Information on bullous and nonbullous impetigo rashes.

What is Impetigo?

Impetigo is a highly contagious skin infection that is caused by staphylococcus (staph) and streptococcus (strep) bacteria. It is most common amongst children aged between 2- 6 years than adults. This skin infection may often start as a minor scratch or appear as a red sore on the upper lip – similar to a cold sore or fever blister.

It then forms a blister that ruptures and secretes to form a yellowish-brown crust. Impetigo is spread by direct contact to others from sharing towels, clothing, toys and other personal items. These sores may also spread to other parts of the body including the face or hands as well as to other people from scratching or touching.

There are types of impetigo, non-bullous and bullous impetigo. Non-bullous impetigo is the most common form and is caused by staphylococcus and streptococcus bacteria. It is characterized by tiny blisters or scabs that form yellowish-brown crusts. Bullous impetigo is caused by staphylococcus bacteria which produces toxins that cause breakage in the skin.

The symptoms and signs of non-bullous and bullous impetigo include:

Non-bullous impetigo

• Affects the nose, face, arms, and legs
• Appears as small blisters or scabs
• Forms yellow or honey-colored crusts

Bullous impetigo

• Appears in various skin areas such as buttocks
• Blisters leave red, raw skin with ragged edge

What Causes Impetigo?

Impetigo is caused by two types of bacteria, Staphylococcus aureus (staph) and Streptococcus pyogenes (strep). Both types of bacteria are known to thrive wherever there is close contact with large groups of people, particularly in schools or daycare environments. Staph and strep bacteria are harmless until they enter through a wound and cause an infection. Children are more likely to develop impetigo through a cut, scrapes, burns or insect bite or if the skin has already been irritated by other skin problems such as eczema, poison ivy, chicken pox or allergies. Impetigo in adults comes about as a result of injury to the skin, also by skin conditions such as dermatitis.

Risk factors include:

• Poor hygiene habits
• Direct contact with a person who has impetigo
• Using personal items such as towels, linen or clothing of a person with impetigo
• Anemia
• Chronic dermatitis
• Malnutrition
• Crowded conditions
• Participation in skin-to-skin contact sports such as football
• Warm, humid weather
• People with diabetes or a compromised immune system

Diagnosing Impetigo

If your child develops sores or blisters, consult your doctor for a proper diagnosis. Your doctor may remove a bit of material from the sore with a cotton swab to have it tested for the presence of bacteria.

Help for Impetigo

The treatment for impetigo depends on the type of impetigo, the severity of the condition and the age of your child. Treatment options include topical and oral antibiotics as well as certain hygienic measures. Minor cases of impetigo may be treated by simply cleaning the wound – wash the wound two to three times a day with mild soap and water.

Soak stubborn crusts in warm water or compress them with a saline solution before applying topical antibiotics. Parents should ensure that the child’s fingernails are cut short to avoid scratching of the affected area. Topical antibiotics such as Bactroban may be applied to the skin to treat the infection. If the infection is widespread or slow to respond to the ointment, oral antibiotics are administered.

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