Impetigo

Impetigo is a skin infection that is common in young children but can also affect adults.   

At Banner Health, we understand how concerning skin infections like impetigo can be, especially for parents. Our experienced health care providers are committed to providing expert care to help diagnose, treat and prevent this infection. 

What is impetigo?

Impetigo is a skin infection caused by bacteria, usually Staphylococcus aureus (S. aureus or staph) or Streptococcus pyogenes (group A streptococcus or strep). It occurs when bacteria enter the skin through minor cuts, scrapes, insect bites, rash or skin conditions like eczema. The break in the skin allows bacteria to enter and cause a bacterial infection. But impetigo can also infect healthy skin.

Impetigo is contagious so it can be easily passed from one person to another, especially in schools, daycare centers and sports teams. It is often seen in young children ages 2 to 5, but it can affect anybody of any age.

How does impetigo spread?

Impetigo spreads through close contact with an infected person or sharing items like towels or bedding with someone with impetigo. You can also develop impetigo from an open scratch or cut.

Types of impetigo

There are three types of impetigo:

• Non-bullous impetigo: Also called crusted impetigo, this is the most common type of impetigo. It starts with small red spots or rash that become blisters (small bubbles on the skin filled with fluid). Eventually, these blisters burst and form a yellowish-brown (honey-colored) crust. Non-bullous impetigo usually affects the face, hands, arms and legs.
• Bullous impetigo: This type causes larger blisters filled with clear or yellow fluid. The blisters may stay intact for a longer time before bursting. Crusts may form at the open sore. Bullous impetigo can appear on the stomach, arms or legs.
• Ecthyma: This is a deeper, more severe form of impetigo. Ecthyma causes thick, ulcer-like blisters that break into sores. The sores crust over and may leave scars. Ecthyma usually appears on the lower legs.

Each type requires a different approach.  A Banner Health provider can help you get the proper diagnosis and treatment.

What are risk factors for impetigo?

Young children are most at risk for impetigo, but adults may also have the infection. A child is more likely to get impetigo if they:

• Are in close contact with someone who has impetigo
• Live in a warm, humid climate
• Have cuts, scrapes, rash or insect bites
• Don’t keep clean (poor hygiene)
• Play contact sports
• Have other skin conditions like eczema, dermatitis or psoriasis 
• Have other skin infections like lice, scabies, chickenpox or herpes simplex
• Have a weakened immune system

Symptoms of impetigo

The symptoms of impetigo can vary depending on the type of infection, but the following are common signs:

• Red sores, rash or blisters: These spots often appear around the nose, mouth or hands. They can spread to other parts of the body.
• Crusting: After the sores burst, they leave a yellowish-brown crust that may look like honey or brown sugar.
• Itching or irritation: The infected area may itch or be sore. You may be tempted to scratch.
• Swelling or redness: The skin around the sores may be red, raw or swollen.
• Enlarged lymph nodes: If the infection spreads, lymph nodes (found in your neck or underarms) may become swollen. 

Impetigo can cause similar symptoms to other skin conditions, like cold sores and ringworm. Talk to a Banner Health specialist for a proper diagnosis and treatment plan. 

Diagnosing impetigo

A health care provider diagnoses impetigo by looking at the sores. Sometimes, they may take a sample from the blister or fluid to test for bacteria, which can help determine the right antibiotic to prescribe.

How do you treat impetigo?

Impetigo is treated with topical (applied to the skin) or oral (taken by mouth) antibiotics and home care. 

Topical antibiotics

For mild cases, topical antibiotic creams, gels or ointments, such as mupirocin or fusidic acid, can be applied to the affected area to kill the bacteria and prevent the infection from spreading. Your provider will instruct you on how often to apply the medicine and how to complete the full course of treatment. 

Oral antibiotics

Oral antibiotics will be given for more severe cases to fight the infection. Common oral antibiotics include amoxicillin, cephalexin or clindamycin. Follow your provider’s instructions and finish the entire prescription to ensure the infection is fully treated.

Home care

While using antibiotics, keep the affected area clean and dry. Gently wash the sores with soap and water. Where possible cover the sores loosely with a clean bandage to prevent the bacteria from spreading to others. Wash your hands often and avoid touching the infected area. 

The condition will heal within a week to 10 days. Contact your health care provider if symptoms don’t improve, get worse or return. 

Do essential oils treat impetigo?

Home remedies like essential oils or extracts may help manage impetigo symptoms but should be used with antibiotic treatment. The FDA does not regulate these products, so you may not know exactly what they contain. Talk to your health care provider before using essential oils and extracts.

Complications of impetigo

While impetigo is usually a mild skin infection, it can lead to serious problems if not treated properly. Complications are rare but may include:

• Scarring or skin damage
• Post-streptococcal glomerulonephritis (a rare kidney condition) 
• Rheumatic fever (a disease that affects the heart, joints, brain and skin)
• Cellulitis (a deep skin infection)
• Sepsis (an infection of the blood)

Preventing impetigo

To prevent impetigo from spreading or happening again, take the following steps:

• Good hygiene: Wash your hands often with soap and water. Sneeze into a tissue or in your elbow. 
• Avoid touching sores: Do not pick or scratch cuts, scratches and bug bites. Clip fingernails to avoid scratching.
• Keep sores covered: Where possible cover impetigo sores with a clean bandage to prevent bacteria from spreading. 
• Don’t share personal items: Do not share towels, clothing or other personal items that might have come into contact with the infection.
• Wash clothing and bedding: Wash items that may have touched infected skin in hot water and dry them well. 
• Stay home: If  your child has impetigo, cover open sores when possible and have them stay home from school.  Your child can return to school the next day after starting antibiotics (oral or topical). 

How Banner Health Can Help

Banner Health is committed to providing the best possible care for skin infections like impetigo. Our team of health care professionals will work with you to diagnose, treat and prevent future infections. Schedule an appointment today.