Impetigo is a bacterial skin infection caused by two types of bacteria: these are Streptococcus and Staphylococcus;
Impetigo is also called ‘school sores’ because it mostly affects pre-school and primary school-aged children: that is those between 2 to 5 years of age;
Although it can affect all ages but is less common in older kids and adults;
It usually occurs in summer and autumn;
Impetigo: stock photo from NHS
How do I recognize that my child has impetigo?
Impetigo causes sores on the skin;
The sores are typically red and your child may complain of itchyness and pick them;
At the beginning they may be red, moist and weepy. After this, a flat, crusty yellow or ‘honey-coloured’ scab can appear;
The sores often start as blisters that break open and leak a clear fluid or pus for a few days;
These sores can occur anywhere on the body but usually appear on the skin around the nose and mouth the arms and legs;
What are the complications of impetigo?
Very rarely, impetigo can lead to more serious illnesses such as sepsis or rheumatic fever. But these are rare;
How does impetigo spread?
Impetigo is highly infectious meaning that they can easily spread from one child to another;
Impetigo spreads when people touch impetigo sores or the fluid from sores, and spread the infection via their hands to other parts of their body;
It can also spread by touching surfaces or objects which have been contaminated by the sores, including clothing, sheets and towels;
Impetigo
Who is most at risk of impetigo?
Impetigo is dangerous for babies because their immune system is not fully developed. So it is crucial that people with impetigo keep away from newborns and young babies and one seeks medical advice and starts treatment ASAP;
Children suffering from eczema, scabies or insect bites are also at increasedc risk;
How is impetigo diagnosed?
Your doctor will diagnose impetigo from their appearance although he/she may test the fluid for bacteria too;
How is impetigo treated?
Impetigo is typically treated with antibiotic ointment although in severe widespread cases oral antibiotics are used;
Bactroban ointment for impetigo
Fucidin cream is also used for impetigo
Another alternative ointment for impetigo
The antibiotic ointment should be applied until the sores have completely healed;
You will need to finish the whole couse of oral antibiotics even if the impetigo has started to clear;
You can clean the sores x2–3 daily with soap and water and gently wipe them. Pat them dry with a clean towel. Apply the antibiotic ointment as per pharmacist instruction and cover them with a waterproof dressing;
When should I contact my doctor/paediatrician again?
Inform your paediatrician if the sores spread further, your child develops a fever or a new rash develops;
How can I avoid impetigo spreading to others?
Keep your child’s sores clean and covered with a waterproof dressing until they have healed;
Discard used dressings as soon as they are taken off;
Wash your hands with soap and running water for 20 seconds after touching or cleaning sores and after handling contaminated objects such as dressings, sheets and towels;
Press enter or click to view image in full size
Wash your hands thoroughly after handling your child with impetigo
Avoid sharing clothes, towels or bed sheets with anyone who has impetigo;
Avoid bathing children in the same bathwater if any child has impetigo
Wash clothes, sheets and towels used by someone with impetigo every day, ideally in hot water of 60 C;
When can he return to school or childcare?
Keep your child home from school, childcare and other group settings until at least 24 hours of antibiotic treatment has started;
All sores on exposed skin should be covered when returning to school;
Take home messages
Impetigo is very common in children.
It is very easily spread to other kids and adults.
Treatment is with an antibiotic cream in localized cases while antibiotics given by mouth is used when there is widespread disease.
References
Hartman-Adams H, Banvard C, Juckett G. Impetigo: diagnosis and treatment. American family physician. 2014 Aug 15;90(4):229–35.
Pereira LB. Impetigo-review. Anais brasileiros de dermatologia. 2014;89(2):293–9.
Steele A, Stacey HJ, De Soir S, Jones JD. The safety and efficacy of phage therapy for superficial bacterial infections: a systematic review. Antibiotics. 2020 Oct 29;9(11):754.
Disclaimer
Get Eugene Azzopardi’s stories in your inbox
Join Medium for free to get updates from this writer.
The information in this Blog is provided for educational purposes only. It is not intended as medical advice. Kindly consult your family doctor or your paediatrician if you have any concerns about your child’s health.
Copyright
Copyright Dr. Eugenio Azzopardi, Consultant in Paediatric Emergency Medicine. All rights reserved.
