Impetigo

Impetigo is a common bacterial infection of the skin that can appear on many parts of the body. It can happen to anyone, of any age, but is more common in children age 2 to 5 years old.

Causes

The skin normally has bacteria on it. Impetigo usually starts when there is a break in the skin, such as from scratching, an insect bite, a scrape, or other skin problems The bacteria can then invade the skin and cause an infection. Sometimes, impetigo will start on skin that is not injured.

Impetigo is very contagious. So once there is an infection, it needs to be treated so it doesn't get worse, spread to other areas, or spread to other people. Impetigo can easily be passed to other family members, friends, schoolmates, or co-workers. It spreads through close contact and scratching, rubbing, or touching an infected area.

Symptoms

There is often a skin injury like a scratch, scrape, or insect bite that may have gone unnoticed before the infection began. Symptoms of impetigo include:

  • Red, inflamed area or rash

  • One or many red bumps

  • Bumps that turn into blisters filled with yellow fluid or pus

  • Blisters that break or leak, causing honey-colored crusting or scabbing over the area

  • Skin sores that spread to other surrounding areas of the body, or to other people

Home care

These guidelines will help you care for your infection at home.

Wound care

  • Clean the area several times a day. But, don’t scrub it. The best way to clean the area is to soak the sores in warm, soapy water until they get soft enough to be wiped away. This will help remove the crust that forms from the dried liquid. In areas that you can’t soak, like the mouth or face, you can put a clean, warm washcloth over the infected are for 5 to 10 minutes at a time, until the scabs soften enough to remove. Be sure to clean this washcloth before reusing it, and wash your hands well with soap and water.

  • Cover sores with a nonstick bandage or dressing. This will help catch drainage, prevent scratching, and prevent spreading the infection.

  • Trim fingernails, if needed, to prevent scratching. Picking at the sores may leave a scar.

  • If the infection is on or around your lips, don't lick or chew on the sores. This will make the infection worse.

Preventing spread

Follow these additional steps to limit the spread of infection to other parts of the body and to other people:

  • Wash your hands and your child’s hands often with soap and water.

  • Don't have direct skin-to-skin contact with other people.

  • Don't touch or scratch the sores. Keep the sores covered.

  • Don't share the infected person’s personal items, such as washcloths, towels, pillows, sheets, or clothes with others.

  • Wash the infected person's clothing, sheets, towels and other personal items in hot, soapy water. Don't wash them with items that are used by other household members.

  • Disinfect frequently touched surfaces, like doorknobs and counters.

Medicines

  • You can use over-the-counter medicine as directed based on age and weight for pain, fever, fussiness, or discomfort, unless another medicine was prescribed. In infants ages 6 months and older, you may use ibuprofen or acetaminophen. If you or your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines. Also talk with your provider if your child is taking blood-thinner medicines.

  • Don't give aspirin to your child. Aspirin should never be used in children ages 18 and younger who are ill with a fever. A condition called Reye syndrome may develop that can cause severe disease or death. 

  • Impetigo is often treated with antibiotic topical creams, lotions, or ointments. Apply these as directed by your healthcare provider.

  • If you were given oral antibiotics, take them as directed by your healthcare provider until they are used up. It's important to finish the antibiotics even if the wound looks better to make sure the infection has cleared.

Follow-up care

Follow up with your healthcare provider if the sores continue to spread after 3 days of treatment. It will take about 7 to 10 days to heal completely.

Your child should stay out of school and sports until completing 2 full days of antibiotic treatment and the rash is clearing.

When to get medical advice

Call your healthcare provider right away if any of the following occur:

  • Fever of 100.4°F (38°C) or higher, or as advised by your provider

  • Increased amounts of fluid or pus coming from the sores

  • Increasing number of sores or spreading areas of redness after 2 days of treatment with antibiotics

  • Increasing swelling or pain

  • Loss of appetite or vomiting

  • Abnormal drowsiness, weakness, or change in behavior

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