Impetigo is a highly common skin infection that leads to sores and blisters. Predominantly affecting infants and children, this bacterial infection, often referred to as “school sores” due to its easy spread in schools and daycare settings, is caused by staphylococcus or streptococcus bacteria. Recognizing impetigo and knowing when to seek medical help is crucial for prompt treatment and preventing its spread. But when exactly should you consider seeing a doctor for impetigo? This article will guide you through understanding impetigo, its symptoms, and when medical consultation becomes necessary.
What is Impetigo?
Impetigo is a superficial bacterial skin infection characterized by sores and blisters. While it can affect anyone, it is most frequently observed in young children. The term “school sores” is often used because impetigo spreads rapidly in environments like schools and childcare centers, highlighting its contagious nature. It’s essential to be aware of impetigo, especially if you have young children, to ensure timely management and prevent further spread.
[CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.
](https://www.healthdirect.gov.au/symptom-checker)
Recognizing Impetigo Symptoms
The hallmark symptom of impetigo is the appearance of sores on the skin. These sores evolve from blisters that can enlarge quickly and subsequently rupture. Upon bursting, they leave behind moist patches often marked by a distinctive brown crust around the edges. These blisters can vary in size and are typically itchy, causing discomfort.
In some instances, impetigo manifests as sores covered with a thick, soft, yellowish crust that overlies a moist, red base. This form is particularly characteristic of impetigo. Furthermore, smaller blisters can merge, forming larger, flaccid blisters, a condition known as bullous impetigo.
Symptoms usually emerge within 1 to 3 days following exposure to the bacteria. The infection remains contagious as long as fluid oozes from the sores. Contagiousness ceases once the sores crust over or after 24 hours of commencing antibiotic treatment.
Accompanying symptoms may include fever, swollen lymph nodes (glands), and a general feeling of being unwell. It’s important to monitor for these systemic symptoms in addition to the skin sores.
Alt text: Close-up of a young child’s face exhibiting characteristic impetigo sores around the mouth and nose, highlighting the typical appearance of the bacterial skin infection.
Is Impetigo Contagious?
Yes, impetigo is highly contagious. It spreads through direct contact with sores or fluids from sores of an infected person, or by touching items contaminated with the bacteria, such as towels, bedding, and toys. This ease of transmission is why impetigo is so common among children in group settings.
Newborn babies are particularly vulnerable to impetigo, and the infection can pose significant risks to them. Therefore, strict hygiene practices and isolation of infected individuals are crucial, especially around infants. Children with impetigo should stay away from babies and should not attend school or childcare until at least 24 hours after starting antibiotic treatment or until the blisters have completely dried out to prevent further spread of the infection.
Causes of Impetigo
Impetigo is primarily caused by two types of bacteria: Staphylococcus aureus and Streptococcus pyogenes. These bacteria can invade the skin through breaks or injuries, even minor ones like scratches, insect bites, or cuts. Pre-existing skin conditions that cause breaks in the skin, such as eczema or chickenpox, can also increase the risk of impetigo.
Factors that facilitate the spread of these bacteria and contribute to impetigo include:
- Age: Young children are more susceptible due to less developed hygiene habits and frequent minor skin injuries.
- Crowded environments: Schools, childcare centers, and similar settings promote easy transmission.
- Warm, humid weather: Bacteria thrive in these conditions, making impetigo more common in summer months.
- Close contact sports: Sports involving skin-to-skin contact can increase the risk of spreading impetigo.
- Compromised immune system: Individuals with weakened immune systems are more prone to bacterial infections, including impetigo.
When to See a Doctor for Impetigo
While impetigo is often mild and treatable, knowing when to seek medical advice is important to prevent complications and ensure effective treatment. You should go to the doctor for impetigo in the following situations:
- If you suspect impetigo: If you notice sores or blisters that match the description of impetigo, especially if they are spreading or your child is affected, it’s best to consult a doctor for confirmation and guidance.
- If symptoms are worsening or not improving: Impetigo should start to improve with treatment within a few days. If the sores are increasing in number, size, or severity despite home care measures, medical intervention is needed.
- If there are signs of secondary infection: Increased pain, swelling, redness, warmth around the sores, or fever could indicate a more serious, secondary bacterial infection that requires prompt medical attention.
- If impetigo is widespread: Extensive impetigo, covering a large area of the body, may necessitate oral antibiotics rather than topical treatments, which a doctor can prescribe.
- If bullous impetigo is suspected: The presence of large, fluid-filled blisters (bullous impetigo) often requires medical assessment as it may need specific treatment strategies.
- Impetigo in newborns: Due to the potential dangers of impetigo in newborns, immediate medical attention is crucial if a newborn shows any signs of impetigo.
- Recurrent impetigo: If you or your child experience repeated episodes of impetigo, a doctor can help identify underlying causes or predisposing factors and recommend preventive strategies.
