Impetigo

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Introduction

What is impetigo?

Impetigo is a highly contagious bacterial infection of the uppermost layers of the skin. It is most commonly caused by streptococcal or staphylococcal bacteria. Impetigo generally occurs when these bacteria enter the top layers of the skin through an abrasion or lesion and form an infection. While impetigo is most common in young children between the ages 2-5, primarily children living in unsanitary conditions, it is possible to develop impetigo as an adult.

Impetigo can develop anywhere on the body, although it is most common on the extremities. It spreads easily through fluids that leak from blisters that form as part of the disease. Affected individuals usually have more than one lesion. Many people who have impetigo will develop a rash that is associated with the disease. Symptoms of impetigo usually begin within one to three days after infection.

Impetigo can develop anywhere on the body, although it is most common on the extremities. It spreads easily through fluids that leak from blisters that form as part of the disease. Many people who have impetigo will develop a rash that is associated with the disease. Symptoms of impetigo usually begin within one to three days after infection.

Impetigo is fairly easily treated with topical or oral antibiotics. However, it may recur even after successful treatment, particularly in young patients.

Since the development of impetigo is an indication of a bacterial infection, you should seek prompt medical care if you experience any of the symptoms of impetigo, such as sores that contain pus; redness, warmth, or swelling; or an itchy rash. Seek immediate medical care (call 911) for serious symptoms, such as difficulty breathing, loss of consciousness, or high fever (higher than 101 degrees Fahrenheit), as these could be signs of a life-threatening condition.

Symptoms

What are the symptoms of impetigo?

Symptoms of impetigo include blisters that may leak fluid, as well as itching and rash. These symptoms are relatively easy to spot and can aid your health care provider in identifying the disease and preparing an appropriate treatment plan.

Common symptoms of impetigo

You may experience impetigo symptoms daily or just once in a while. At times any of these symptoms can be severe:

  • Formation of pus-filled blisters
  • Itching feeling
  • Rash
  • Redness, warmth or swelling
  • Sores that leak fluid and crust over

Serious symptoms that might indicate a life-threatening condition

In some cases, impetigo may accompany a deeper or more widespread infection that can be serious or life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Confusion or loss of consciousness for even a brief moment
  • Difficulty breathing or rapid breathing
  • High fever (higher than 101 degrees Fahrenheit)
  • Increase in size of nearby lymph nodes (lymphadenopathy)

Causes

What causes impetigo?

Impetigo is caused by the infiltration of bacteria, usually Streptococcus or Staphylococcus, into the upper layers of your skin. These bacteria typically enter the skin through a lesion or abrasion, although you can develop impetigo through other kinds of injuries. Other common ways that the bacteria enter the skin include bite marks left by animals, insects, or other people.

Impetigo most commonly develops in young children, although it is possible to contract impetigo as an adult. Impetigo is contagious and is most easily spread by scratching the infected skin and spreading the fluids that leak from sores in the infected area. If you have impetigo, you should clean infected areas frequently. It is also important to wash your hands and any other body parts or materials that come in contact with infected areas to prevent the spread of infected fluid.

What are the risk factors for impetigo?

A number of factors increase the risk of developing impetigo. Not all people with risk factors will get impetigo. Risk factors for impetigo include:

  • Common cold (viral respiratory infection)
  • Contact dermatitis
  • Contact sports
  • Daycare environment
  • Development of abrasions or lesions on the skin
  • Unsanitary living conditions
  • Warm environment

Reducing your risk of impetigo

Since impetigo is contracted through invasion of bacteria into the upper layers of the skin, several simple habits can help you reduce your risk of developing impetigo including:

  • Cleaning skin abrasions and lesions promptly and applying an antibacterial agent
  • Maintaining clean living conditions

Treatments

How is impetigo treated?

Since impetigo is caused by a bacterial infection, it is treated through the use of antibiotics. There has been a significant rise in the number of community-based (outside of the hospital) antibiotic resistant skin infections. Laboratory culture testing will help determine the best antibiotic options. These antibiotics may be prescribed by a health care provider, and they may be administered either topically or orally.

Medical treatments for impetigo

Common medical treatments for impetigo include:

  • Topical antibiotics, such as mupirocin (Bactroban)

  • Oral antibiotics, such as cephalexin (Keflex) or penicillins

What you can do to improve your impetigo

In addition to taking antibiotics to treat the bacterial infection that causes impetigo, you can also prevent your impetigo from spreading by:

  • Avoiding scratching the affected areas

  • Cleaning infected areas of skin frequently with an antibacterial soap

  • Keeping your hands clean and washing any other body parts or materials that come in contact with infected areas

  • Using a nonadhesive dressing to cover affected areas to prevent spread

What are the potential complications of impetigo?

The most common potential complication of impetigo is the spreading of the disease. Since impetigo is contagious, it may be spread to other people or to other parts of the body. Care should be taken to reduce exposure of the infected areas to other people and to prevent the spread of liquids from the infected area to other parts of your own body.

Glomerulonephritis, an inflammation of critical structures in the kidney, is a rare complication of Streptococcus infections.

Although not common, complications of untreated impetigo can be serious or life threatening. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of impetigo include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Impetigo. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/impetigo/Pages/Default.aspx
  2. Impetigo. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000860.htm
  3. Koning S, van der Sande R, Verhagen AP, et al. Interventions for impetigo. Cochrane Database Syst Rev 2012; 1:CD003261.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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