Definition and Causes
- Impetigo is a bacterial skin infection that is very common in children.
- It is caused either by contact with another person or a contaminated surface (Ex: the benches in a locker room), or from contact with his/her own nasal flora being spread into a break in the skin, such as a bite or scratch.
- The most common bacteria’s causing impetigo are strep or staph.
- It typically begins as small red bumps (or a single lesion), which then grow into coin-shaped sores with honey-colored scabs or crusts.
- Once present, impetigo is spread by scratching. The bacteria can be left under fingernails and can then be passed to another location on the skin. It’s very important not to pick at the sores.
- The diagnosis is easy by appearance on examination
- Culturing the sore isn’t required to diagnose the infection, though occasionally this may be done.
- Wash and bandage: Clean the area well with soap and water and then apply antibiotic ointment (see below) and a Band-Aid to prevent scratching and spread.
- Antibiotic ointment: Treat with an over the counter ointment such as Bacitracin, Polysporin, or Triple Antibiotic ointment applied 3 times/day. Sometimes we will send a prescription for a slightly stronger antibiotic ointment called Mupirocin (Bactroban). One time per day, It is also helpful to apply ointment under the nails and inside both nostrils, to prevent spread of impetigo (don’t put under nails if child puts hands in mouth). In addition to topical antibiotics, occasionally an oral antibiotic may be prescribed.
- Preventing spread: Launder sheets and towels often. After bathing, dry lesions separately so that the same towel does not dry skin with impetigo and unaffected skin. Don’t bathe with siblings. Throw away used tissues promptly so that the infection can’t be spread to a surface where the tissue is left or to another person who picks it up.
Return to School and Sports
- Children can return to school 24 hours after beginning an antibiotic (ointment or oral) and draining lesions should be kept covered.
- Children can return to contact sports once they have been on antibiotics for 3 days, as long all there are no remaining lesions with pus or drainage.
- Impetigo sore gets bigger or more develop after 48 hours on antibiotic (ointment or oral)
- Sores are not healed in 1 week
- Fever develops or he/she becomes worse
- You think your child needs to be seen