Impetigo

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KEY POINTS

• Impetigo is a skin infection caused by Staphylococcus or Streptococcus bacteria. The infection begins as one or more blisters. The blisters form pus inside and then break open.
• If the infection is mild, all you may need to do is keep your skin clean so the infection can heal on its own. Your healthcare provider may prescribe an antibiotic for larger or more serious infections.
• Ask your provider how to take care of yourself at home, if there are activities you should avoid, and when you can return to your normal activities.

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What is impetigo?

Impetigo is a skin infection caused by bacteria. It is more common in children than in adults. Impetigo is usually a mild infection but it can spread and cause serious illness if it is not treated.

What is the cause?

Impetigo is caused by Staphylococcus or Streptococcus bacteria. These bacteria usually live on your skin without hurting you. However, if the bacteria get into the deeper layers of the skin, they may cause an infection. This can happen if you have a skin condition like eczema, or if you have a scratch, scrape, insect bite, or other irritation that causes a break in the skin. Impetigo is more common when it is hot and humid.

Scratching the infected area and then touching other parts of your body can spread the infection. Impetigo is very contagious. Physical contact can spread the infection to other people. It can also be spread by contaminated clothing, sports equipment, towels, bedding, and toys.

What are the symptoms?

Impetigo can infect any part of the body, but often appears on the face between the upper lip and nose. The infection begins as one or more blisters. The blisters form pus inside and then break open. The pus from the blisters usually dries as a gold or yellow-colored crust. The blisters or sores are painless, but may itch.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine your skin. Your provider may use a swab to get a sample of fluid from one of the sores. The sample is sent to the lab and tested. If you have an infection, it may take several days to find out what kind of germ is causing it. Knowing what germ is causing the infection helps your provider choose the right medicine to treat it.

How is it treated?

The treatment depends on your age and the severity and type of infection that you have. If the infection is mild, all you may need to do is keep your skin clean so the infection can heal on its own. Your healthcare provider may recommend a nonprescription antibiotic ointment or prescribe one for you to put on your skin.

Some people carry the bacteria inside their nose and the infection may come back if the nose is not treated. Your provider will tell you if you need to put some of the antibiotic ointment inside your nose and for how long.

For larger or more serious infections, your provider may prescribe an antibiotic to take by mouth or give you a shot of antibiotic medicine.

The sores should start to heal within 2 to 5 days after you start using an antibiotic. If you are taking antibiotic medicine, the infection usually stops being contagious after 24 hours of treatment. If you are using an antibiotic ointment instead, the sores will no longer be contagious when they stop oozing and are drying up.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. If your provider prescribed an antibiotic to take by mouth, take the medicine for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and the infection may come back.

In addition, you can:

• Gently wash the infected area with antibacterial soap.
• To remove the crusts, first soak the area for 15 to 20 minutes in warm soapy water. Then gently remove the crusts with a warm washcloth.
• Don’t share hand towels with others while you have this infection.
• Wash any washcloths or towels you use in hot water separately from other laundry.
• Cover sores on the face with a bandage if necessary to prevent scratching, especially when sleeping. Cover any sores that are draining with a bandage to protect clothing and prevent spread. Wash your hands after touching the area.
• Shave around sores, not over them.
• Avoid touching the sores as much as possible.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent impetigo?

• Wash cuts and scratches, insect bites, or other breaks in the skin with warm water and soap right away to prevent infection. Cover the area with a bandage.
• Wash your hands often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also wash your hands before eating or touching your eyes.
• Do not share washcloths, towels, clothing, sleeping bags, bedding, bath water, or personal items like razors or combs.
• Avoid sharing sports equipment, such as football pads, as much as possible.
• Use hot, soapy water to wash clothes and bedding. Dry clothes on the hot setting if you use a dryer.
• Shower or bathe using soap every day and after you exercise.

In sports such as wrestling, where there may be close contact, athletes who have impetigo should not compete while they have the infection. It’s also important to keep mats and equipment clean.