Impetigo: Causes, Symptoms, Types, Treatment & Prevention

Impetigo is a common and highly contagious bacterial skin infection that mainly affects children, although adults can also develop it. It usually causes red sores, blisters, and yellowish or honey-colored crusts on the skin. Impetigo commonly appears around the nose and mouth but can develop on other parts of the body.

The infection is usually treatable with appropriate medical care. Early treatment can help reduce the risk of spreading the infection to other people and prevent complications.

What Is Impetigo?

Impetigo is a superficial bacterial infection of the skin. It commonly occurs when bacteria enter the skin through a small cut, scratch, insect bite, or damaged area.

The two bacteria most commonly associated with impetigo are Staphylococcus aureus and Streptococcus pyogenes.

Impetigo spreads easily through close contact and by sharing contaminated items such as towels, clothing, bedding, and personal belongings.

Types of Impetigo

There are three main types of impetigo:

1. Non-Bullous Impetigo

Non-bullous impetigo is the most common type. It usually begins as small red spots or blisters that break open and develop a characteristic honey-colored crust.

It commonly affects the face, especially around the nose and mouth, but can occur anywhere on the body.

2. Bullous Impetigo

Bullous impetigo causes larger, fluid-filled blisters. These blisters may appear on the trunk, arms, legs, or other areas of the body.

The blisters can break easily and leave moist areas of skin underneath.

3. Ecthyma

Ecthyma is a deeper form of bacterial skin infection that can develop from impetigo. It causes painful sores that may develop thick crusts and ulcers.

Ecthyma can take longer to heal and may leave scars.

What Causes Impetigo?

Impetigo is caused by bacteria that infect the outer layers of the skin. The most common bacteria responsible are Staphylococcus aureus and Streptococcus pyogenes.

The bacteria can enter the skin through:

• Cuts and scratches
• Insect bites
• Minor injuries
• Eczema or other skin conditions
• Scratching irritated skin
• Existing skin infections
• Broken or damaged skin

Sometimes impetigo can develop even when there is no obvious injury to the skin.

Is Impetigo Contagious?

Yes. Impetigo is highly contagious.

It can spread through direct skin-to-skin contact or by touching objects contaminated with fluid from infected sores.

The infection may spread from one area of the body to another when a person scratches the sores and then touches another part of their skin.

Children can easily spread impetigo at schools, daycare centers, playgrounds, and during close physical contact.

Impetigo Risk Factors

Several factors can increase the risk of developing impetigo.

Common risk factors include:

• Young age, especially preschool and school-age children
• Close contact with an infected person
• Warm and humid weather
• Crowded living conditions
• Poor access to hygiene facilities
• Existing skin conditions such as eczema
• Cuts, insect bites, or scratches
• Participation in contact sports
• A weakened immune system

Symptoms of Impetigo

The symptoms of impetigo can vary depending on the type of infection.

Common symptoms include:

• Red patches on the skin
• Small blisters
• Fluid-filled sores
• Sores that break open
• Honey-colored or yellowish crusts
• Itching
• Mild tenderness
• Skin irritation
• Enlarged nearby lymph nodes in some cases

Honey-Colored Crusts

One of the classic signs of impetigo is a yellow or honey-colored crust that forms after the sores break open and dry.

The crust may develop around the nose and mouth or on other areas affected by the infection.

Where Does Impetigo Usually Occur?

Impetigo can occur anywhere on the body, but it commonly affects:

• Face
• Around the nose
• Around the mouth
• Hands
• Arms
• Legs
• Trunk

Children frequently develop sores around the nose and mouth because these areas are commonly touched or scratched.

How Is Impetigo Diagnosed?

Doctors can usually diagnose impetigo by examining the affected skin and asking about symptoms.

In many cases, laboratory tests are not necessary.

A healthcare professional may recommend a skin swab or bacterial culture if:

• The infection keeps returning
• Treatment does not work
• The infection is severe
• Antibiotic-resistant bacteria are suspected
• The diagnosis is uncertain

Impetigo Treatment

Impetigo treatment depends on the number of sores, their location, and how severe the infection is.

1. Topical Antibiotics

For a small number of localized sores, a doctor may prescribe a topical antibiotic.

The medicine is applied directly to the affected skin as instructed.

