Impetigo: overview and more


Impetigo is a highly contagious bacterial skin infection that causes sores and honey-colored scabs or blisters. It can be itchy and painful, and this happens when skin, especially already irritated or damaged skin, comes into contact with the common type of staph or strep bacteria in the throat .

Impetigo can happen to anyone, but it generally affects infants and children and is most common between the ages of 2 and 5. People diagnosed with impetigo are usually treated with topical antibiotics or oral antibiotics to avoid complications and prevent its spread.

Types and symptoms of impetigo

Impetigo in the hand of a child. Matthew Roberge / Getty Images

There are three types of impetigo, which are classified according to the appearance of the infected skin and the depth of penetration of the infection into the layers of the skin .

Although there are some common areas where impetigo begins, untreated infections can quickly spread to other parts of the baby's body. Pain and itching can occur with all types of impetigo, and scratching can further spread the infection.

Non-bullous impetigo (contagious impetigo)

V The most common form of impetigo, it affects only the outermost layers of the skin, called the epidermis . This often occurs in areas where the skin has been damaged, irritated, or damaged.

The nasal passages are usually affected, especially in children with a runny nose. The face, neck, and arms are other areas of the body where injuries can be seen.

Main features:

  • It begins with red, itchy sores that drain clear fluid or pus for several days.
  • Then, crusty, honey-colored lesions appear on the ulcers.

Bullous impetigo

Bullous impetigo also affects the epidermis. It tends to form in areas where the skin folds or rubs against other skin, including the arms, legs, torso, buttocks, armpits, and groin .

Main features:

  • It all starts with bubbles filled with liquid.
  • The lesions are much larger and can remain on the skin longer before bursting.
  • The lesions may secrete a yellow fluid.

Ecthyma (deep impetigo)

This is a more serious bacterial infection than It enters the deepest layer of the dermis skin.

Main features:

  • It begins with a pustule; blisters are painful.
  • The blisters turn into deep, perforated ulcers; a brownish-black crust may also form.

When to contact a healthcare provider

If you notice painful or itchy red bumps, honey-colored sores, or blisters on your child's skin, see a pediatrician right away so it can be treated to prevent it from spreading to other parts of the child or other people.

If your child has a high fever, swollen glands, blood in the urine, or is flabby, seek emergency medical attention.


Impetigo can occur when exposed to the skin:

  • Staphylococcus aureus , a type of staph that causes various types of skin infections and other problems.
  • Group A streptococcus (GAS or group A streptococcus, also known as Streptococcus pyogenes) , also responsible for strep throat, cellulitis , and other infections.

The possible culprit for impetigo ultimately depends on its type .

Type of impetigo Caused by S. aureus Caused by group A streptococcus
Not blistering

Ecthyma can be the result of untreated impetigo, which develops into a deeper infection.

Impetigo can develop as a primary infection when bacteria invade normal skin, or as a secondary infection when bacteria invade already irritated or broken skin, such as from a wound, insect bite , poison ivy , eczema , herpes , or scabies .

The cause of the spread is direct contact with infected foci. This can happen in different ways and with different settings, for example:

  • When a child scratches an infected area and then touches another part of their body.
  • Hugging, shaking hands, or other forms of direct contact with an infected person
  • Playing certain sports like wrestling.
  • Crowded places like schools or kindergartens .

The S. aureus bacteria generally colonize (live) on the skin of children and adults. It is found especially in the nose, so it can be easily spread if children pick their noses.

Although technically a step separates you from direct contact, the infection can also spread by touching the clothing, towels, or sheets of an infected person.

The bacteria that cause impetigo thrive in warm, humid environments, while infections are more common in tropical or subtropical climates .


The diagnosis of impetigo is usually made after a doctor examines the skin and detects a typical infection.

A healthcare professional may also want to do a culture if they suspect that the impetigo is caused by resistant bacteria, such as MRSA (methicillin-resistant Staphylococcus aureus) , or if the rash persists.

Watch out

For small areas of infection, an over-the-counter or prescription topical antibiotic is usually sufficient. You will also need to regularly wash the affected area with soap and warm water and then cover it with a bandage to prevent it from spreading to other people.

For more extensive or persistent infections, an oral or intravenous antibiotic may be necessary. For example, ecthyma is usually treated with oral antibiotics.

MRSA is resistant to many of the antibiotics commonly used to treat impetigo, including Keflex (cephalexin), Augmentin (amoxicillin, clavulanic acid) , Zithromax (azithromycin) , and cefdinir. If MRSA is causing the infection, a stronger antibiotic such as Cleocin (clindamycin) or Bactrim (sulfamethoxazole, trimethoprim) may be needed.

Once treatment is started, the infection should clear up in a few days. If you don't notice a change, tell your doctor, as you may need a different medicine.

Repeated infections

Impetigo can be obtained more than once. If impetigo or other staph skin infections continue to occur, your doctor may recommend that everyone in your family be treated with antibiotics, such as bactroban nasal gel (mupirocin) , twice a day for five to seven days.

Other measures may also be recommended, such as baths with Hibiclens (an antiseptic and antimicrobial skin cleanser) and frequent hand washing.

How long is impetigo contagious?

Children generally stop being infectious after taking antibiotics for 24 to 48 hours, there is no more discharge from the lesions, and signs of improvement are seen .


Most cases of impetigo resolve without complications or scarring. If a scar appears, it is usually due to a deep infection of the ecthyma. In these cases, you can go to a dermatologist who will suggest a treatment to minimize the appearance of a scar.

In very rare cases, impetigo can lead to serious complications if left untreated. They may include:

  • Post-streptococcal glomerulonephritis , Inflammation of the kidney filters, which can develop after a group A streptococcal infection. This can lead to hematuria (bloody urine) and high blood pressure .
  • Scarlet fever a disease caused by group A streptococci, characterized by fever, rash and redness of the tongue
  • Septicemia , a serious infection of the bloodstream caused by bacteria.

Get the word of drug information

As with most infections, one of the best preventative measures you can take to reduce the risk of impetigo or prevent the spread of an existing infection is to wash your hands frequently and for at least 20 seconds at a time .

Make sure children practice good hand hygiene, and if they have bites, scratches, or rashes, watch them closely and keep them clean and covered.

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