15134 Impetigo

Overview

Impetigo is a common, highly contagious bacterial skin infection. It causes sores and blisters, usually around the nose, mouth, hands, and sometimes the nappy area in children. The sores often burst, ooze fluid, and form a golden-brown crust. It is usually not serious but needs prompt treatment to help it heal and stop it spreading to others.

Yes, impetigo is one of the most common skin infections in children worldwide. It is more frequent in warm, humid weather and in places where people live close together.

Anyone can get impetigo, but it mainly affects young children. It is also more likely in people who have cuts, scrapes, insect bites, or skin conditions like eczema. People with a weakened immune system or who live in crowded or unhygienic conditions are also at higher risk.

Symptoms

Common symptoms

• Red sores that quickly burst and leave a yellow-brown crust
• Itchy skin, which can sometimes be painful
• Sores often around the nose, mouth, and on the hands
• Mild swelling or tenderness of the affected skin

Symptoms in children

• Sores commonly appear on the face, especially around the mouth and nose.
• They can also spread to other areas like the arms, legs, or nappy area.
• Children may feel generally unwell, tired, or have a slight fever.
• The sores may be mistaken for cold sores, but they are not the same.

Symptoms in older adults

• Impetigo is less common in older adults but can happen, especially in nursing or care homes.
• Sores may be more widespread and slower to heal.
• People with diabetes, poor circulation, or a weakened immune system may have more severe symptoms.

Causes

Main causes

• Bacteria that live on the skin, most commonly Streptococcus pyogenes or Staphylococcus aureus
• The bacteria get in through a break in the skin, such as a cut, scrape, insect bite, or eczema patch
• The infection spreads to other people through direct skin contact or contact with contaminated objects like towels, clothes, and toys

Risk factors

• Being a child, especially between ages 2 and 5
• Living in a warm, humid climate
• Having skin conditions like eczema, scabies, or allergies
• Direct contact with someone who has impetigo
• Poor hygiene or crowded living conditions
• A weakened immune system due to illness or certain medications

When to see a doctor

See a doctor urgently if:

• If the infection is spreading rapidly or covers a large area of skin
• If you or your child have a high fever, chills, or severe pain
• If you see red streaks on the skin or the sore becomes very painful – this can be a sign of a deeper infection

Book a routine appointment if:

• If the sores have not started to heal within a few days or are getting worse
• If you or your child keep getting impetigo after treatment
• If you are pregnant, have a chronic condition like diabetes, or have a weakened immune system

Diagnosis

A doctor or nurse can usually diagnose impetigo by looking at the skin and asking about your symptoms. They may also ask whether anyone in your family or school has had the infection recently.

Tests that may be done

• In most cases, no tests are needed.
• If the infection is severe, keeps coming back, or does not improve with treatment, a doctor may take a swab from the sore to identify the exact bacteria and guide further treatment.

What to expect at your appointment

The appointment is usually quick and simple. The healthcare provider will look at the affected skin and may ask a few questions. They will explain the treatment options and give practical advice on how to stop the infection spreading.

Treatment

Impetigo often heals on its own within a few weeks, but treatment can speed up recovery and make it less contagious. For mild cases, a doctor may prescribe an antibiotic cream or ointment to apply to the affected skin. For more widespread infections, an oral antibiotic (taken by mouth) may be needed. It is important to complete the full course of treatment as prescribed, even if the skin starts to look better.

Self-care at home

• Gently wash the affected skin with warm water and a mild soap or antiseptic wash, as advised by your healthcare provider.
• Use a clean, soft cloth to carefully soak off crusts if recommended by your doctor.
• Wash your hands regularly with soap and water, especially after touching the sores.
• Keep your fingernails short to prevent scratching and spreading the infection.
• Avoid sharing towels, flannels, pillows, clothes, or sports equipment.
• Keep the sores covered with a light dressing or clothing where possible.

Medical treatments

Your doctor may prescribe an antibiotic cream or ointment, which you apply to the affected areas a few times a day. If the infection is widespread or stubborn, they may give you an antibiotic to take by mouth. Always complete the full course of antibiotics, even if the skin appears to improve. In some cases, your doctor may also suggest a medicated wash to reduce the number of bacteria on your skin.

When is surgery considered?

Surgery is not needed for impetigo.

Living with this condition

Most people manage impetigo at home comfortably. Follow your doctor's advice and keep the affected area clean and dry. Children can usually return to school or nursery once the sores have dried up or crusted, or after starting treatment as advised by the doctor or local public health guidance. It helps to keep the infected skin covered while around others.

Lifestyle tips

• Wash your hands thoroughly and often, especially after touching the affected skin.
• Bathe or shower regularly and dry with a clean towel.
• Do not share personal items like towels, bedding, razors, or sports gear.
• Avoid nail-biting, picking at sores, or scratching.
• Use separate towels and change bed linen and clothes frequently until the infection clears.

Diet and exercise

There is no special diet needed for impetigo, but eating well and staying hydrated supports your immune system. If you feel unwell or have a fever, it is best to rest and drink plenty of fluids. Once you feel well, normal exercise and activity are fine.

Mental health and emotional wellbeing

Impetigo is visible and itchy, which can feel embarrassing or upsetting, especially for children. Other people's reactions can also cause worry. It is completely normal to feel self-conscious. Remember that impetigo is a common, treatable skin infection, and it will not last long. Talking to a partner, friend, or your GP can help you feel more at ease.

Prevention

You cannot always prevent impetigo, but you can lower the risk by washing hands regularly, keeping skin clean and moisturized, and covering any cuts, scrapes, or insect bites with a clean plaster. Treat underlying skin conditions like eczema promptly, and avoid close contact with anyone who has impetigo.

Vaccines

There is no vaccine for impetigo.

Screening programmes

There is no routine screening for impetigo, but it is often detected during ordinary check-ups or when someone seeks care for their skin.

Complications

If left untreated

• The infection may spread to other parts of the body or to other people.
• In rare cases, the bacteria can cause a deeper skin infection called cellulitis.
• Very rarely, certain types of bacteria may affect the kidneys, leading to a condition called post-streptococcal glomerulonephritis.
• Scarring is uncommon, but repeated scratching or picking can leave marks.

Long-term outlook

With proper treatment and good hygiene, impetigo usually clears up completely within 1 to 2 weeks and rarely leaves any permanent marks. Even without treatment, it often heals on its own, but treatment helps it heal faster and reduces the risk of spreading. Following your healthcare provider's advice and finishing the full treatment course gives the best chance of a full recovery.

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