What Is Impetigo?
Impetigo is a common, contagious bacterial skin infection that often affects the face, arms, and legs. Anyone can contract impetigo, though impetigo in children (especially in those ages 2–6) and infants is more common than impetigo in adults. The infection often begins where skin is broken, such as lacerations, insect bites, or a rash such as eczema, though it may also occur on healthy, unbroken skin. When this condition infects healthy skin, it is known as primary impetigo. When it occurs in broken skin, it is known as secondary impetigo.
Bacteria thrive in hot, humid, and moist environments. As such, the impetigo-causing bacteria tend to peak in the warmest and wettest months of the year, such as summer and fall in Boardman, OH. In warm, humid climates, impetigo may be prevalent year-round. According to the Food and Drug Administration, there are more than 3 million cases of impetigo in the United States every year. There are three primary types of impetigo — bullous impetigo, nonbullous impetigo, and ecthyma — based on the impetigo-causing bacteria and the resulting sores. Each of the following types of impetigo goes through a series of stages.
- Bullous Impetigo. Bullous impetigo is typically always caused by a bacteria known as Staphylococcus aureus. It is characterized by large blisters, or bullae, filled with a clear fluid that can become dark and cloudy. The blisters start on unbroken skin and are not surrounded by reddened areas of skin. The blisters then become limp and clear before bursting open. Once the blisters have burst, a yellow-colored, crusted sore forms over the area. After healing, they don't usually leave behind scars.
- Nonbullous Impetigo. Nonbullous impetigo is primarily caused by the Staphylococcus aureus bacteria. This is the most common form of impetigo and starts with red-colored, itchy sores usually on the skin around the mouth and the nose. Over time, the sores break open with irritated, red skin surrounding them. Then, a brown-yellow crust forms over them. The red spots fade once the crusts heal, and no scarring is left behind.
- Ecthyma. Ecthyma is a less common, severe form of impetigo. This form occurs when cases of impetigo go untreated. Ecthyma affects deeper layers of skin than other types of impetigo. The infection develops as painful blisters, usually on the buttocks, thighs, legs, feet, and ankles. With time, the blisters become pus-filled sores with a thick surrounding crust with red surrounding the sores. Ecthyma sores heal slowly, and they may leave behind scars once healed.
Impetigo Symptoms
The main symptoms of impetigo are red sores on the skin that are often clustered around the nose and lips. The sores develop quickly and transform into blisters that ooze and burst open. Once burst, the blisters form a honey-colored crust covering. The clusters of blisters may grow larger to cover a more significant portion of the surrounding skin. After these crusts form, they develop red marks that fade without leaving behind scars once healed. In some cases, the red sores develop a yellowish crust without first forming blisters.
Impetigo sores are often described as itchy and painful at times. It can be uncomfortable and cause distress to those with the condition. Occasionally, impetigo symptoms may also include swollen glands in the area of the outbreak as well as a fever. Infants and young children with bullous impetigo may develop large blisters in their skin folds or around their diaper area. These blisters burst open and develop a scaly border. Ecthyma is a serious form of impetigo that causes painful pus- or fluid-filled sores. If you suspect that you or your child has impetigo, consult your primary care physician or our dermatologists right away.
Impetigo Causes
Impetigo bacteria, usually staphylococci or streptococci organisms, cause this condition in adults and children. These bacteria can make their way into the body through a break in the skin from a rash, insect bite, scratch, cut, or any other damage to the skin. Once the bacteria enter the body, they begin to invade and colonize. You can contract impetigo by touching the sores of another person with the infection or if you touch items, such as clothing, bedding, or towels, that person used. These bacteria are common in our environment, though most people who come into contact with them won't always develop impetigo. A portion of the population normally carries staph bacteria inside of their nose (mucous membranes), and they may develop impetigo if the bacteria spreads to their skin.
Both children and adults are at a higher risk of developing impetigo if the following applies to them.