- Diagnostic uncertainty: Impetigo can sometimes be confused with other skin conditions like cellulitis, contact dermatitis, or insect bites. A doctor can accurately diagnose impetigo and rule out other conditions.
[FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.
](/australian-health-services)
Diagnosing Impetigo
Diagnosing impetigo typically involves a straightforward clinical examination by a doctor. The characteristic appearance of the sores is often sufficient for diagnosis. The doctor will examine the skin and the nature of the sores to confirm impetigo.
In some cases, particularly if the diagnosis is uncertain or to identify the specific bacteria causing the infection, a doctor may take a swab of the sore. This swab is then sent to a laboratory for bacterial culture and sensitivity testing. This helps in confirming the bacterial cause and determining the most effective antibiotic treatment.
Impetigo Treatment Options
Treatment for impetigo primarily aims to eliminate the bacterial infection and prevent its spread. Antibiotics are the mainstay of treatment and are typically prescribed based on the severity of the impetigo.
- Topical antibiotics: For mild cases of impetigo, antibiotic creams or ointments are usually sufficient. These are applied directly to the sores after cleaning. Mupirocin or fusidic acid are commonly used topical antibiotics.
- Oral antibiotics: In more severe or widespread cases of impetigo, or when topical treatments are ineffective, oral antibiotics may be necessary. These are taken by mouth and work systemically to combat the infection. Common oral antibiotics include cephalexin or dicloxacillin.
It is crucial to complete the full course of antibiotics as prescribed by your doctor, even if the sores appear to be healing. This ensures complete eradication of the bacteria, prevents recurrence, and reduces the risk of antibiotic resistance.
In addition to antibiotics, home care measures play a vital role in managing impetigo:
- Gentle cleaning: Wash the sores 2 to 3 times a day with mild soap and water or a saline solution (1 teaspoon of salt in a cup of boiled and cooled water). Pat dry gently with a clean, disposable towel.
- Apply medication: After cleaning and drying, apply the prescribed antibiotic cream or ointment.
- Cover sores: Cover the treated sores with a clean, waterproof dressing to prevent further spread of infection and to avoid touching them.
- Avoid scratching: Itching is common, but scratching can worsen impetigo and spread the infection. Keep fingernails short and consider covering hands, especially in children, to minimize scratching.
- Good hygiene: Practice frequent handwashing with soap and water, especially after touching sores or dressings. Use separate towels and personal items, and wash bedding and clothing that may have come into contact with the infection daily in hot water.
Alt text: Detailed shot of hands being thoroughly washed with soap under running water, emphasizing the importance of hand hygiene in preventing the spread of infections like impetigo.
Preventing the Spread of Impetigo
Preventing impetigo primarily involves practicing good hygiene and taking precautions to avoid spreading the infection if it occurs. Key preventive measures include:
- Maintain good hygiene: Regular handwashing with soap and water, especially after outdoor activities, contact with other children, or touching potentially contaminated surfaces.
- Keep skin clean and dry: Clean any cuts, scratches, or insect bites immediately with soap and water and cover with a clean bandage until healed.
- Avoid sharing personal items: Do not share towels, washcloths, clothing, razors, and other personal items, especially in households or communal living situations where impetigo might be present.
- Isolate infected individuals: Keep children with impetigo away from school, childcare, and other group settings until they are no longer contagious (usually 24-48 hours after starting antibiotics or when sores are completely crusted over).
- Clean contaminated items: Wash bedding, towels, and clothing of an infected person daily in hot, soapy water and dry them in a hot dryer. Clean and disinfect toys and surfaces that may have been contaminated.
- Educate children: Teach children about the importance of handwashing and not sharing personal items, especially in school and daycare settings.
Potential Complications of Impetigo
While impetigo is usually a mild infection that resolves with treatment, complications can occur, though they are rare. Potential complications include:
- Cellulitis: The infection can spread deeper into the skin and surrounding tissues, causing cellulitis, a more serious bacterial skin infection requiring more aggressive treatment.
- Lymphangitis (Lymph node infection): The infection can spread to the lymph nodes, causing lymphadenitis, characterized by swollen and painful lymph nodes.
- Scarring: Rarely, severe impetigo, particularly bullous impetigo, may lead to scarring.
- Poststreptococcal glomerulonephritis: In rare cases, impetigo caused by streptococcus bacteria can lead to kidney inflammation (glomerulonephritis). This is a rare but serious complication, and prompt treatment of impetigo helps reduce this risk.
Conclusion
Knowing when to seek medical advice for impetigo is crucial for effective management and preventing potential complications. While not always serious, impetigo can be uncomfortable and contagious. If you suspect impetigo, especially if symptoms are worsening, widespread, or occurring in a newborn, it’s important to consult a doctor. Early diagnosis and appropriate treatment, along with diligent hygiene practices, can help resolve impetigo quickly and minimize the risk of spread and complications. Remember, if in doubt about whether you or your child has impetigo or how to manage it, seeking professional medical advice is always the best course of action.
[ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.
](https://www.healthdirect.gov.au/question-builder)
