You’ve heard our skin is covered with bacteria, and it’s true! These so-called “good” bacteria take up space on our body’s surface and prevent disease-causing bacteria from moving in. But even good bacteria can become a problem when there is a breakdown of our skin’s protective barrier. Sometimes the breakdown is large, such as a scratch or scrape. Other times the breakdown is small. Something as simple as dry skin or an insect bite can allow surface bacteria to invade.
How the infection looks depends on the type of bacteria, the location on the body, how deep the bacteria go and our immune system’s response to the infection. When bacteria infect a wide patch of skin, we call it “cellulitis.” When it goes deep and forms a pocket of pus, we say an “abscess” has formed.
Another type of skin infection is called “impetigo.” We use this name when the infection is small and superficial, meaning it is limited to the very top layers of skin. Bacteria that cause this type of infection usually live in the nose and spread to our fingers when we rub, blow or pick. Our fingers move the bacteria to other parts of the body, and impetigo results when these bacteria settle on broken down skin and invade.
Impetigo is common on the face, especially around the nose and mouth. We also see it on arms and legs and under the diaper. Group A Streptococcus (which also causes strep throat) and Staphylococcus aureus are the most common causes of impetigo.
What Does Impetigo Look Like?
Impetigo usually begins as small sores that are red and a little itchy. These sores tend to break open and leak a small amount of clear fluid. As the fluid dries, it forms a crusty, yellow or “honey-colored” scab on top of the sore. Sometimes small blisters appear, which also leak and scab. Impetigo can be limited to one area of skin or many lesions can appear at various locations.
How Do We Treat Impetigo?
If the skin infection is small and limited to a particular area, topical antibiotics can be applied directly to the sore. These work best when scabs are soaked with soap and warm water and then gently removed before applying the antibiotic ointment. Large or widespread impetigo may require an oral antibiotic. If you suspect your child has impetigo, contact his or her medical provider to determine the best course of treatment.
Can Impetigo Become Dangerous?
It can! The bacteria might invade more widely or deeply, resulting in cellulitis or an abscess. They can also work their way into the bloodstream and travel to other parts of the body. It is important to watch for symptoms, such as increasing redness, swelling, pain, pus or bloody drainage, fever or vomiting. If these or other concerning symptoms develop, let your child’s doctor know right away.
Can We Prevent Impetigo?
Yes! Tips for preventing impetigo make sense when we think about how these skin infections form. Treat dry skin with moisturizing lotion or cream. Clean scratches, scrapes and insect bites with soap and water. Avoid rubbing or picking the nose. And wash hands often, especially after using the restroom or blowing your nose.
Dr Mike Patrick is an Assistant Professor of Pediatrics at the Ohio State University College of Medicine and Medical Director of Interactive Media for Nationwide Children's Hospital. Since 2006, he has hosted the award-winning PediaCast, a pediatric podcast for parents. Dr Mike also produces a national podcast for healthcare providers—PediaCast CME, which explores general pediatric and faculty development topics and offers free AMA PRA Category 1 Credit™ to listeners.
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