SKINIPEDIA - Skin Encyclopedia: IMPETIGO (school sores)

Impetigo - School Sores

Summary

Impetigo, or school sores, is a highly contagious skin infection caused by the bacteria, Staphylococcus and Streptococcus. The infection is characterised by inflamed blisters that pop, weep and form crusts. Treatment options include antibiotic creams or ointments and syrups or tablets.

Impetigo is a skin infection caused by the Staphylococcus or Streptococcus bacteria. It is also known as ‘school sores’, because it commonly affects school-aged children. Impetigo is more common during the warmer months.

Staphylococcus or Streptococcus bacteria can live harmlessly on and inside various areas of the body, such as the skin surface and nose. However, cuts and abrasions or eczema may allow the bacteria to cause infection to deeper skin tissues. Healthy, intact skin can sometimes develop impetigo too. The condition is characterised by collections of small, crusting blisters that usually form on the face or limbs.

Impetigo looks unsightly, but it isn’t dangerous and doesn’t cause any lasting damage to the skin. However, it is highly contagious. A child with impetigo should be kept home from school or Day Care until appropriate treatment has begun and the sores on exposed areas are covered with a waterproof dressing.

• The skin itches and reddens
• A collection of blisters forms, commonly around the nose and mouth
• The blisters pop and weep a yellow, sticky fluid
• The area develops a raised and wet-looking crust
• The scab dries and falls off
• The skin completely heals after a few days.

• Fever
• Swollen lymph glands
• General feeling of unwellness (‘malaise’).

Impetigo is very contagious

Impetigo blisters and crusts are filled with bacteria. This makes the condition highly contagious, particularly when the site is weeping. The skin is usually itchy, so the child scratches and spreads the infection from under their fingernails to other areas of the body or to another person. Infection can also be spread by handling contaminated clothing or articles.

Diagnosis

Impetigo may be diagnosed by an experienced clinician on the basis of the appearance of the infection or it may also be diagnosed by taking a swab of the blisters or crust, and checking for the presence of bacteria.

Treatment

Impetigo can be treated with prescription antibiotic ointments or creams, which need to be reapplied until the sores have completely healed. Antibiotic syrups or tablets may also be prescribed. It is important to complete any course of antibiotics you are prescribed. If left untreated, impetigo can lead to skin abscesses.

Care of the infection at home

Suggestions for home care include:

• Apply a waterproof dressing to stop further spread of the infection.
• Wash the sores (lesions) with an antibacterial or antiseptic soap every eight to 12 hours.
• After each wash, pat the lesions dry.
• See your doctor if the sores spread and get worse despite treatment, or if the child becomes unwell with fever.

• Encourage everyone to wash their hands with soap frequently.
• Cut your child’s fingernails short and encourage them not to scratch scabs or pick their nose.
• Avoid scratching or touching the sores to prevent spread to other areas of the body.
• Keep affected areas of skin clean and covered to minimise the chance of spreading the infection.
• Always wash your hands with soap before and after touching sores or scabs.
• Encourage children to use their own towel and face cloth.
• Wash the child’s linen, towels and clothes separately
• Dispose of used dressings promptly and thoroughly wash hands with soap after the dressings have been disposed of.

• Your doctor
• Your pharmacist
• Your local Maternal and Child Health nurse
• Maternal and Child Health Line (24 hours) Tel. 13 22 29
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)

• Impetigo (school sores) is a highly contagious type of skin infection caused by the Staphylococcus or Streptococcus bacteria.
• The infection is characterised by inflamed blisters that pop, weep and form crusts.
• Treatment options include antibiotic creams, ointments, antibiotic syrup and tablets.

Impetigo (Impetigo Contagiosa) Article by: Alan Rockoff, MD, and John Mersch, MD, FAAP

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