What Is Impetigo

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What is impetigo?

Impetigo is a bacterial infection of the surface of the skin. In the UK it is the most
common skin infection seen in young children.

What causes impetigo?

In the UK, impetigo is usually due to a germ known as Staphylococcus aureus. In
hot climates it may be due to a germ called Streptococcus pyogenes, or to a mixture
of the two. These germs pass from person to person, and impetigo can spread
rapidly through families and school classes by skin-to-skin contact or, less often, by
bedding, clothing and towels. However impetigo can also arrive out of the blue, with
no hint of where it came from.

What does impetigo look like?

Impetigo can crop up anywhere, but is most common on exposed areas of skin such
as the face, around the nose and mouth and on the hands. Groups of thin-roofed
pus-filled blisters appear a few days after contact with someone who has impetigo.
The blisters tend to break quickly to leave round oozing patches covered with honey-
coloured or brownish crusts that look a bit like brown sugar. The patches are small at
first, half an inch or so across, but slowly get bigger.

The germs that cause impetigo can invade normal skin, but can also take advantage
of skin that is already damaged by cuts or grazes, insect bites, head lice, scabies,
cold sores, or eczema.

Impetigo is most common in children, and in warm humid weather.

Is impetigo hereditary?

No, but several members of a family often get it at the same time.

What are its symptoms?

Impetigo can be sore and itchy but does not usually make you feel ill.

Smaller patches can come up nearby and may enlarge too. As the patches clear up,
their crusts fall off and the areas heal without leaving scars.

How will impetigo be diagnosed?
Your doctor will base the diagnosis on the way the rash looks, and will check to see if
it has come up on top of another skin condition, such as scabies.

A swab from a crusted area may be sent to the laboratory to see which germ is
causing the impetigo and which antibiotic is most likely to help. However, treatment
should not wait until the results are through.

Can impetigo be cured?

Yes. Usually it clears quickly but it will not do so if it is based on an unrecognised
underlying skin problem such as scabies or head lice (see above).

How can impetigo be treated?

   •   The first step is to take the crusts off gently and regularly, soap and water is as
       good for this as anything else.
   •   You can then rub an antibiotic cream or ointment onto the patches and the skin
       around them, two or three times a day, until they clear up (usually in 7 – 10
       days). Mupirocin or fusidic acid are often used for impetigo. Unlike some other
       antibiotic creams they seldom cause allergy. However, the bacteria that cause
       impetigo are becoming less likely to respond to them than in the past. For that
       reason, creams containing antiseptics such as chlorhexidine, hydrogen
       peroxide or iodine may be used.
   •   Finally, your doctor will decide whether you need to have a course of antibiotic
       tablets as well as the antibiotic ointment. You may need this if your impetigo is
       extensive, slow to get better with antibiotic creams alone, or keeps coming

What can I do?

Your main aim must be to stop the impetigo spreading to other people, and
especially to newborn babies. Try not to touch patches of impetigo, and stop other
people touching them too.

   •   Wash your hands after putting the antibiotic cream or ointment on the impetigo.
   •   Don’t share towels, flannels, etc, until the infection has cleared. Towels,
       pillowcases, and sheets should be changed after the first day of treatment, and
       clothing should be changed and laundered daily for the first few days.

Children with impetigo should be kept off school or nursery for a few days after
treatment has started, at least until new blisters and crusting stop coming up, or until
the impetigo is clear.
Further Information:

Dermatology Department

Tel: 0151 282 6517


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