Impetigo, like headlice, is one of those things that affects most children at some point, and that most parents dread, mainly because of the hassle of minimising infection amongst the rest of the family.
It’s a highly-contagious bacterial skin infection, usually exhibited as painful and itchy blisters and sores around the mouth and nose (in very young children it can also occur in the nappy area). It’s not serious, but it is sore and itchy, and looks pretty nasty.
There are two types: bullous impetigo (large, painless pus-filled blisters) and non-bullous impetigo (the most common form, more contagious, with blisters that quickly burst and crust-over). It can either occur on its own, by bacteria entering the skin usually through a small nick in the skin, or as a complication of some other condition like eczema.
Precautions necessary to avoid infection amongst other members of the family include ensuring that hands are always washed if they touch the sores, and not sharing towels or bed linen.
Impetigo can normally be banished with the application of antibiotic cream like fucidin, available on prescription, but it will go away on its own in time. The risk of infection normally disappears within 48 hours of applying the cream, or when the sores have healed/dried if cream is not used. If that doesn’t work (usually because it has spread to affect a large area), then oral antibiotics might be prescribed. Whether or not antibiotics are prescribed, you should bathe the infected skin by cleaning it with cooled, boiled water on some cotton wool every day. Use warmer water if there is a crust that should be soaked off (you don’t need to remove all the crust). Keep your child’s fingernails short and make sure they’re as clean as possible to avoid secondary infections happening when they scratch the marks.
Impetigo can sometimes cause more serious conditions like cellulitis if it spreads to the deeper levels of the skin, or if it spreads to the lymph nodes (when it causes a condition called lymphadenitis). Your doctor can obviously advise if these become an issue but they are quite rare.
To prevent re-infection, ensure that your children know to wash their hands regularly, and clean areas of their skin that might be open to infection, like areas of eczema or insect bites and small grazes. Use antibacterial soap and keep fingernails short. If impetigo does affect the family then keep all linen, clothing and towels separate to minimise cross-infection, washing items that belong to the person who is infected with hot water.
You should take your child to see your GP if they show signs of impetigo so that you can be given cream to speed up the recovery. However, you should also see your GP if your child doesn’t improve after three days of treatment, or if they develop a high temperature or show other signs of infection like redness, warmth or tenderness around the impetigo.