Impetigo: A Skin Infection

Impetigo, which is a superficial skin infection, usually occurs due to bacteria called Staphylococcus aureus. It is the most prevalent skin infection among young children. Impetigo is a highly infectious skin condition and is also more common in children compared to adults. Sometimes, it occurs due to Staphylococcus aureus, Streptococcus pyogens, or a mixture of the two bacteria. Impetigo is common in individuals in hot climates. It rapidly spreads from person to person by direct skin contact or less frequently, by clothing and towels or bedding. It easily passes among family members and school mates. The name ‘scrum fox’ describes the impetigo spread among rugby players. Occasionally, impetigo appears without an apparent origin.

Staphylococcus bacteria easily enter the already damaged skin by the insect bites, scabies, eczema, cold sores, cuts or grazes, or head lice. However, they can invade the normal skin too. Impetigo commonly occurs in humid warm weather.

Symptoms of impetigo

Impetigo can appear at any place on the skin. However, it is more common on uncovered regions of the skin like hands and the face (especially around the mouth and nose). It begins as multiple pus-filled thin-roofed vesicles (blisters) on the skin. They are likely to break easily and form circular oozing patches coated with brownish or honey-coloured crusts. These round patches are small initially and gradually get bigger. Small ‘satellite’ patches can appear close by and may widen too. Impetigo can be painful and itchy. However, it doesn’t normally give you the sense of being ill. During the healing process, their crusts drop and the infected regions recover without leaving marks.

Diagnosis

Impetigo can be diagnosed according to your clinical history and the appearance of the rash. Your doctor will check to verify if impetigo has appeared along with other skin disease. A swab from crusted wounds can be sent to a laboratory to identify which bacteria are leading to the impetigo. It will be helpful to select the most suitable antibiotic to cure the condition. However, your doctor will offer another antibiotic until the result is available. If you get repeated attacks of impetigo or impetigo appears resistant to the usual treatments, it may be necessary to take a swab from the nostrils to check if the particular bacteria are harbouring in your nose. Your family members should be also checked.

Management of impetigo

Normally, impetigo clears rapidly. However, it may take a long time to heal, if the condition is associated with an underlying skin disease like head lice, scabies, eczema, or cold sores.

Impetigo can be prevented by good personal hygiene, especially hand washing with soap.

Topical antibiotics like fusidic acid are applied on the infected skin. Topical mupirocin can be used three times daily for a type of Staphylococcus, which is resistant to an antibiotic called methicillin. If the microorganisms are found in your nostrils, your doctor will offer nasal mupirocin to eliminate them. Extensive impetigo is treated with oral antibiotics for seven to ten days.