Skin Infections – Impetigo

BY LINDA STEVENSON, PhD, RN, FNP-C, PEDIAQ SENIOR NURSE PRACTITIONER

It’s summer, and with it comes lots of outside play, and with that comes cuts, scrapes, bug bites, and itchy allergic rashes. Kids scratch and pick at the sores and scabs and the next thing it’s red, slightly swollen, and there is clear yellowish drainage and honey colored crusting on the area. Your child now has a common contagious superficial skin infection called impetigo. It is usually caused by Staph aureus, a bacteria we all carry on our skin.

Impetigo is most common in children ages 2 to 6 years but can also occur in teens and infants. It spreads easily in schools, daycare, and camp. Sports that involve skin-to-skin contact such as football and wrestling increase the risk of developing the skin infection.

Impetigo occurs more in the summer months and in warm humid climates. A child is more likely to develop impetigo if their skin is irritated or open, such as with eczema, poison ivy, bug bites, cuts or scrapes. It often appears as red sores on the child’s face, arms, legs and sometimes the perineum. The sores develop into fluid filled vesicles that burst and then honey colored crusts develop. They are itchy, and cause discomfort in mild cases.

Impetigo is not dangerous, but if left untreated, cellulitis can develop – the infection can spread to the lymph nodes, bloodstream, and it can become serious. So, if you suspect your child has impetigo see your pediatrician.

Antibiotics are the mainstay of the treatment plan for impetigo. Your pediatrician will decide if your child needs oral antibiotics, or if the lesion is small enough to be treated with topical antibiotic ointment, or both. Always finish the course of antibiotics to prevent recurrence of the infection and decrease developing resistant bacteria. When applying antibiotic ointment you will need to apply wet compresses to the lesions to help gently remove the crusting and scabs first. This is important, as the ointment will not be able to be absorbed thru the scabs and crusts.  Your child will be considered contagious until they have been on antibiotics for 24 to 48 hours.

The best prevention for skin infections is hand washing and not scratching bites or picking at scabs or touching the face with dirty hands. Easier said than done depending on the age of your child.  Wash all cuts, scrapes, and bug bites when they occur, and keep them clean as much as possible. And, as always, see your child’s pediatrician for any concerns.