What is it about ?
Impetigo is a skin infection that can be caused by two types of bacteria: a staphylococcus (Staphylococcus aureus) or streptococcus (group A beta-hemolytic streptococcus).
Children and adults can carry this bacteria (for example in the nose) without developing impetigo. Usually, the bacteria are spread through infected hands or toys; sometimes the infection is caused by coughing or sneezing. You are more likely to get impetigo if you have eczema because eczema makes your skin more vulnerable to infections.
Children are more often affected by impetigo than adults. The infection usually starts around the nose or mouth, but can spread all over the body. Impetigo is always treated, because it is contagious and it spreads easily in the family, at nursery, daycare and at school. Contamination is possible as long as the wounds have not dried or healed.
Where and how often?
Impetigo mainly occurs in children, with a peak in the age group of 1 to 9 years. The number of cases has increased in recent years.
How to recognize it?
Skin infection caused by streptococci is usually characterized by scabs or small ulcers. Staph infection tends to blister. The infection often starts where the skin is already damaged (scratch, scratch lesion, or eczema).
Usually the skin is affected around the nostrils and chin, but scabs also often appear in other places, starting with sores or red macules and sometimes vesicles filled with yellow fluid (pus). The inflamed sites can also coalesce and spread all over the body.
How is the diagnosis made?
The doctor will take a good look at your whole body for any small lesions. He will be able to distinguish impetigo from other conditions such as cold sores (herpes simplex) or infection by a fungus (yeast infection). In the event of lesions which recur regularly on the scalp or in the nape of the neck, the possibility of a lice infestation should be considered. The doctor may optionally take a sample of the lesions using a small swab and send it to the laboratory to check which bacteria is causing the infection and which antibiotic would be preferred.
What can you do ?
In case of suspicion of impetigo, it is best to consult the doctor without delay. Impetigo should always be treated to avoid infecting other people.
Wash your hands well before and after applying the treatment. This will prevent you from infecting other parts of your body. Trim your fingernails cleanly and do not try to touch or scratch the lesions. Preferably, use a new towel every day and only use it for yourself to avoid infecting other people as much as possible.
It is important to gently wash and remove scabs before applying antibiotic ointment. The bacteria can indeed survive under the scabs and maintain the infection, so that the treatment does not work enough.
What can your doctor do?
Treatment depends on the extent and appearance of the impetigo. The doctor will check if:
- the disease is confined to a small area: in this case, the treatment consists of washing and removing the scabs and applying antibiotic ointment;
- the disease is more extensive (from more than 6 cm2): an antibiotic in the form of a tablet is necessary;
- there is underlying eczema on the skin: this case requires an ointment based on corticosteroids and a local antibiotic, combined with an antibiotic in tablet form until the skin is healed. Then you have to tackle the eczema.
Self-contamination with bacteria from the nose often causes the infection to come back (recurrence). That is why it is important to apply the antibiotic ointment to the nostrils as well.
Your doctor will also be vigilant if streptococci are the cause of impetigo. People affected by this form of impetigo sometimes later develop inflammation of the kidney filters (glomerulonephritis). If there is any suspicion, the doctor will check your urine for the presence of blood cells and proteins and, if necessary, refer you to a specialist doctor.
Want to know more?
- Impetigo: a skin infection – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Impetigo (image) – DermIS – Dermatology Information System
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