It was a calm Wednesday afternoon, and I had just finished a quick lunch at the clinic. My mind wandered for a moment as I glanced at the stack of files on my desk. I had seen a variety of cases that morning—routine vaccinations, a suspected ear infection, and a sprained ankle from an overly enthusiastic soccer game.
As I sipped the last of my coffee, my thoughts shifted to how unpredictable days in the clinic could be. Would the next patient bring something routine or something unexpected? I barely had time to finish the thought when the nurse knocked on my door.
“Dr. Priya, Ellie’s here with her son Ben,” she said. “She’s worried about some sores on his face.”
“Alright, send them in,” I said, clearing my desk and preparing to meet them.
A few moments later, Ellie walked in, holding Ben’s hand. Ben, a curious four-year-old I’d seen before, peeked shyly from behind his mom’s leg. But it wasn’t his usual bright demeanour that caught my attention—it was the red patches on his cheeks.
“Dr. Priya,” Ellie began, her voice tinged with concern, “Ben has these sores that started as small red spots, and now they’re spreading. They’re oozing and crusting over, and he keeps scratching them. I’m worried—what’s going on?”
As Ben clung tightly to his mom, I leaned down to his level and offered him a small toy truck from my desk. “Hi, Ben,” I said warmly, trying to put him at ease. As he started playing with the truck, I turned my attention back to Ellie. “Let’s take a closer look and figure this out together.”
What is Impetigo?
“Impetigo,” I began, “is a highly contagious bacterial skin infection, often called ‘school sores.’ It’s common in young children like Ben, especially in settings like daycare where kids are in close contact.”
Ellie frowned. “Does it only happen to kids?”
“No,” I said, “adults can get it too, but it’s much more common in children. Their skin is more sensitive, and they’re more likely to scratch or touch small cuts, which can introduce bacteria.”
What Causes Impetigo?
Ellie looked concerned. “But how did this happen? Ben didn’t have any cuts or injuries.”
“Impetigo is usually caused by bacteria—either Streptococcus pyogenes or Staphylococcus aureus,” I explained. “Sometimes, these bacteria get in through tiny cuts, scrapes, insect bites, or even just irritated skin.”
I pointed to a small scab on Ben’s nose. “Even something as small as this could allow bacteria to enter.”
Ellie sighed. “He’s been scratching his mosquito bites non-stop this week. That’s probably how it started.”
“Exactly,” I said. “Warm, humid weather can also make it easier for the bacteria to grow, and close contact with other kids at daycare could have spread it.”
What Are the Symptoms of Impetigo?
To help Ellie understand, I described the classic symptoms of impetigo:
- Red sores or blisters: These often appear around the mouth, nose, or other parts of the face first.
- Weeping sores: The blisters break open, releasing fluid that forms a golden-yellow crust.
- Spreading patches: The infection can spread quickly to other parts of the face or body.
- Mild itching: Children often scratch the sores, which can worsen the infection.
- Occasional discomfort: The sores aren’t usually painful but can feel irritated.
Ellie looked at Ben and said, “It’s spreading just like that! I thought maybe it was just a rash, but it doesn’t look like any rash I’ve seen before.”
What Are the Risks of Impetigo?
Ellie leaned forward. “But is this something I should be really worried about? Could it get worse?”
I reassured her. “Impetigo itself isn’t usually dangerous, but if left untreated, it can lead to complications.”
I explained:
- Secondary infections: “If Ben keeps scratching, the bacteria can go deeper into the skin, causing a more serious infection called cellulitis.”
- Rare complications: “In some cases, infections caused by Streptococcus can lead to kidney problems, like glomerulonephritis. This is very rare but can happen if the infection spreads quickly.”
- Spreading to others: “Impetigo is very contagious, so it’s important to stop it from spreading to other kids at daycare or to family members.”
How to Prevent the Spread of Impetigo
Ellie glanced at Ben’s little sister, who was sitting in her stroller nearby. “How do I make sure she doesn’t get it too?”
