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ImpetigoBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/impetigo/DS00464
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Impetigo (im-puh-TIE-go) is a highly contagious skin infection that mainly affects infants and children. Impetigo usually appears as red sores on the face, especially around a child's nose and mouth. The sores burst and develop honey-colored crusts.
Impetigo may clear on its own in two to three weeks, but antibiotics can shorten the course of the disease and help prevent the spread to others.
You may need to keep your child home from school or day care until he or she is no longer contagious, which is usually 24 to 48 hours after you begin antibiotic treatment. Without antibiotics, impetigo is contagious until the sores go away.
Classic signs and symptoms of impetigo involve red sores that quickly rupture, ooze for a few days and then form a yellowish-brown crust. The sores usually occur around the nose and mouth but can be spread to other areas of the body by fingers, clothing and towels.
A less common form of the disorder, called bullous impetigo, may feature larger blisters that occur on the trunk or diaper area of infants and young children.
A more serious form of impetigo, called ecthyma, penetrates deeper into the skin — causing painful fluid- or pus-filled sores that turn into deep ulcers.
When to see a doctor
If you suspect that you or your child has impetigo, consult your family doctor, your child's pediatrician or a dermatologist.
You're exposed to the bacteria that cause impetigo when you come into contact with the sores of someone who's infected or with items they've touched — such as clothing, bed linen, towels and even toys.
Factors that increase the risk of impetigo include:
- Age. Although anyone can develop impetigo, it most commonly occurs in children ages 2 to 6.
- Crowded conditions. Impetigo spreads easily in schools and child care settings.
- Warm, humid weather. Impetigo infections are more common in summer.
- Certain sports. Participation in sports that involve skin-to-skin contact, such as football or wrestling, increases your risk of developing impetigo.
- Broken skin. The bacteria that cause impetigo often enter your skin through a small skin injury, insect bite or rash.
Older adults and people with diabetes or a compromised immune system are more likely to develop ecthyma, a deeper and more serious form of impetigo.
Impetigo typically isn't dangerous, but complications can sometimes occur. Examples include:
- Scarring. The ulcers associated with ecthyma, a deeper and more serious form of impetigo, can leave scars.
- Cellulitis. This potentially serious infection affects the tissues underlying your skin and eventually may spread to your lymph nodes and into the bloodstream. Left untreated, cellulitis can quickly become life-threatening.
- Kidney problems. One of the types of bacteria that cause impetigo can also damage your kidneys.
Preparing for your appointment
Your family doctor or your child's pediatrician can diagnose impetigo. When you call to make your appointment, ask if you should follow any restrictions to prevent infecting others in the waiting room.
Because appointments can be brief and there's often a lot to discuss, it can help to be well prepared. Here are some tips to help you get ready for your appointment and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions helps you make the most of your appointment. List your questions from most important to least important in case time runs out. For impetigo, some basic questions to ask your doctor include:
- What might be causing the sores?
- Are tests needed to confirm the diagnosis?
- What is the best course of action?
- Is there a generic alternative to the medicine you're prescribing?
- Can I wait to see if the condition goes away on its own?
- What can I do to prevent the infection from spreading?
- What skin care routines do you recommend while the condition heals?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did the sores start?
- What did the sores look like when they started?
- Have you had any recent cuts, scrapes or insect bites to the affected area?
- Are the sores painful or itchy?
- What, if anything, makes the sores better?
- What, if anything, makes the sores worse?
- Does someone in your family already have impetigo?
- Has this problem occurred in the past?
Tests and diagnosis
Doctors usually diagnose impetigo by looking at the distinctive sores. Usually, lab tests aren't necessary. But if the sores don't clear, even with antibiotic treatment, your doctor may take a sample of the liquid produced by a sore and test it to see what types of antibiotics might work best on it. Some types of the bacteria that cause impetigo have become resistant to certain antibiotic drugs.
Treatments and drugs
Antibiotics are the mainstay of impetigo treatments. These drugs can be delivered by an ointment or cream that you apply directly to the sores. You may need to first soak the affected area in warm water or use wet compresses to help remove the overlying scabs.
If you have more than just a few impetigo sores, your doctor might recommend antibiotic drugs that can be taken by mouth. Be sure to finish the entire course of medication even if the sores are healed. This helps prevent the infection from recurring and makes antibiotic resistance less likely.
Lifestyle and home remedies
For minor infections that haven't spread to other areas, you could try treating the sores with an over-the-counter antibiotic cream or ointment that contains bacitracin. Placing a nonstick bandage over the area can help prevent the sores from spreading.
Keeping the skin clean is the best way to keep it healthy. Treat cuts, scrapes, insect bites and other wounds right away by washing the affected areas.
If someone in your family already has impetigo, take these measures to help keep the infection from spreading to others:
- Gently wash the affected areas with mild soap and running water and then cover lightly with gauze.
- Wash an infected person's clothes, linens and towels every day and don't share them with anyone else in your family.
- Wear gloves when applying any antibiotic ointment and wash your hands thoroughly afterward.
- Cut an infected child's nails short to prevent damage from scratching.
- Wash hands frequently.
- Keep your child home until your doctor says he or she isn't contagious.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Feb. 26, 2013.
- Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed Feb. 26, 2013.
- Baddour LM. Impetigo. http://www.uptodate.com/home. Accessed Feb. 26, 2013.
- AskMayoExpert. Impetigo. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Ferri FF. Ferri's Clinical Advisor 2013:5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23. Accessed Feb. 27, 2013.
- Impetigo care. American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Impetigo.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed Feb. 27, 2013.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 12, 2013.
- Wolff K, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology.6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=45. Accessed Feb. 28, 2013.
- Baddour LM. Patient information: Impetigo (beyond the basics). http://www.uptodate.com/home. Accessed Feb. 28, 2013.