Impetigo in older adults

Overview

Impetigo is a common and highly contagious bacterial skin infection. It causes sores and blisters, often around the nose and mouth, but can appear anywhere on the body. In older adults, it may be more serious because the skin is thinner and the immune system is weaker.

Impetigo is most common in children, but it does occur in older adults, especially those living in close quarters like nursing homes, or those with existing skin conditions or weakened immune systems.

Older adults, particularly those over 65, are at higher risk if they have diabetes, poor circulation, skin conditions like eczema, or a weakened immune system. It can also affect caregivers or family members who are in close contact.

Symptoms

Common symptoms

• Red sores that quickly burst and ooze fluid, forming a honey-colored crust
• Blisters that can be itchy or slightly painful
• Swollen lymph nodes near the infection

Symptoms in children

• Sores often appear around the nose and mouth
• May also appear on arms, legs, or diaper area
• Children may scratch and spread the infection

Symptoms in older adults

• Sores may be larger and more widespread
• Healing can be slower due to thinner skin and weaker immunity
• Possible secondary infections, like cellulitis (a deeper skin infection)

Causes

Main causes

• Bacterial infection with Staphylococcus aureus or Streptococcus pyogenes
• Bacteria enters through a break in the skin, like a cut, scratch, or insect bite

Risk factors

• Living in crowded or shared spaces (nursing homes, assisted living)
• Having skin conditions such as eczema, psoriasis, or dermatitis
• Weakened immune system due to age, illness, or medications
• Poor hygiene or lack of access to clean water and soap
• Diabetes or circulatory problems

When to see a doctor

See a doctor urgently if:

• If you have signs of a severe infection (high fever, chills, spreading redness)
• If you have a chronic condition like diabetes and develop sores
• If sores are very painful or you feel generally unwell

Book a routine appointment if:

• For mild sores that do not improve with basic cleaning after a few days
• If you are unsure whether the sores are impetigo or something else

Diagnosis

A doctor can usually diagnose impetigo by looking at the sores. Sometimes they may take a small swab from a sore to send to a lab to confirm the bacteria type.

Tests that may be done

• Physical examination of the sores
• Skin swab culture to identify the bacteria

What to expect at your appointment

The doctor will ask about your symptoms, any recent skin injuries, and your overall health. The swab is painless and results come back in a few days.

Treatment

Impetigo is usually treated with antibiotics to kill the bacteria and prevent complications. Treatment can be topical (creams) or oral (tablets) depending on severity.

Self-care at home

• Gently wash the sores with soap and water and remove crusts daily
• Cover sores with a clean, dry bandage to prevent spreading
• Wash your hands frequently, especially after touching the sores
• Do not share towels, bed linens, or clothing until sores are healed

Medical treatments

Doctors may prescribe antibiotic creams for mild cases. For more widespread or stubborn infections, they may give oral antibiotics. Treatment typically lasts 5 to 7 days. It is important to complete the full course even if sores improve.

When is surgery considered?

Surgery is not needed for impetigo. Very rarely, if an abscess forms, a small drainage procedure may be done.

Living with this condition

You can manage impetigo at home while taking antibiotics. Keep sores clean and covered. Avoid close contact with others until the sores have crusted over and are no longer draining – typically 48 hours after starting effective treatment.

Lifestyle tips

• Wash your hands often with soap and water
• Clean and cover any cuts or scratches promptly
• Change bed linens and towels daily until sores heal

Diet and exercise

No specific dietary changes are needed. A balanced diet supports your immune system. Gentle activity is fine, but avoid contact sports or swimming until the infection clears.

Mental health and emotional wellbeing

Having visible sores can be embarrassing and cause anxiety, especially in older adults. Remember that impetigo is very treatable and not a reflection of poor hygiene. Talk to your doctor if you feel distressed.

Prevention

Yes, good hygiene is the best prevention. Wash hands regularly, clean and cover any skin breaks, avoid sharing personal items, and keep your skin moisturized to prevent cracking.

Vaccines

There is no vaccine for impetigo itself. However, staying up to date on vaccines that prevent skin infections (like tetanus) is wise. Ask your doctor.

Screening programmes

There is no routine screening for impetigo. If you have contact with someone who has it, watch for sores and see a doctor at the first sign.

Complications

If left untreated

• Cellulitis – a deeper skin infection that can spread
• Kidney inflammation (post-streptococcal glomerulonephritis) – rare but serious
• Scarring or changes in skin color
• Spread of infection to others, especially in close-contact settings

Long-term outlook

With proper treatment, most people with impetigo recover fully without long-term problems. In older adults, healing may take a little longer, but the outlook is excellent if you see a doctor early. Good skin care and hygiene can prevent recurrences.

Find support

Local organisations

• UK National Health Service (NHS) – Impetigo information · United Kingdom

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