Impetigo

Discover How This Childhood Skin Infection is Diagnosed and Treated

Pediatrician Examining a Girl s Rash
Fuse/Getty Images

What is Impetigo?

Impetigo is a common bacterial skin infection that typically affects children who are either in preschool or are school-aged. 

Impetigo Symptoms

Children with impetigo develop honey-colored, crusted lesions, usually beginning in areas where the skin has been broken, irritated, or damaged (like from a scrape, an insect bite, or poison ivy, for example). The nostrils, especially ​in kids with runny noses, are commonly affected.

The face, the neck, and the hands, are other areas of the body where you are likely to see lesions. Untreated infections can quickly spread to other areas on the child's body, and they may itch. 

The most common type of impetigo, described above, is referred to as "non-bullous" impetigo. Another type, "bullous" impetigo, causes much larger skin lesions that look like blisters and quickly rupture. This type of impetigo commonly affects a child's trunk or buttocks.

If you notice any of these skin symptoms on your child, call the pediatrician immediately.

Diagnosis of Impetigo

Although bacterial cultures can be done (that's when fluid is extracted from a blister and tested), diagnosis is usually based on the typical appearance of the rash.

Bacterial cultures are helpful if your pediatrician suspects that your child's impetigo is being caused by a resistant bacteria, such as MRSA (methicillin resistant staph aureus), or if he or she simply has a rash that isn't going away.

Impetigo Treatments

For small areas of infection, an over-the-counter or prescription-strength topical antibiotic may be all that is needed, in addition to washing the area with warm, soapy water and covering it. For more extensive or persistent infections, an oral or intravenous antibiotic might be needed.

As mentioned earlier, MRSA is a bacteria that is resistant to many of the antibiotics that are commonly used to treat impetigo, including Keflex, Duricef, Augmentin, Zithromax, and Omnicef. And there have been increased rates of community-acquired MRSA. If MRSA is the cause of the infection, a stronger antibiotic, such as Clindamycin or Bactrim, may be needed. 

Once treatment starts, the infection should begin to disappear within a few days.

What You Need To Know

  • The most common strains of bacteria that cause impetigo include group A beta-hemolytic streptococci (GABHS) and Staphylococcus aureus.
  • Impetigo is spread by direct contact with infected lesions. If a child scratches an infected area and then touches another part of his or her body, the lesions can spread. The infection can also spread if someone touches the clothes, towels, or sheets of an infected person.  
  • Children are usually no longer contagious once they have been on antibiotics for 24 to 48 hours, there is no longer a discharge, and you are seeing signs of improvement.
  • The S. aureus bacteria commonly lives on or colonizes the skin of children and adults. It is especially common to find it in the nose, so it can spread easily when children pick their noses.
  • Keep bites, scrapes, and rashes clean and covered, and apply a triple antibiotic to them three times a day to prevent them from getting infected by the staph bacteria.
  • To get rid of staph colonization, it can sometimes help to treat all family members with mupirocin (Bactroban) nasal gel twice a day for five to seven days, take daily baths with Hibiclens (an antiseptic, antimicrobial skin cleanser), and encourage very frequent hand washing.
  • Folliculitis is a similar infection that involves hair follicles.
  • Glomerulonephritis, which can cause hematuria (bloody urine) and high blood pressure, is a rare complication of having impetigo.

Sources:
1Habif: Clinical Dermatology, 4th ed., Copyright © 2004 Mosby, Inc.
2 Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed., Copyright © 2003 Churchill Livingstone, An Imprint of Elsevier

Continue Reading