Seen most commonly in children, we look at the causes, signs, symptoms and treatment options for this bacterial skin infection.
Impetigo is a highly contagious skin condition. In the UK, it is the most common bacterial skin infection seen in children, but it can affect people of any age. However, it is not usually serious and the skin recovers well following treatment.
Dr Adam Friedmann, consultant dermatologist at Stratum Clinics offers his expert advice when it comes to spotting, treating and preventing impetigo:
What is impetigo?
Impetigo is typically caused by the bacteria Staphylococcus aureus, but less frequently it can be caused by Streptococcus pyogenes. The two most common types of impetigo are non-bullous and bullous:
• Non-bullous impetigo
This is the most common type of impetigo. It starts out like tiny blisters that eventually burst, leaving areas of skin that are red and often weepy. Over time, these patches will crust over with a golden crust, giving impetigo its characteristic appearance of looking like the skin is coated in sticky brown sugar or honey.
• Bullous impetigo
This results in larger, fluid-filled blisters that look clear, then become cloudy. These blisters are more likely to stay longer on the skin without bursting, but when they do burst, the same golden crusting appears. It is just as contagious as non-bullous impetigo.
Impetigo can start anywhere on the body, but is more commonly found on exposed areas, such as the face, particularly around the nose and mouth, and hands.
Impetigo signs and symptoms
The incubation period for impetigo is up to 10 days from initial exposure to the bacteria, so you won’t see symptoms straight away. The length of incubation will depend on what strain it is (streptococcal infections are approximately one to three days, while staphylococcal infections are more like four to 10 days).
The first signs of impetigo is itchy blisters that develop sores before forming a yellow crust.
The first signs of impetigo tend to be itchy blisters. These develop pus and red sores that quickly burst and ooze for a few days, before forming a yellow/brown crust. On the whole, you’ll notice these around the nose and mouth first, before they quickly spread to other parts of the body.
While impetigo can feel sore and itchy, sufferers don’t tend to feel too poorly with it.
How is impetigo spread?
Due to the contagious nature of impetigo, the infection can quickly spread to other parts of the body and is also easily spread from person to person, by direct contact with the infected skin. It’s therefore imperative that sufferers don’t touch or scratch their sores, blisters or crusty patches – this will also help to avoid scarring.
Impetigo can spread very quickly through families and school classes. Here are a few simple measures you can take to help stop impetigo from spreading:
✔️ Don’t share towels, bedsheets or clothing.
✔️ Avoid all close contact (this includes playing contact sports and going to the gym, where you might share gym equipment).
✔️ Avoid preparing food for others.
✔️ Look after your skin by keeping sores, blisters and crusty patches clean and dry, and covering them with loose clothing or gauze bandages.
✔️ Wash your hands frequently.
✔️ Wash bedsheets and towels/flannels often at a high temperature.
✔️ In cases of children, wash or wipe down toys with detergent and warm water.
✔️ Keep children off school until the weeping and golden crusting is gone.
Impetigo risk factors
Who is most likely to catch impetigo? Anyone can develop impetigo, but it’s very common in young children typically aged two to six years old. The bacteria that cause impetigo can infect normal skin, but typically infects skin that is already damaged – for example, due to eczema or cold sores, bites, scabies, cuts or grazes.
Impetigo can quickly spread to other parts of the body and is also easily spread from person to person.
People with lowered immunity, such as those undergoing chemotherapy or suffering with diabetes, are also more prone to becoming infected.
Although impetigo usually clears up on its own after a few weeks, because of the contagious nature of the infection, sufferers will usually be treated with antibiotics to help speed up the process.
If only a small patch of skin is affected, an antibiotic ointment used for five days is usually suffice. Topical mupirocin or fusidic acid is very successful in treating mild forms of the condition. To speed the healing process, avoid touching patches of impetigo and ensure you wash your hands immediately before and after applying the antibiotic cream/ointment.
Sometimes for the antibiotic cream to be as effective as possible, it might be best to regularly soak the affected areas with a wet compress, to gently help remove the scabs. This will allow the prescribed creams to be absorbed into the skin more easily.
If the infection has spread to other areas of the body, your doctor may prescribe an antibiotic pill, such as penicillin, to be taken for seven to 10 days. Erythromycin can be used in those allergic to penicillin.
After antibiotic treatment begins, healing should start within a few days. Like all antibiotics, it’s important to continue to use the treatment as prescribed and not stop early, even if the impetigo has cleared up. While the infection is healing, gently wash the skin daily with clean gauze and antiseptic soap. To prevent spreading, cover infected areas with gauze bandages or loose clothing.
Impetigo infection period
During impetigo’s contagious period, it’s advisable to stay away from school or work. The infection usually gets better in seven to 10 days of treatment. As a rule, individuals are no longer contagious once the sores have disappeared.
However, this timeframe can be reduced with appropriate topical antibiotics. With effective antibiotics, the sufferer is usually considered noncontagious after about 48 hours of treatment.
Impetigo prevention tips
Check out the below advice to help you keep impetigo at bay in the future:
✔️ Practise good hygiene. This can really help to prevent impetigo. Washing hands often and thoroughly, and taking regular baths and showers is important.
✔️ If you notice your child has a cut or scrape, is irritated by an insect bite or suffers with eczema, keep a particular eye on their skin and ensure those areas are kept clean and covered.