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Impetigo: Causes, Symptoms & Treatment

Impetigo is a common, highly contagious bacterial skin infection that mainly affects children. It causes honey-colored crusts or blisters and responds well to antibiotic treatment.

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Things worth knowing about "Impetigo"

Impetigo is a common, highly contagious bacterial skin infection that mainly affects children. It causes honey-colored crusts or blisters and responds well to antibiotic treatment.

What is Impetigo?

Impetigo (also known as impetigo contagiosa) is one of the most common bacterial skin infections in childhood. It is primarily caused by the bacteria Staphylococcus aureus or Streptococcus pyogenes and is highly contagious. Adults can also be affected, especially those with weakened immune systems or close contact with infected individuals.

Causes

Impetigo results from a bacterial infection of the superficial layers of the skin. It spreads through direct skin-to-skin contact or via contaminated objects such as towels or toys. Contributing risk factors include:

Minor skin injuries, scratches, or insect bites
Poor hygiene practices
Close contact in communal settings (daycare, schools)
Warm and humid climates
Weakened immune system

Symptoms

Impetigo most commonly appears on the face, especially around the nose and mouth, as well as on the arms and legs. Two main forms are recognized:

Non-bullous Impetigo (most common form)

Red patches that develop into small blisters
Blisters burst, leaving characteristic honey-colored crusts
Mild itching

Bullous Impetigo

Larger, fluid-filled blisters called bullae
Blisters rupture, leaving moist, red areas
Commonly caused by Staphylococcus aureus

Diagnosis

The diagnosis is usually made clinically based on the characteristic appearance of the skin lesions. In straightforward cases, no further testing is required. For uncertain, severe, or recurrent cases, a skin swab may be taken to identify the causative bacteria and determine antibiotic sensitivity.

Treatment

Impetigo is highly treatable. The approach depends on the extent of the infection:

Topical Treatment (for mild impetigo)

Antibiotic ointments such as fusidic acid or mupirocin are applied directly to the affected skin areas.
Gentle cleansing of crusts with water and mild soap is recommended.

Systemic Treatment (for widespread impetigo)

Oral antibiotics (e.g., amoxicillin-clavulanate or cephalosporins) are prescribed when the infection is extensive or does not respond to topical therapy.

General Measures

Regular and thorough handwashing
Avoiding sharing towels, clothing, or other personal items
Affected children should stay home from school or daycare until the lesions have healed

Complications

In rare cases, impetigo can lead to more serious conditions, including:

Cellulitis: a deeper infection of the connective tissue beneath the skin
Post-infectious glomerulonephritis: a kidney inflammation that can follow streptococcal infection
Sepsis: in very rare cases, a life-threatening bloodstream infection

References

World Health Organization (WHO): Skin infections - impetigo. Geneva, 2022. Available at: https://www.who.int
Hartman-Adams H., Banvard C., Juckett G. - Impetigo: Diagnosis and Treatment. American Family Physician, 2014; 90(4): 229-235.
Stevens D.L. et al. - Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections. Clinical Infectious Diseases, 2014; 59(2): e10-e52.

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