I smiled. “That’s a great question. Here’s what you can do to stop impetigo from spreading:”
- Separate personal items: Ben should have his own towel, soap, and face cloth. Don’t let anyone share these items.
- Wash hands frequently: Teach Ben to wash his hands with antibacterial soap, especially after touching his face.
- Trim nails short: Keeping his nails short will reduce scratching and the chance of spreading bacteria.
- Clean and cover sores: Wash the sores gently with warm water and apply a dressing or gauze to cover them.
- Disinfect shared surfaces: Regularly clean doorknobs, toys, and other items that Ben touches.
- Wash clothes and linens daily: Use hot water to wash his bedding, clothes, and towels to kill bacteria.
Ellie looked relieved. “I’ll start doing that as soon as we get home.”
How is Impetigo Treated?
“Let’s talk about how we’ll treat Ben’s infection,” I said, outlining a clear plan:
1. Cleaning the sores
“First, gently wash the sores three times a day with warm water and an antiseptic solution like Betadine. This helps disinfect the skin and remove any crusts.”
2. Topical antibiotics
“For smaller sores like Ben’s, an antibiotic ointment such as mupirocin (Bactroban) will work well. Apply it to the sores three times a day after cleaning them.”
3. Antiseptic baths (if needed)
“If the sores start spreading to other areas, you can give Ben an antiseptic bath with products recommended by your pharmacist.”
4. Oral antibiotics
“For more widespread infections or if the sores aren’t healing, Ben may need an oral antibiotic like penicillin. But for now, I think the ointment should be enough.”
Ellie asked, “How long will it take for him to get better?”
“With treatment, you’ll start seeing improvement in 2–3 days,” I said. “But make sure to finish the full course of antibiotics to prevent the infection from coming back.”
Key Takeaways About Impetigo
Before Ellie and Ben left, I summarized the key points:
- Impetigo is a common, contagious skin infection, especially in children.
- It’s caused by bacteria entering the skin through cuts, bites, or scrapes.
- Symptoms include red sores, weeping blisters, and yellow crusts.
- Good hygiene and topical antibiotics are key to treatment and prevention.
- Complications are rare but can occur if untreated.
Frequently Asked Questions (FAQs)
1. What is impetigo?
Impetigo is a common and highly contagious skin infection, primarily affecting children. It causes red sores that can rupture, ooze fluid, and develop a yellowish crust.
2. What causes impetigo?
Impetigo is usually caused by bacteria such as Staphylococcus aureus or Streptococcus pyogenes. It often occurs after a cut, scrape, or insect bite.
3. What are the symptoms of impetigo?
Symptoms include red sores around the nose and mouth, sores that rupture and ooze fluid, and the formation of a yellowish crust.
4. How is impetigo diagnosed?
A healthcare provider can diagnose impetigo by examining the sores. In some cases, a swab of the sore may be taken for laboratory testing.
5. What is the treatment for impetigo?
Treatment typically involves topical or oral antibiotics to eliminate the bacteria causing the infection. Keeping the affected area clean and avoiding scratching is essential.
6. Can impetigo be prevented?
Yes, impetigo can be prevented by maintaining good hygiene, keeping wounds clean and covered, and avoiding sharing personal items like towels and clothing.
7. How long does impetigo last?
With proper treatment, impetigo usually clears up within one to two weeks. Without treatment, it can last longer and spread to others.
8. Is impetigo serious?
Impetigo is generally not serious and can be effectively treated with antibiotics. However, if left untreated, it can lead to more severe infections.
As Ellie left the clinic, holding Ben’s hand, she looked more confident. “Thank you, Dr. Priya,” she said. “I feel like I know exactly what to do now.”
If you ever notice red sores or crusted blisters on your child, don’t wait—consult your doctor. Early treatment can stop the infection from spreading and help your child recover quickly.
