Impetigo is a common and highly contagious skin infection, mostly affecting infants and young children, though adults can get it too. It usually starts with red sores around the nose and mouth, which can break open, ooze, and form a yellow-brown crust. Despite its alarming appearance, impetigo is typically mild and treatable with antibiotics.
What Is Impetigo?
Impetigo is a bacterial skin infection caused mainly by two types of bacteria: Staphylococcus aureus and Streptococcus pyogenes (Kliegman et al., 2020). These bacteria can enter the skin through small cuts, insect bites, or other skin injuries. Children often catch impetigo through close contact with other infected children, especially in school or daycare settings.
There are two primary types of impetigo: non-bullous (the more common form) and bullous impetigo. Non-bullous impetigo starts as tiny red spots that quickly turn into blisters and then crust over. Bullous impetigo causes larger fluid-filled blisters, mainly seen in infants (Mayo Clinic, 2023).
Who Is at Risk?
Children between the ages of 2 and 5 are most at risk because they often have cuts or scrapes and are in close contact with others (Centers for Disease Control and Prevention [CDC], 2022). However, adults can also develop impetigo, especially athletes or people living in crowded conditions. People with weakened immune systems or skin conditions like eczema are more susceptible too (Habif, 2021).
How Does It Spread?
Impetigo spreads through direct contact with an infected person or by touching objects like towels, clothing, or toys that have the bacteria on them. Poor hygiene, hot and humid weather, and skin injuries increase the chances of catching the infection (Smith & Johnson, 2019).
That’s why outbreaks often happen in summer months or in places where people are in close quarters like schools, camps, or military barracks (Paller & Mancini, 2022).
Recognizing the Symptoms
The symptoms of impetigo usually appear within 4 to 10 days after exposure. In non-bullous impetigo, the sores start as red bumps around the nose or mouth and soon turn into blisters that burst and form a honey-colored crust (DermNet, 2021). These crusts often itch, and scratching can spread the infection to other parts of the body.
In bullous impetigo, the blisters are larger, filled with fluid, and can appear on the torso, arms, or legs. These blisters are less likely to burst right away and usually leave behind red, raw skin after breaking (Bolognia et al., 2018).
Diagnosis and Treatment
Doctors usually diagnose impetigo by simply looking at the skin, but sometimes a sample of the fluid from a blister might be tested to confirm which bacteria is causing the infection (Cohen & Powderly, 2020).
Treatment depends on the severity of the infection. Mild cases are often treated with antibiotic ointments like mupirocin. More widespread cases may require oral antibiotics (Tan et al., 2020). It’s important to complete the full course of antibiotics to prevent the infection from coming back or becoming resistant.
During treatment, keeping the skin clean, avoiding scratching, and washing hands often can help prevent spreading it to others.
Can Impetigo Be Prevented?
Yes. Good hygiene is key. Regular handwashing, not sharing personal items, and keeping wounds clean and covered can significantly reduce the risk (CDC, 2022). In schools or group settings, it’s important to isolate infected individuals until they’re no longer contagious usually after 24 hours of antibiotic treatment.
Complications Are Rare but Possible
While impetigo is usually mild, complications can happen. If left untreated, it might lead to deeper skin infections like cellulitis or, rarely, kidney inflammation due to post-streptococcal glomerulonephritis (Stevens & Bryant, 2017).
Antibiotic resistance is also a growing concern. Repeated infections or misuse of antibiotics can make the bacteria harder to treat (World Health Organization [WHO], 2023).
Impetigo may be common and uncomfortable, but it’s not dangerous when treated properly. Parents, caregivers, and educators should be familiar with its signs and know how to prevent its spread. Early treatment, good hygiene, and awareness can go a long way in managing and avoiding this skin condition.
References
- Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2018). Dermatology (4th ed.). Elsevier.
- Centers for Disease Control and Prevention. (2022). Impetigo: Prevention & Treatment. https://www.cdc.gov/impetigo/
- Cohen, J., & Powderly, W. G. (2020). Infectious Diseases (5th ed.). Elsevier.
- DermNet. (2021). Impetigo. https://dermnetnz.org/topics/impetigo
- Habif, T. P. (2021). Clinical Dermatology: A Color Guide to Diagnosis and Therapy (7th ed.). Elsevier.
- Kliegman, R. M., et al. (2020). Nelson Textbook of Pediatrics (21st ed.). Elsevier.
- Mayo Clinic. (2023). Impetigo. https://www.mayoclinic.org/diseases-conditions/impetigo/
- Paller, A. S., & Mancini, A. J. (2022). Hurwitz Clinical Pediatric Dermatology (6th ed.). Elsevier.
- Smith, R., & Johnson, T. (2019). Impetigo outbreaks in schools and preventive measures. Pediatric Health, 6(3), 120–125.
- Stevens, D. L., & Bryant, A. E. (2017). Impetigo and erysipelas. New England Journal of Medicine, 376(3), 253–262.
- Tan, T., et al. (2020). Antibiotics for impetigo. Cochrane Database of Systematic Reviews, 2020(4). https://doi.org/10.1002/14651858.CD003261.pub3
- World Health Organization. (2023). Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
