign; it heals without scarring. But it can sometimes cause complications, such as:

• Cellulitis: infection that affects the tissue under the skin and can spread to the bloodstream. This can become life threatening if left untreated.
• Glomerulonephritis (kidney problem): Impetigo can cause a reaction in the kidneys that can lead to kidney damage.

What should I do once my child has it?

1. Call your pediatrician or telehealth service for antibiotic treatment.
2. Keep nails short and clean.
3. Wash linens, clothes and towels with hot water.
4. Avoid sharing towels and clothes.
5. Keep lesions covered when in contact with other children.
6. Try to keep lesions loosely covered, the scabs need airflow to heal. 
7. If attending school, sports or daycare, always cover lesions. 
8. If not improved after 2-3 days of starting the ointment (or oral antibiotic if needed), seek medical care again.

When can your child go back to school, daycare?
24 hours after starting the antibiotic (topically or orally) kids may return to daycare, school, or sports.

 

Can they get it again?

Unfortunately, yes. Many children have this infection recurrently. They might even be colonized by the bacteria, usually in their nose, even though they may not have symptoms in their nose. This colonization can lead to a child getting Impetigo after any minor skin lesion such as insect bites. If the infection is recurrent, your pediatrician may want to swab your child’s nose to check for the staph bacteria.

 

If you have any questions about Impetigo, please log into your account and send us your question. We are here to help.

 

Dr. Valerie Hines, MD FAAP