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Impetigo, bullous on the buttocks
Impetigo, bullous on the buttocks

Impetigo on a child's face
Impetigo on a child's face

Impetigo

Definition:

Impetigo is a common skin infection.



Causes, incidence, and risk factors:

Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA ) is becoming a common cause.

The skin normally has many types of bacteria on it. When there is a break in the skin, bacteria can enter the body and grow there. This causes inflammation and infection. Breaks in the skin may occur with:

  • Animal bites
  • Human bites
  • Injury or trauma to the skin
  • Insect bites

Impetigo may also occur on skin where there is no visible break.

It is most common in children who live in unhealthy conditions. 

In adults, it may occur following another skin problem. It may also develop after a cold or other virus.

Impetigo can spread to others. You can catch the infection if the fluid that oozes from the blisters touches an open area on your skin.



Symptoms:

Symptoms of impetigo are:

  • One or many blisters filled with pus that are easy to pop. In infants, the skin is reddish or raw-looking where a blister has broken. 
  • Blisters that itch:
    • Filled with yellow or honey-colored fluid
    • Oozing and crusting over
  • Rash that may begin as a single spot, but spreads to other areas with scratching
  • Skin sores on the face, lips, arms, or legs, that spread to other areas
  • Swollen lymph nodes near the infection ()


Signs and tests:

Your health care provider will look at your skin to determine if you have impetigo.

The health care provider may take a sample of bacteria from your skin to grow in the lab.This can help determine if MRSA is the cause. Specific antibiotics are needed to treat this type of bacteria.



Treatment:

The goal is to cure the infection and relieve the symptoms.

Your doctor will prescribe an antibacterial cream. You may need to take antibiotics by mouth if the infection is severe.

Wash (do not scrub) the skin several times a day with an antibacterial soap to remove crusts and drainage.



Support Groups:



Expectations (prognosis):

The sores of impetigo heal slowly. Scars are rare. The cure rate is very high, but the problem often comes back in young children.



Complications:
  • Kidney failure (post-streptococcal glomerulonephritis ) (rare)
  • Many patches of impetigo (in children)
  • Permanent skin damage and scarring (very rare)
  • Spread of the infection to other parts of the body (common)


Calling your health care provider:

Call your health care provider if you have symptoms of impetigo.



Prevention:

Prevent the spread of infection.

  • If you have impetigo, always use a clean washcloth and towel each time.
  • Do not share towels, clothing, razors, and other personal care products with other family members.
  • Avoid touching blisters that are oozing.
  • Wash your hands thoroughly after touching infected skin.

Keep your skin clean to prevent getting the infection. Clean minor cuts and scrapes well with soap and clean water. You can use a mild antibacterial soap. 



References:

Habif TP. Bacterial infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 9.

Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 90.


Morelli JG. Cutaneous Bacterial Infections. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 657.





Review Date: 11/20/2012
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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