Impetigo
Published content is for information purposes and is intended for healthcare professionals.
TLDR
Impetigo is a skin infection that spreads through direct contact and causes red sores with crusts. It can lead to complications if untreated, but proper treatment usually brings recovery. Doctors diagnose impetigo by examining the appearance and location of the sores and considering the patient's medical history.
Treatment involves antibiotics applied on the skin or taken by mouth, depending on the severity. Patients should maintain good hygiene and follow health guidelines to prevent spreading the infection.
Treatment involves antibiotics applied on the skin or taken by mouth, depending on the severity. Patients should maintain good hygiene and follow health guidelines to prevent spreading the infection.
What is Impetigo?
Impetigo is a skin infection caused by bacteria, often developing on injured or eczema-affected skin. It spreads through close contact or contaminated objects. Symptoms include red sores with a honey-colored crust around the nose and mouth.
Staphylococcus aureus and Streptococcus pyogenes are common causes, entering the skin through cuts or insect bites. It can also spread through direct contact with an infected person or sharing contaminated items like towels. The bacteria multiply in the skin, leading to the characteristic sores and crusts of impetigo.
Staphylococcus aureus and Streptococcus pyogenes are common causes, entering the skin through cuts or insect bites. It can also spread through direct contact with an infected person or sharing contaminated items like towels. The bacteria multiply in the skin, leading to the characteristic sores and crusts of impetigo.
Key points
Impetigo, a bacterial skin infection, spreads through direct contact or contaminated items and is characterised by red sores with honey-colored crusts.
What are the complications?
If impetigo is left untreated, it can lead to serious complications such as acute glomerulonephritis, cellulitis, and septicemia. Acute glomerulonephritis is a kidney condition that can develop following a streptococcal impetigo infection. Cellulitis is a bacterial skin infection that can spread to the deeper layers of the skin and the bloodstream, while septicemia refers to a severe bloodstream infection.
However, with appropriate antibiotic therapy, most people recover within a few weeks. If the infection does not improve after completing the initial course of treatment, it is important to consider other diagnoses or underlying causes and seek referral to a specialist for further evaluation or alternative treatment options.
However, with appropriate antibiotic therapy, most people recover within a few weeks. If the infection does not improve after completing the initial course of treatment, it is important to consider other diagnoses or underlying causes and seek referral to a specialist for further evaluation or alternative treatment options.
Key points
Complications of untreated impetigo may include acute glomerulonephritis and cellulitis. Proper treatment usually leads to recovery, but alternative options may be needed if initial therapy fails.
How is it diagnosed?
Impetigo is diagnosed based on the appearance and location of the sores. During examination, healthcare providers might observe fluid-filled blisters that burst and form a crust.
These sores usually start as small blisters that burst quickly, becoming a brownish or golden crust. They can appear anywhere on the body but are most common on exposed skin areas like the face, arms, and skin folds.
Besides checking how the sores look, it's important to ask about when they started, how they've changed, where they are, and if there's been contact with anyone else with a similar rash. Inquiring about any past skin problems or weakened immune system is also crucial to ensure an accurate diagnosis.
These sores usually start as small blisters that burst quickly, becoming a brownish or golden crust. They can appear anywhere on the body but are most common on exposed skin areas like the face, arms, and skin folds.
Besides checking how the sores look, it's important to ask about when they started, how they've changed, where they are, and if there's been contact with anyone else with a similar rash. Inquiring about any past skin problems or weakened immune system is also crucial to ensure an accurate diagnosis.
Key points
Impetigo is diagnosed by carefully examining the appearance and location of sores, along with a comprehensive medical history to ensure an accurate diagnosis.
How is it managed?
The management of impetigo involves the use of topical or oral antibiotics. For non-bullous impetigo in people who are not systemically unwell or at high risk of complications, a short course of a topical antibiotic such as fusidic acid or mupirocin is recommended.
For widespread non-bullous impetigo, oral antibiotics such as flucloxacillin, clarithromycin, or erythromycin may be prescribed. It’s important to consider any drug allergies of the person when deciding on treatment.
Additionally, previous use of topical antibiotics should be taken into account, as antimicrobial resistance can develop rapidly with extended or repeated use.
For widespread non-bullous impetigo, oral antibiotics such as flucloxacillin, clarithromycin, or erythromycin may be prescribed. It’s important to consider any drug allergies of the person when deciding on treatment.
Additionally, previous use of topical antibiotics should be taken into account, as antimicrobial resistance can develop rapidly with extended or repeated use.
Key points
Impetigo is treated with topical or oral antibiotics. For mild cases, topical antibiotics like fusidic acid are recommended, while oral antibiotics are prescribed for widespread non-bullous impetigo.
Patient counselling
Patients should be informed about good hygiene measures to aid healing and reduce the spread of impetigo to other areas of the body and to other people.
These measures include washing affected areas with soap and water, washing hands regularly, avoiding scratching affected areas, and avoiding sharing towels, face cloths, and other personal care products.
It’s also important to inform patients of Public Health England exclusion recommendations, which advise staying away from school and other childcare facilities or work until all lesions are healed, dry, and crusted over, or until 48 hours after initiation of treatment
These measures include washing affected areas with soap and water, washing hands regularly, avoiding scratching affected areas, and avoiding sharing towels, face cloths, and other personal care products.
It’s also important to inform patients of Public Health England exclusion recommendations, which advise staying away from school and other childcare facilities or work until all lesions are healed, dry, and crusted over, or until 48 hours after initiation of treatment
Key points
Patients should practice good hygiene, such as washing affected areas and hands regularly, to prevent impetigo spread. They should also adhere to Public Health England's exclusion recommendations.
References
1. Hall, L.M., Gorges, H.J., van Driel, M., Magin, P., Francis, N. and Heal, C.F. (2021). International Comparison of Guidelines for Management of impetigo: a Systematic Review. Family Practice, 39(1). doi:https://doi.org/10.1093/fampra/cmab066.
2. Hartman-Adams, H., Banvard, C. and Juckett, G. (2014). Impetigo: Diagnosis and Treatment. American Family Physician, [online] 90(4), pp.229–235. Available at: https://pubmed.ncbi.nlm.nih.gov/25250996/ [Accessed 24 Jan. 2024].
3. Nardi, N.M. and Schaefer, T.J. (2020). Impetigo. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430974/ [Accessed 24 Jan. 2024].
4. NICE. (n.d.). Scenario: Management of Impetigo. [online] Available at: https://cks.nice.org.uk/topics/impetigo/management/management/ [Accessed 24 Jan. 2024].
2. Hartman-Adams, H., Banvard, C. and Juckett, G. (2014). Impetigo: Diagnosis and Treatment. American Family Physician, [online] 90(4), pp.229–235. Available at: https://pubmed.ncbi.nlm.nih.gov/25250996/ [Accessed 24 Jan. 2024].
3. Nardi, N.M. and Schaefer, T.J. (2020). Impetigo. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430974/ [Accessed 24 Jan. 2024].
4. NICE. (n.d.). Scenario: Management of Impetigo. [online] Available at: https://cks.nice.org.uk/topics/impetigo/management/management/ [Accessed 24 Jan. 2024].