Impetigo produces uncomfortable, unsightly, crusty blisters and sores. Fortunately, you can prevent and treat this common condition. Here’s how, along with what causes impetigo and its different types.
What is impetigo?
Primarily a skin condition that affects infants and young children, impetigo appears as blisters or sores on the face, especially around the mouth and nose. It may also show up on hands, arms, legs and your trunk. Although children are most often affected, people at any age can contract this contagious condition.
Impetigo is diagnosed after careful examination by a doctor. He or she will ask about the patient’s history or if the patient has other skin conditions. The doctor may also take a culture or sample of skin, tissue or fluid to test for the presence of impetigo-causing bacteria.
There are several types of impetigo:
- Impetigo contagiosa , or non-bullous impetigo, is a highly contagious form caused by the bacteria streptococcus pyogenes, otherwise known as strep. It typically affects skin around the nose, mouth, hands and forearms. Scratching can spread it to other parts of the body, making it very difficult to heal.
Commonly starting as itchy red sores, these blisters often rupture after about 24 hours. Then, they’ll ooze for a few days before forming a thick, honey brown crust. Even though the blisters are itchy and leave behind a red mark as they heal, they usually don't scar. Red marks should fade within a few weeks.
- Bullous impetigo is caused by the staphylococcus aureus (staph) bacteria. It ordinarily appears in children under two years old as red, pus-filled blisters on the trunk, arms and legs. Although unsightly, these blisters aren't normally painful. The clear pustules will ultimately rupture, forming a yellowish scab, before healing completely. Unfortunately, bullous impetigo can persist longer than other types, and the pustules may be larger than with impetigo contagiosa.
- Ecthyma , the most serious form of impetigo, attacks the dermis, or deeper layer of the skin. Painful, fluid-filled sores typically form on the legs and feet. These eventually become hard, grayish ulcers with a tough, crusty covering. Lymph nodes may swell during an outbreak. Because bacteria reach the dermis, the potential for scarring from ecthyma is high, so avoid scratching at these lesions.
How do you get impetigo?
Impetigo results from staphylococcus aureus or streptococcus pyogenes bacteria, which typically live on skin’s surface and enter the body through cuts, insect bites or abrasions. Bacteria can be spread in many ways, including:
- Scratching. People with eczema, scabies, herpes, chicken pox or contact dermatitis are highly prone to developing impetigo, because scratching when you have these conditions can create small openings in the skin and spread bacteria. Unfortunately, even small openings in the skin can allow bacteria to enter and cause impetigo.
- Touching infected people or their objects. Even if the skin isn't broken, impetigo can spread through skin-to-skin contact in crowded environments — like classrooms and commuter trains — or warm, humid environments — such as saunas, spas and gyms. You can also catch impetigo by handling items touched by an infected person, especially clothes, bedding and toys.
How can you prevent impetigo?
Careful hygiene is crucial to keeping skin healthy and free of impetigo-causing bacteria. To avoid contracting impetigo:
- Be conscientious of proper wound care, particularly with children. Clean cuts, scrapes, bug bites, eczema or any type of skin rash, such as contact dermatitis or poison ivy. These can all provide an ideal breeding ground for the staph or strep bacteria. Be sure to wash the areas thoroughly and apply the appropriate ointment.
- Wash hands regularly with soap.
- Shower regularly.
How do you treat impetigo?
Call your doctor if you notice any blisters, crusting or other impetigo-like signs. A mild case of impetigo may heal without medication, but a more severe case will most likely need oral or topical antibiotics. Some other tips to help heal impetigo:
- Keep the affected areas clean. Wash them gently with warm water and soap, and pat dry. If you have crusts or scabs, gently remove these with a clean washcloth prior to applying topical medications. Otherwise, the crusts will prevent the medication from penetrating.
- Apply topical antibiotics or take oral antibiotics as prescribed by your doctor. Even if symptoms begin to get better, finish the entire course of antibiotics, or the infection may come back and get worse.
- Wear gloves if applying topical medications, and throw them away when you’re done. If this isn’t possible, then wash your hands immediately after applying medication to affected areas. This will reduce your risk of spreading the bacteria to other parts of your body.
- Use soothing creams to help minimize itchiness and irritation. Peter Thomas Roth Aloe-Cort Cream contains soothing aloe vera and hydrocortisone.
- Cover affected areas with gauze and bandages. This should help prevent the infection from spreading to other parts of your body or to other people.
- Cut fingernails short to minimize bacterial infection from itching or scratching affected areas. Bacteria can thrive under fingernails.
- Don't share towels, clothing or bed linens. Wash them separately in hot water.
- Avoid hot tubs, saunas or swimming pools until all lesions have healed completely.
- Keep kids at home during an active impetigo infection.
- Call your doctor if symptoms don’t improve, if you develop a fever or if the affected area becomes red and hot to the touch.
Although impetigo causes unsightly skin lesions, with careful attention, it can be managed. However, because the condition may require prescription medication and is so contagious, visit your doctor before trying at-home remedies. Most importantly, to prevent the spread of infection or scarring, don't pick at or scratch the blisters!
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