2. Oral Antibiotics

Doctors may prescribe oral antibiotics when impetigo is widespread, severe, or involves multiple areas of the body.

Antibiotics should be taken exactly as prescribed. Do not stop treatment early unless your healthcare professional advises you to do so.

3. Cleaning the Affected Skin

Gently cleaning the affected area can help remove crusts and reduce bacteria on the skin.

Use clean water and mild soap unless your healthcare professional recommends another method.

Avoid aggressively scrubbing the sores because this can irritate the skin and potentially spread the infection.

How Long Does Impetigo Take to Heal?

With appropriate treatment, impetigo often begins to improve within a few days. The exact healing time depends on the severity of the infection and the treatment used.

If symptoms are not improving after treatment or become worse, contact a healthcare professional.

How to Prevent Impetigo From Spreading

Because impetigo is contagious, preventing transmission is important.

You can reduce the risk of spreading impetigo by:

• Washing your hands regularly
• Keeping infected sores clean and covered when appropriate
• Avoiding scratching the sores
• Keeping fingernails short
• Avoiding close skin-to-skin contact while the infection is contagious
• Not sharing towels or clothing
• Washing bedding and clothing regularly
• Cleaning commonly touched surfaces
• Avoiding sharing personal items such as razors

Children with impetigo may need to stay away from school or daycare for a period recommended by their healthcare professional.

Can You Prevent Impetigo?

Good skin hygiene can reduce the risk of impetigo.

Clean cuts, scratches, and insect bites with soap and water and keep them protected while they heal. People with eczema should follow their treatment plan because damaged or irritated skin can increase the risk of bacterial infection.

If someone in the household has impetigo, avoid sharing towels, clothes, bedding, and other personal items.

When Should You See a Doctor?

Contact a healthcare professional if:

• The sores are spreading quickly
• There are many sores
• The infection is painful or severe
• The skin around the sores becomes increasingly red or swollen
• There is fever
• The infection is near the eyes
• Symptoms do not improve with treatment
• Impetigo keeps coming back
• A child develops widespread skin sores

Prompt medical evaluation is particularly important if the infection appears severe or is affecting a young child.

Possible Complications of Impetigo

Most cases of impetigo resolve with appropriate treatment. However, complications can occasionally occur.

Possible complications include:

• Cellulitis
• Deeper skin infection
• Ecthyma
• Scarring, particularly with ecthyma
• Post-streptococcal glomerulonephritis, a rare kidney complication associated with certain streptococcal infections

Seek medical care if new or unusual symptoms develop after an impetigo infection.

Impetigo vs. Other Skin Conditions

Several skin conditions can look similar to impetigo. These include:

• Eczema
• Cold sores
• Contact dermatitis
• Fungal skin infections
• Insect bites
• Chickenpox

Because treatment differs between these conditions, it is important to get a medical evaluation when the diagnosis is uncertain.

Frequently Asked Questions About Impetigo

Is impetigo a serious infection?

Impetigo is usually a mild and treatable skin infection. However, it is highly contagious and can occasionally cause complications, so appropriate treatment is important.

Can adults get impetigo?

Yes. Although impetigo is especially common in children, adults can also develop the infection.

Does impetigo go away on its own?

Some mild cases may resolve without treatment, but because impetigo spreads easily and can cause complications, medical advice is recommended. Antibiotic treatment may be necessary.

Can impetigo spread to other parts of the body?

Yes. Scratching infected sores can transfer bacteria to other areas of the skin and cause new lesions.

Is impetigo caused by poor hygiene?

Not necessarily. Impetigo can affect anyone. However, good hygiene and proper care of cuts and skin injuries can help reduce the risk of infection and transmission.

Can you get impetigo more than once?

Yes. Having impetigo once does not provide permanent protection. A person can develop the infection again.

Final Thoughts

Impetigo is a contagious bacterial skin infection that commonly causes red sores, blisters, and honey-colored crusts. It is most common in children but can affect people of any age. The infection is generally treatable with appropriate medical care.

Keeping the skin clean, avoiding scratching, not sharing personal items, and following prescribed treatment can help control the infection and prevent it from spreading.

If you or your child develops rapidly spreading sores, severe symptoms, fever, or an infection that does not improve, consult a healthcare professional for proper diagnosis and treatment.