Impetigo
Overview
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- Impetigo is a common skin infection caused by streptococcus (strep) or staphylococcus (staph) bacteria.
- Most of the time, the skin is an effective barrier that keeps bacteria out.
- When there is a break in the skin, bacteria can enter the body and grow there, causing inflammation and infection.
- Breaks in the skin may occur with any bites (insect, animal or human) or injury or trauma to the skin.
- Impetigo may also occur on skin where there is no visible break.
Who gets impetigo?
- It is most common in children, particularly those in poor or crowded houses
- In adults, it may follow other skin disorders or occur in people with lower immune function
- Impetigo is contagious, meaning it can spread to anyone so famliy members are more at risk if a child has it
- If the fluid that oozes from the blisters of someone else touches an open area on your skin, you may get impetigo too.
Symptoms
- Impetigo often starts as a single blister or red lesion
- Blisters may fill with pus or yellow honey coloured fluid
- It also starts as any lesion (bite, damaged skin) that doesn't heal and develops a crusty scab
- Sometimes it looks like a rash -- may begin as a single spot, but if a person scratches, it may spread to other areas
- Common sites are skin lesions on the face, lips, arms, or legs, that spread to other areas
- You may develop swollen lymph nodes near the infection (lymphadenopathy)
Diagnosis
- Impetigo can usually be diagnosis based on the appearance and history. For images of impetigo from DermNet
- Sometimes a skin swab is needed if it is recurrent or not responding as expected.
- A swab is also taken if there is concern that an antibiotic resistant strain of bacteria such as MRSA is the cause
Treatment
- For mild infection, the first choice is Fusidic acid cream for 7 days ( BPAC booklet 2011)
- Remove crusted area by washing with saline or antibacterial soap (1 to 3 times each day)
- You can also soak lesions with a mixture of half a cup of white vinegar in a litre of warm water. Apply a cloth soaked in this mix to moist areas for about ten minutes three times a day. Gently wipe off the crusts.
- If an antiseptic (such as povidone iodine, hydrogen peroxide cream or chlorhexidine) or antibiotic ointment (such as fusidic acid, or mupirocin) is prescribed, apply it two or three times a day to the affected areas and surrounding skin.
- Look carefully for new lesions to treat. Continue for several days after healing.
- Keep affected areas covered with plaster or dressing and stay away from school or childcare until at least 24 hours after treatment started.
- Wash (do not scrub) the skin several times a day, preferably with an antibacterial soap, to remove crusts and drainage.
Moderate Infection or Not Responding
More severe cases may require antibiotics, taken by mouth such as Flucloxacillin for 7 days. (BPAC 2011)
Prevention
- Reminder: Impetigo is very easily spread to other parts of your body or other people.
- Make sure you have your own towel, soap and face towels, and never share them (disposable paper towels are useful).
- Keep bed linen, clothes and towels separate.
- All family members should use an antibacterial soap.
- Keep your fingernails cut short. Try not to scratch or pick at sores.
- Keep sores covered with a dressing, such as gauze and tape.
- Wash your hands thoroughly before preparing food.
More Information
- Impetigo - DermNet section
- Imepetigo - What is it? - Best Health UK website
- Stopping impetigo from spreading - Best Health Uk website
- Antibiotics - Choices for common infections. Best Practice Advisory Centre NZ (BPAC) - May 2011