Impetigo

What is the best treatment for impetigo? Recommendations to minimize the risk of contagion.

Symptoms and Causes

Impetigo is a highly contagious skin infection caused by bacteria of the staphylococcus or streptococcus type. In most cases, it presents with reddish superficial ulcers around the mouth and nose, which can spread to the hands and feet through discharge. After about a week, the lesions open, ooze for a few days, and eventually form honey-colored scabs.

There are three different types of impetigo known:

Vulgar Impetigo: It presents small wounds that gradually turn into scabs. It is the most common.
Bullous Impetigo: Causes larger lesions in the form of blisters that take longer to open.
Ecthyma: Known as deep impetigo because the vesicles penetrate the skin, presenting an ulcer-like appearance and forming yellowish scabs.

Although anyone can contract this skin disease, infants and children are more likely to develop it.

Symptoms

Impetigo symptoms are very easy to recognize, although they vary slightly depending on the variant contracted. The most prominent symptoms are:

Reddish ulcers on the face, especially around the nose and mouth.
Yellowish discharge from the lesions when they break open.
Brownish scabs after all the liquid has drained.
Large blisters in the case of bullous impetigo, which may also form on the trunk.
Ulcers with pus in the case of ecthyma.
Mild pain caused by the skin lesions.
Light itching in the affected area.

Causes

Impetigo is caused by staphylococcus bacteria, though streptococci can also be responsible. Contagion occurs through direct contact with others who have impetigo or by sharing objects or clothing.

Risk Factors

Some circumstances that increase the likelihood of contracting impetigo include:

Age: Young children are most prone to contracting it, especially between the ages of two and five.
Contact with infected individuals: It is common for children to catch it in daycare or school.
Previous skin injuries: Insect bites or wounds, as bacteria take advantage of these openings to access the skin.
Other skin conditions.
Weakened immune system.
Climate: Heat and humidity facilitate the infection.

Complications

Impetigo is a mild disease and it is not common for it to cause major health problems or scars on the skin. However, in rare cases, it may lead to serious complications such as:

Scarring: After the scabs from ecthyma sores fall off.
Bacterial kidney problems: Especially post-streptococcal glomerulonephritis, an inflammation of the capillaries responsible for filtering urine in the kidneys.
Infection in the deeper layers of the skin: It can spread to the blood or lymph nodes.

Prevention

Although impetigo is highly contagious, the risk of contracting it can be reduced by keeping the skin clean at all times. When wounds, eczema, or insect bites occur, it is essential to wash the area to keep it as healthy as possible.

To prevent transmission to others when having impetigo, the following actions can be included in the daily routine:

Gently clean the affected area frequently.
Wash clothes, sheets, and towels daily.
Keep nails short to minimize damage in case of scratching.
Use gloves to apply medication.
Maintain proper hand hygiene.
Stay at home until the disease is no longer contagious.

Diagnosis

No special tests are needed to diagnose impetigo, as observing the lesions is enough for a doctor to identify it. A physical examination is, therefore, the usual procedure for detection.

In some cases, the disease does not resolve despite medication. In these instances, a sample of the discharge is usually taken to be analyzed in a laboratory to find the most suitable antibiotic to treat the infection.

Treatment

As impetigo is a bacterial infection that causes sores or blisters on the skin, topical antibiotics are the best way to treat it. Mupirocin creams are typically prescribed. To enhance their effectiveness, it is recommended to follow these steps: