Impetigo – spot the symptoms

Impetigo – also known as impetigo contagiosa, infantigo, or ‘school sores’ – is a contagious skin infection causing sores and blisters mainly on the face and hands.

It can be confused with other skin conditions such as cold sores, chickenpox, or eczema, but is easily diagnosed when the sores burst and crusty golden or yellow-colored patches appear.

Although impetigo can be itchy, uncomfortable, and look unpleasant, it is rarely anything serious.

However, because it is highly infectious, getting diagnosed and treated will help speed up healing, reducing the risk of others catching it. It will also prevent any complications.

What are the symptoms?

The most common type of impetigo is called non-bullous impetigo. Bullous impetigo, another type, is much rarer and mainly affects babies and children under 2.

Non-bullous impetigo usually affects your face – particularly around your mouth and nose – and hands, but it can also appear on arms and legs.

Early symptoms are usually red sores or blisters. These will burst a few days after appearing and you may notice pus or fluid leak from them.

Unlike chickenpox, they will form crusty, yellow, or golden-brown patches rather than individual crusted pox.

These impetigo patches can:

• look lumpy, as if something like a cornflake is stuck to your skin
• grow in size and spread to other parts of your body
• be itchy and may be painful
• heal without scarring.

Bullous impetigo symptoms are similar but have less redness around spots or patches. You may also feel unwell with a fever and swollen glands.

What causes it and who is affected?

Impetigo is caused by bacteria – usually either group A Streptococcus, Staphylococcus aureus, or both.

The bacteria normally infects skin that has been cut, scraped, scratched, bitten (by an insect), damaged – or that’s already affected by conditions such as scabies.

As it is contagious it spreads on the skin – and to others. So you can catch it if you have contact with the sores of an infected person or via infected items, such as:

• bed sheets
• towels
• toys.

Although common in young children, anyone can get impetigo as it is easily spread. You are at greater risk of catching it if you:

• have infected or injured skin
• have scabies, eczema, or cellulitis
• work closely with children, for example in schools, daycare, camps
• work or participate in close-contact sports, such as boxing
• spend time in hot and humid climates
• do not wash your hands and face properly.

Although stress does not cause impetigo it can affect the immune system, making it harder for your body to fight off a bacterial infection should you get infected.

When to see a doctor and getting diagnosed

If you think you have impetigo, call your doctor first. As it is contagious they may prefer a video or phone call, rather than seeing you in person.

Your doctor will be able to diagnose impetigo just by looking at it.

In rare cases, complications can be caused, such as scarring, cellulitis, and kidney problems, so it’s important to get checked by a doctor.

Also see a doctor if your impetigo gets worse, keeps coming back, or you are concerned about your symptoms.

Treatment for impetigo

Treatment will depend on how mild or severe your symptoms are and will take your overall health into account.

Your doctor will most likely prescribe a course of either:

• hydrogen peroxide (antiseptic) cream if it’s in 1 place
• antibiotic cream or tablets if it covers a wider area
• oral antibiotics – for bullous impetigo.

Your impetigo should get better with treatment within a few days. Just be sure to complete your antibiotics – even if it clears up before the end of your course.

If your impetigo keeps coming back, your doctor may also recommend using an antiseptic body wash and nasal ointment to clear it up.

You may also need a skin or nasal swab for further testing and referral to a dermatologist or specialist if you are unwell with impetigo or at risk of complications.

Self-care tips

Impetigo spreads easily through skin-to-skin contact and is contagious up to 48 hours after you’ve started treatment.

Following these steps can help contain it – and stop it spreading to others – so make sure you:

• stay off work and avoid gyms or playing on a team – until you are no longer contagious
• keep affected areas clean (using soap and water) and dry
• cover up impetigo patches
• wash hands regularly – especially before and after applying cream to affected areas
• wash towels and bedding on a hot wash, ideally every day – and don’t share with others
• wash toys with detergent and warm water if your children have impetigo
• avoid touching sores, blisters, or crusty patches
• do not prepare food for others while you have impetigo.