Impetigo in Children

Impetigo in Children

Impetigo is an infection of the skin. It is most common in babies and children. The infection causes itchy blisters and sores that produce brownish-yellow fluid.

As the fluid dries, it forms a thick, honey-colored crust. These skin changes usually occur on the face, but they can also affect other areas of the body. Impetigo usually goes away in 7–10 days with treatment.

What are the causes?

This condition is caused by two types of bacteria (staphylococci or streptococci bacteria). These bacteria cause impetigo when they get under the surface of the skin. This often happens after some damage to the skin, such as:

  • Cuts, scrapes, or scratches.
  • Rashes.
  • Insect bites, especially when children scratch the area of a bite.
  • Chickenpox or other illnesses that cause open skin sores.
  • Nail biting or chewing.

Impetigo can spread easily from one person to another (is contagious). It may be spread through close skin contact or by sharing towels, clothing, or other items that an infected person has touched.

What increases the risk?

Babies and young children are most at risk of getting impetigo. The following factors may make your child more likely to develop this condition:

  • Being in school or daycare settings that are crowded.
  • Playing sports that involve close contact with other children.
  • Having broken skin, such as from a cut.
  • Having a skin condition with open sores, such as chickenpox.
  • Having a weak body defense system (immune system).
  • Living in an area with high humidity.
  • Having poor hygiene.
  • Having high levels of staphylococci in the nose.

What are the signs or symptoms?

The main symptom of this condition is small blisters, often on the face around the mouth and nose. In time, the blisters break open and turn into tiny sores (lesions) with a yellow crust. In some cases, the blisters cause itching or burning. With scratching, irritation, or lack of treatment, these small lesions may get larger.

Other possible symptoms include:

  • Larger blisters.
  • Pus.
  • Swollen lymph glands.

Scratching the affected area can cause impetigo to spread to other parts of the body. The bacteria can get under the fingernails and spread when the child touches another area of his or her skin.

How is this diagnosed?

This condition is usually diagnosed during a physical exam. A sample of skin or fluid from a blister may be taken for lab tests. The tests can help confirm the diagnosis or help determine the best treatment.

How is this treated?

Treatment for this condition depends on the severity of the condition:

  • Mild impetigo can be treated with prescription antibiotic cream.
  • Oral antibiotic medicine may be used in more severe cases.
  • Medicines that reduce itchiness (antihistamines)may also be used.

Follow these instructions at home:

Medicines

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Apply or give your child’s antibiotic as told by his or her health care provider. Do not stop using the antibiotic even if the condition improves.

General instructions

  • To help prevent impetigo from spreading to other body areas:
    • Keep your child’s fingernails short and clean.
    • Make sure your child avoids scratching.
    • Cover infected areas, if necessary, to keep your child from scratching.
    • Wash your hands and your child’s hands often with soap and warm water.
  • Before applying antibiotic cream or ointment, you should:
    • Gently wash the infected areas with antibacterial soap and warm water.
    • Have your child soak crusted areas in warm, soapy water using antibacterial soap.
    • Gently rub the areas to remove crusts. Do not scrub.
  • Do not have your child share towels with anyone.
  • Wash your child’s clothing and bedsheets in warm water that is 140°F (60°C) or warmer.
  • Keep your child home from school or daycare until she or he has used an antibiotic cream for 48 hours (2 days) or an oral antibiotic medicine for 24 hours (1 day). Also, your child should only return to school or daycare if his or her skin shows significant improvement.
    • Children can return to contact sports after they have used antibiotic medicine for 72 hours (3 days).
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

  • Have your child wash his or her hands often with soap and warm water.
  • Do not have your child share towels, washcloths, clothing, or bedding.
  • Keep your child’s fingernails short.
  • Keep any cuts, scrapes, bug bites, or rashes clean and covered.
  • Use insect repellent to prevent bug bites.

Contact a health care provider if:

  • Your child develops more blisters or sores even with treatment.
  • Other family members get sores.
  • Your child’s skin sores are not improving after 72 hours (3 days) of treatment.
  • Your child has a fever.

Get help right away if:

  • You see spreading redness or swelling of the skin around your child’s sores.
  • You see red streaks coming from your child’s sores.
  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
  • Your child develops a sore throat.
  • The area around your child’s rash becomes warm, red, or tender to the touch.
  • Your child has dark, reddish-brown urine.
  • Your child does not urinate often or he or she urinates small amounts.
  • Your child is very tired (lethargic).
  • Your child has swelling in the face, hands, or feet.

Summary

  • Impetigo is a skin infection that causes itchy blisters and sores that produce brownish-yellow fluid. As the fluid dries, it forms a crust.
  • This condition is caused by staphylococci or streptococci bacteria. These bacteria cause impetigo when they get under the surface of the skin, such as through cuts or bug bites.
  • Treatment for this condition may include antibiotic ointment or oral antibiotics.
  • To help prevent impetigo from spreading to other body areas, make sure you keep your child’s fingernails short, cover any blisters, and have your child wash his or her hands often.
  • If your child has impetigo, keep your child home from school or daycare as long as told by your health care provider.
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