Impetigo

Causes

Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. The skin normally has bacteria on it. Impetigo usually starts when there is a break in the skin. This can come 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.

Once there is an impetigo 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. It may begin as a single spot but spreads to other areas due to scratching.

• 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 most commonly seen on the face around nose, mouth and ears. It is also common on the arms and legs. Skin sores may 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 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. Wipe it when the scabs soften enough to remove. Be sure to clean this washcloth before reusing it. Wash your hands well with soap and water.

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

• 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 steps to limit the spread of the 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 close contact with other people until the rash is clear or improving after 2 days of antibiotics.

• 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 countertops.

Medicines

• Ask your health care provider if you or your child can take an over-the-counter medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.

• Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.

• 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. This will 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, daycare, and sports until completing 2 full days of antibiotic treatment and the rash is clearing.

When to get medical advice

Contact your health care provider if:

• You or your child has a fever of 100.4°F (38°C) or higher, or as advised by your provider.

• Increased amounts of fluid or pus is coming from the sores.

• There are more sores or spreading areas of redness after 2 days of treatment with antibiotics.

• There is more swelling or pain.

• There is loss of appetite or vomiting.

• Abnormal drowsiness, weakness, or change in behavior happens.