Impetigo in adults

Overview

Impetigo is a common, highly contagious bacterial skin infection. It causes sores or blisters, often around the nose and mouth, that can break open, ooze fluid, and form a honey-colored crust.

Yes, impetigo is very common, especially in young children. Adults can also get it, particularly if they have close contact with an infected person or have a weak immune system.

Impetigo most often affects children aged 2 to 5 years, but it can affect adults of any age. Adults may be more likely to get it if they live in crowded conditions, play contact sports, have skin injuries, or have conditions like eczema.

Symptoms

Common symptoms

• Red sores or blisters, usually around the nose, mouth, hands, or arms
• Blisters that burst and ooze fluid, then form a yellow or honey-colored crust
• Itching around the sores
• Sores that may be painful or feel tender

Symptoms in children

• Sores often appear on the face, especially around the nose and mouth
• Scratching can spread the sores to other parts of the body
• Some children may have mild fever or swollen glands near the sores

Symptoms in older adults

• Sores may appear on areas of skin that are already damaged, like cuts or pressure sores
• Healing may take longer if the person has other health conditions such as diabetes
• Older adults may have a higher risk of the infection spreading deeper into the skin

Causes

Main causes

• Bacteria called Staphylococcus aureus (staph) or Streptococcus pyogenes (strep) entering the skin through a cut, scrape, or insect bite
• Direct contact with the sores of someone who has impetigo
• Touching items like towels, clothing, or toys that have been in contact with infected skin

Risk factors

• Close contact with an infected person, such as in a household or school
• Playing contact sports like wrestling or football
• Having skin conditions like eczema, poison ivy, or minor injuries
• Crowded living conditions or poor hygiene
• Weak immune system due to illness or medication

When to see a doctor

See a doctor urgently if:

• If the sores spread quickly or get very large
• If you have a fever or feel very unwell

Book a routine appointment if:

• If you have sores that do not heal or get worse after a few days
• If you think you or your child might have impetigo

Diagnosis

A doctor or nurse can usually diagnose impetigo by looking at the sores. They may ask about your symptoms and any contact you’ve had with someone who has it.

Tests that may be done

• In rare cases, a swab of the fluid from a sore may be taken and sent to a lab to find out which bacteria are causing the infection.

What to expect at your appointment

The doctor will check the sores and may lightly touch one with a sterile swab. This is quick and usually not painful. They will then recommend treatment based on the likely cause.

Treatment

Impetigo is usually treated with antibiotics, either as a cream or ointment for mild cases, or as pills or liquid for more widespread infections. Treatment helps clear the infection faster and reduces contagiousness.

Self-care at home

• Gently wash the sores with warm soapy water and remove the crusts a few times a day.
• Keep the sores covered with a bandage or clothing to avoid spreading.
• Avoid scratching the sores — keep fingernails short and consider wearing gloves at night.
• Wash your hands thoroughly and often, especially after touching the sores.
• Do not share towels, bedding, or clothing until the sores are healed.

Medical treatments

Your doctor may prescribe an antibiotic cream or ointment to apply to the sores. For more severe or widespread impetigo, they may prescribe oral antibiotics (pills or liquid). It is important to use the medication exactly as directed and finish the full course, even if the sores start to heal. Do not share your medicine with anyone else.

When is surgery considered?

Surgery is not usually needed for impetigo. In very rare cases, if an abscess (a pocket of pus) forms, a doctor may need to drain it.

Living with this condition

While you have impetigo, try to stay away from others as much as possible until the sores have healed or you have been on treatment for at least 48 hours. Cover sores with a bandage, wash your hands often, and do not share personal items.

Lifestyle tips

• Keep your skin clean and dry.
• Change towels, washcloths, and bedsheets daily while infected.
• Wash clothes and linens in hot water.
• Avoid close contact sports or swimming until sores are healed.

Diet and exercise

Eating a healthy, balanced diet supports your immune system, which can help your body fight the infection. Gentle exercise is fine as long as you feel well, but avoid activities that might spread sores to others or cause skin injury.

Mental health and emotional wellbeing

Impetigo sores can be unsightly and may cause embarrassment, especially for adults. Remember that it is a common medical condition and not your fault. Talk to your doctor if you feel anxious or self-conscious about it.

Prevention

Impetigo can often be prevented with good hygiene. Wash hands frequently with soap and water, especially after touching wounds or using the toilet. Clean and cover any cuts, scrapes, or insect bites. Avoid sharing towels, razors, or bedding.

Vaccines

There is no vaccine for impetigo.

Screening programmes

There is no routine screening. If you have skin problems like eczema, keeping them well managed can reduce your risk.

Complications

If left untreated

• The infection can spread to deeper layers of skin, causing cellulitis (a more serious skin infection).
• Rarely, the bacteria can enter the bloodstream and cause a serious illness called sepsis.
• In very rare cases, untreated strep infections can lead to kidney inflammation (glomerulonephritis).

Long-term outlook

With treatment, most people with impetigo get better within a week or two. Even without treatment, it often clears up on its own within a few weeks. The outlook is very good, and scarring is uncommon. Taking the full course of prescribed medicine and practicing good hygiene can help prevent it from coming back or spreading to others.

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