What Is Infantigo (Impetigo)?


If you’ve never heard of impetigo before, then your first question will most likely be, “What is it?”

Impetigo(Infantigo) is a contagious, superficial skin infection.  The condition is sometimes referred to as “school sores” because it is most common in preschool and school-age children between the ages of 2 and 7. However, it can also occur in older kids and adults where a more serious and deeper type of skin infection (ecthyma) is more likely to develop.

It is the most common bacterial skin infection among children, and usually presents on the face, around the nose and mouth, on the hands and forearms, and in young children around the diaper area, under the armpits, and other areas where folds of skin occur. It is also the third most common skin condition overall trailing only dermatitis and viral warts.

Studies from the United Kingdom suggest approximately 2.8% of children aged 0-4 and 1.6% of children aged 5-15 get impetigo. It is more common in children on dialysis and those who grow up in or frequent crowded living conditions such as military bases, day cares, and schools.

What are Causes?

Impetigo is most commonly caused by the bacteria Staphylococcus aureus. However, Streptococcus pyogenes (group A strep) also plays a role in some types of impetigo. An infection is considered highly contagious and is most commonly passed through direct contact. It can spread rapidly through day cares and schools where children scratch the itchy infection and then easily spread it to other areas of their own bodies or to other children.

The bacteria that cause impetigo (Staphylococcus aureus and Streptococcus pyogenes) normally occur on the skin.  Often these bacteria enter the body in a place where the skin has already been irritated by cuts, scrapes, insect bites, poison ivy, or eczema and cause an infection.  It can also enter the body through healthy skin, but this is less common.

Fomites are also important in the spread of impetigo. A fomite is any inanimate object capable of carrying infectious organisms. This can include things like towels, blankets, washcloths, stuffed animals, and clothing.

What Are The Different Types?

Two types of impetigo are generally recognized. These are nonbullous impetigo (impetigo contagiosa) and bullous impetigo. Nonbullous accounts for about 70% of cases.

Sometimes cultures are used to distinguish between the two types, but most often a clinical diagnosis is all that is needed. Nonbullous impetigo tends to result from a host response to the infection whereas bullous impetigo is caused by a staphylococcal toxin. A subtype of nonbullous one (common impetigo) is known to complicate other diseases such as diabetes and AIDS. This subtype is also referred to as impetiginous or secondary impetigo.

What are the Symptoms?

Nonbullous Impetigo

Nonbullous impetigo generally starts out as small red papules that often resemble insect bites or a small cluster of pimples. These papules then enlarge and turn into small blisters which will then pop, ooze, and eventually scab over into a gold/honey colored crust that is said to resemble brown sugar.

These sores are not usually painful, but will be extremely itchy in most cases. The face, extremities, and other areas of the body exposed to the environment are most commonly affected. Sometimes a low-grade fever will accompany the outbreak of impetigo and other flu-like symptoms, such as body aches and chills, may also be present.

Bullous Impetigo

Bullous impetigo is most common in newborns, but it also occurs less frequently in older children and adults. It is caused by toxins released by Staphylococcus aureus and tends to favor areas of moisture such as the edge of diapers and areas where folds of skin come together such as in the neck and armpits.

The Bullous is characterized by large, fluid filled blisters. There is usually no redness of the skin (erythema) surrounding the blisters. These blisters tend to rupture and ooze, resulting in a yellow crust as the contents dry. Bullous tends to be less contagious than nonbullous impetigo and associated symptoms may also include fever, diarrhea, and general fatigue and weakness.

Treatment

Impetigo will often heal on its own within 2 to 3 weeks. Since it is a superficial skin infection, scarring is rarely a problem. However, medical treatment should still be sought by parents who want to relieve a child’s discomfort and improve the cosmetic appearance of the lesions quickly.

A quick look through impetigo pictures, and it’s clear the infection can look downright nasty in a hurry. It can also be extremely uncomfortable because the sores and lesions tend to be extremely itchy. Taking action and seeking medical treatment is advised over letting the infection run its own course.

Medical treatment is also advised to prevent Staph and Strep bacteria from spreading and causing more serious illnesses such as glomerulonephritis. Glomerulonephritis is an inflammation of the blood vessels (glomeruli) in the kidneys and can lead to a decrease in kidney function. Other rare but possible complications from leaving impetigo untreated include sepsis, arthritis, osteomyelitis, endocarditis, pneumonia, cellulitis, toxic shock syndrome, and staphylococcal scalded skin syndrome.

Impetigo treatment alternatives such as the Fast Impetigo Cure can provide instant relief from impetigo symptoms and can greatly reduce the time it takes for your child to heal from impetigo.

The treatment most commonly involves the use of antibiotics.  In cases of mild impetigo, your doctor will prescribe an antibiotic ointment or cream to spread on the affected area several times a day.  Common topical antibiotics include mupirocin (Bactroban) and fusidic acid, although the latter is not licensed for use in the United States.

For more severe cases of impetigo, oral antibiotics may be used in conjunction with an ointment or cream.  There is no standard treatment for impetigo and your doctor may prescribe any of the following:

    • Antistaphylococcal penicillins
    • Amoxicillin/clavulanate
    • Cephalosporins
    • Macrolides

Erythromycin is sometimes also prescribed, but Staph and Strep bacteria are becoming increasingly resistant to it. In most cases, there should be noticeable improvement within three days of beginning treatment with antibiotics.

When applying an impetigo treatment, it is important to wash the sores gently with soap and water several times per day prior to applying the antibiotic ointment.  If sores are crusty, keep a moist towel on the sores for fifteen minutes and gently remove all of the crust and gently pat dry before applying antibiotic ointment. This keeps the area clean and allows the medication to work most effectively on the outbreak.

How To Prevent

There are some important points to keep in mind if you want to prevent the spread of impetigo. When applying a topical treatment, always be sure to use a fresh washcloth every time you wash the sores, and be sure not to share towels or washcloths with anybody else during an outbreak. Wash all washcloths and towels in hot water prior to using again to help prevent spreading the infection on the patient or transmitting the infection to anybody else.

It’s also extremely important not to scratch the sores to prevent the spread to other areas of the body and to prevent the infection from spreading to other individuals. This can be extremely difficult to do, especially with children, because the sores and lesions tend to be extremely itchy. Keep your child’s fingernails short and, if necessary, cover the affected area with gauze or bandages to help prevent scratching.

Good hygiene can help prevent impetigo. Washing the skin and hands regularly with soap and water will reduce the chances of staph and strep bacteria causing an infection and will also prevent it from spreading if the condition is already present.  If somebody you know is infected with impetigo, do not share items such as towels, washcloths, pillows, or blankets.

If you have any skin irritations or open cuts, be sure to keep them clean and covered if possible to help reduce the chance of infection. If you or your child has impetigo, seek medical help and apply an effective treatment rather than waiting for the infection to heal on its own.

Summary Points About Impetigo

Here are some key summary points about impetigo and its treatment:

      • What is impetigo? Impetigo (also known as school sores) is a highly contagious, superficial skin infection most common in children aged 2-7.
      • Impetigo is caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes.
      • There are two main types: nonbullous and bullous.
      • Impetigo treatment most commonly consists of topical and/or oral antibiotics.
      • Impetigo is most commonly passed from one individual to another through direct contact and spreads rapidly in places like day cares, military bases, and schools.
      • Good hygiene is important to prevent impetigo and to stop it from spreading.
      • If you, your child, or someone you know is infected with impetigo, don’t share towels, blankets, pillowcases, toys, and other items which can act as fomites and spread the disease to others.

Other reference:
Infantigo: Pictures, Causes, Prevention and Treatment