Impetigo

What is Impetigo

Impetigo is an infection of the skin. It commonly occurs in young children, but it can also occur in adults. 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. It may be caused by 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 you 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?

The following factors may make you more likely to develop this condition:

  • Playing sports that include skin-to-skin contact with others.
  • Having a skin condition with open sores, such as chickenpox.
  • Having diabetes.
  • Having a weak body defense system (immune system).
  • Having many skin cuts or scrapes.
  • Living in an area that has high humidity levels.
  • Having poor hygiene.
  • Having high levels of staphylococci in your 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 you touch another area of your skin.

How is this diagnosed?

This condition is usually diagnosed during a physical exam. A skin sample or a sample of fluid from a blister may be taken for lab tests that involve growing bacteria (culture test). Lab tests can help to confirm the diagnosis or help to 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

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Apply or take your antibiotic as told by your health care provider. Do not stop using the antibiotic even if your condition improves.

General instructions

  • To help prevent impetigo from spreading to other body areas:
    • Keep your fingernails short and clean.
    • Do not scratch the blisters or sores.
    • Cover infected areas, if necessary, to keep from scratching.
    • Wash your 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.
    • Soak crusted areas in warm, soapy water using antibacterial soap.
    • Gently rub the areas to remove crusts. Do not scrub.
  • Do not share towels.
  • Wash your clothing and bedsheets in warm water that is 140°F (60°C) or warmer.
  • Stay home until you have used an antibiotic cream for 48 hours (2 days) or an oral antibiotic medicine for 24 hours (1 day). You should only return to work and activities with other people if your skin shows significant improvement.
    • You may return to contact sports after you have used antibiotic medicine for 72 hours (3 days).
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

  • Wash your hands often with soap and warm water.
  • Do not share towels, washcloths, clothing, bedding, or razors.
  • Keep your 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:

  • You develop more blisters or sores even with treatment.
  • Other family members get sores.
  • Your skin sores are not improving after 72 hours (3 days) of treatment.
  • You have a fever.

Get help right away if:

  • You see spreading redness or swelling of the skin around your sores.
  • You see red streaks coming from your sores.
  • You develop a sore throat.
  • The area around your rash becomes warm, red, or tender to the touch.
  • You have dark, reddish-brown urine.
  • You do not urinate often or you urinate small amounts.
  • You are very tired (lethargic).
  • You have 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, rashes, bug bites, or open sores.
  • 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 fingernails short, avoid scratching, cover any blisters, and wash your hands often.
  • If you have impetigo, stay home until you have used an antibiotic cream for 48 hours (2 days) or an oral antibiotic medicine for 24 hours (1 day). You should only return to work and activities with other people if your skin shows significant improvement.
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