- Live In A Hot, Humid Environment
- Have Diabetes
- Have A Compromised Immune System
- Have HIV Or Aids
- Are Undergoing Dialysis
- Have Eczema, Dermatitis, Or Psoriasis
- Have Burns, Such As A Sunburn
- Have Insect Bites
- Have Skin Rashes, Such As From Poison Ivy
- Play Contact Sports
- Have Live, Scabies, Herpes Simplex, Or Chickenpox
- Have Cuts, Scrapes, Or Other Skin Damage
Impetigo Treatment
It is a good idea to consult your dermatologist if you suspect impetigo. A Boardman dermatologist with our clinic can usually diagnose the infection by its appearance. If the sores don't go away following treatment, your doctor may need to culture the bacteria by taking a small amount of liquid from the sores and testing it to identify the exact bacteria that caused them. Once the bacteria is identified, your doctor will determine which antibiotics will work best against it. Antibiotics are typically effective for treating impetigo. The type of antibiotic you are prescribed depends upon multiple factors, including the number of blisters and their severity.
Patients with impetigo sores in only a small area of the skin may be prescribed antibiotic impetigo cream, such as prescription mupirocin antibiotic ointment or cream. Before applying topical medication, apply a warm cloth or compress to the area for a few minutes, gently pat dry the area, apply the medication, and place a non-stick bandage over the skin to help prevent the sores from spreading. If the impetigo is severe and widespread, such as ecthyma or multiple impetigo sores, then your doctor may prescribe oral antibiotics. Be sure to finish the entire course of medication, even if the sores become healed.
Impetigo Vs. Cold Sore
If you have a red, inflamed blister on your face or body, it may be difficult to identify whether the cause is impetigo or a simple cold sore. While the best way to diagnose your condition is with the help of a dermatologist in Boardman, OH, there are a number of factors that can help you distinguish these conditions. Both impetigo and cold sores and common skin conditions can affect children and adults. While outbreaks of either generally appear on facial skin, the resulting blisters from both conditions can occur anywhere on the body. Impetigo typically affects children and is caused by either group A Streptococcus or Staphylococcus aureus bacteria. Group A Streptococcus also causes strep throat and is the more common bacterial cause of impetigo. Cold sores can affect people of all ages and occur due to the Herpes Simplex Virus (HSV). The virus exists in HSV-1 and HSV-2, though HSV-1 is much more common, especially in children. Both impetigo and cold sores are contagious and can spread to others, so be sure to take the necessary precautions to reduce your risk or the risk of your child spreading these infections to other individuals.
How Long Does Impetigo Last?
In some cases, impetigo may go away on its own within a few weeks of the blisters first appearing on the skin. In most cases, patients require treatment with oral and/or topical antibiotic medications, as prescribed by their doctor, to fully be rid of the condition and the resulting sores. With treatment, impetigo usually starts to heal within 7-10 days of starting treatment, though this ranges from person to person. Patients with underlying skin infections, other types of infections, or skin diseases may require longer than this period for their impetigo to heal. Patients who experience recurrent impetigo may experience additional signs and symptoms of the condition even after treatment is completed. A possible reason for this is that the causal bacteria naturally colonize the inside of the nose, which increases the risk of developing impetigo on the skin. Patients with recurrent impetigo should be evaluated by their dermatologist for the carriage of the causative bacteria.
Impetigo Prevention
Impetigo can easily spread to other parts of the body or other people until the infection is no longer contagious. Contagion of impetigo typically stops within 48 hours of starting prescription treatment and when the patches dry out and crust over. You can help avoid spreading impetigo to others and other parts of your body by following these steps.
- Cleaning The Infected Area With Soap & Water
- Loosely Covering Scabs & Sores Until They Heal
- Gently Removing Crusts From Scabs
- Washing Your Hands With Soap & Hot Water After Touching The Areas
- Avoid Touching The Rash As Much As Possible
- Isolate Children With Impetigo Until They Complete Treatment
- Avoid Using Hot Tubs And Swimming Pools
- Taking The Full Course Of Antibiotic Medication To Prevent Reinfection