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Ideal Impetigo Treatments to Reduce Symptoms and Address Causes


Story at-a-glance -

  • Impetigo is a skin condition that arises from staph or strep bacterial overgrowth. Also referred to as school sores or pyoderma, it is one of the most prevalent skin infections spread in children of school age
  • This skin condition is characterized by red, itchy rashes or crusted wounds. Impetigo also causes large, easy-to-rupture blisters, which eventually start oozing yellow or white liquid when punctured
  • A 2015 study determined that at any given time, approximately 162 million children in the whole world suffer from impetigo, with the 111 million belonging to developing countries

You come into contact with hundreds of millions of bacteria on a daily basis, with your skin and immune systems being your first lines of defense against any possible infection or disease that may stem from these microorganisms. Your skin becomes susceptible to bacterial infections when your defenses become compromised.

One of the possible infections that may stem from your exposure to bacteria is impetigo, a skin condition that arises from staph or strep bacterial overgrowth. As a contagious skin disease, it’s relatively easy to contract, especially if you’ve been near anyone who appears to be suffering from this illness. While impetigo is extremely contagious and may look rather unpleasant, it’s not a very serious disease. However, this does not mean that care and treatment should be overlooked, as there are numerous possible complications that may arise.

If you suspect that you’re suffering from impetigo, or if someone close to you is, the first thing you should do is to get enough information to properly determine whether your assumptions are correct, or better yet, consult a healthcare professional. You can start by reading this article to know more about the causes, symptoms, treatment options and ways to prevent impetigo.

What Is Impetigo?

Impetigo, also referred to as school sores or pyoderma, is one of the most prevalent skin infections spread in children of school age.1 Its name was derived from the Latin word, “impetere,” which means “to assail.”2 Impetigo is commonly seen in children, as the bacteria responsible for this skin infection may be easily passed from child to child in a school setting. Unfortunately, this infection is not discriminatory when it comes to age, and depends solely on the immune system function of a specific person.

This skin condition is characterized by red, itchy rashes or crusted wounds. Impetigo also causes large, easy-to-rupture blisters, which eventually start oozing yellow or white liquid when punctured. While the rashes may appear painful, impetigo is relatively painless, but may be extremely itchy.

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Why Is Impetigo Common in Kids?

A 2015 study determined that at any given time, approximately 162 million children in the whole world suffer from impetigo, with 111 million living in developing countries.3 Studies also show the high prevalence of concurrent scabies and impetigo in young children, with scabies patients being 2.8 times more likely to have impetigo.4

Impetigo is mostly seen in children between the ages of 2 and 5 years old.5 A number of factors may influence this percentage, including hygiene, weather and the presence of preexisting skin conditions.6 The 2015 study further concluded that impetigo cases were highest in tropical and resource-poor regions.

One of the possible reasons why impetigo is more widespread in children is the fact that their immune systems are still developing. When children grow up, their susceptibility to this skin condition also wanes, with a few exceptions. If your child is currently in school, it would be best that you teach them proper hygiene to lower their risk of contracting this skin condition from their schoolmates.7

When Is Impetigo Most Prevalent?

In a 2005 study that was conducted over the span of eight years, it was found that impetigo was more prevalent in the summer months. It may be influenced by numerous factors, including the change in temperature and the clothing choices during this season. Statistics show that between 1996 and 2003, impetigo cases were consistently higher in late summer compared to winter or any other season throughout the year.

While the exact reason for this has not been determined because of varying conditions, the researchers suggest that this might be because of increased skin-to-skin contact due to minimal clothing during the summer and the higher risk for skin trauma due to outdoor activities.8

Impetigo in Adults

Impetigo may be more prevalent in children, but this does not mean that adults are safe from this skin condition. Unfortunately, susceptibility to the bacteria that causes this uncomfortable condition cannot be fully outgrown, especially with people who have weak or compromised immune systems.9

This skin condition may arise from other conditions, or even after a respiratory infection or other viral infections.10 Adults have also been found to be at higher risk of suffering from complications in comparison to children.11

Should Adults Stay Off Work When They Have Impetigo?

During the onset of impetigo, adults may have to stay at home to avoid causing an outbreak at their workplace, especially if the lesions are still leaking. If you’ve contracted this skin condition from an unknown source, consider skipping work for a few days up until the sores start scabbing over.12

When Should You Contact a Healthcare Professional for Impetigo?

While impetigo is not usually a dangerous condition, the staph or strep infection that causes this might progress to something worse. If you feel any other symptom that you think is not normal, it’s best to consult a healthcare professional. If you notice the following, do not hesitate to seek medical advice immediately:13

  • Increased fluids from punctured wound
  • Intense pain and swelling
  • Loss of appetite
  • Drowsiness, weakness and change in behavior

Impetigo Symptoms to Look Out For

It’s easy to identify impetigo if you’re familiar with its symptoms. The symptoms usually start on the face, near the mouth and the nose. You may get a small rash on your face, which may then start filling with liquid.

In some cases, these usually start out from small wounds, insect bites or cuts on the skin, which usually function as entry points for the bacteria. These blisters are very easy to puncture, giving way to yellowish scabs on your face once the wound dries up. The good news is that these blisters typically heal without leaving scars.14 Aside from the skin lesions, other symptoms that you should look out for are:15

  • Itching and soreness — When the symptoms are only starting to show, the affected skin may feel itchy, which persists until the blisters appear. Once the blisters start oozing, the raw skin left behind may be sore before they start scabbing over16
  • Swollen lymph nodes — In severe cases, the lymph nodes near the infected area may feel tender or appear swollen
  • Weakness
  • Fever
  • Diarrhea and vomiting

Skin Conditions That Share Symptoms With Impetigo

While impetigo’s appearance may seem easy to differentiate from other skin conditions, there are certain situations where it may be mistaken for another infection or skin problem, as their marks can closely resemble impetigo sores. Some of the conditions that people should look out for include the following:17

  • Pemphigus vulgaris is an autoimmune disorder that causes skin and mucous membrane blisters. The immune system produces antibodies that specifically attack the cells that bond the skin layers, causing the development of blisters.
  • Folliculitis refers to the infection of multiple hair follicles by staph bacteria. This is characterized by small pustules.18
  • Follicular mucinosis affects hair-producing parts of the skin and is typically seen in the face, neck and scalp. This condition is usually caused by the deposition of mucin in the follicular epithelium.19
  • Erysipelas is a skin infection that affects the upper layers of the skin. This infection is accompanied by the development of fiery red rashes. Patients with erysipelas may also suffer from high fever, chills and nausea.

If marks start appearing on your skin, it would be best that you consult with a health professional to ensure that you’re getting diagnosed correctly.

Impetigo Causes You Should Know About

Impetigo is typically caused by two different bacteria: Streptococcus pyogenes and Staphylococcus aureus. However, methicillin-resistant Staphylococcus aureus, or MRSA, has now been traced as a possible strain for impetigo as well.20

What Are Strep and Staph?

Streptococcus pyogenes and Staphylococcus bacteria are two of the most common bacteria that cause numerous infections and illnesses in the human body, including scarlet fever, pharyngitis, pneumonia, meningitis and sinusitis.21

Staph infections occur more frequently as these bacteria may be found on the skin of healthy people. It is also one of the usual causes of skin infection, when they make their way inside through a wound. Aside from impetigo, staph may cause other skin conditions, such as cellulitis and boils.

In worst-case scenarios, a staph infection may lead to septicemia, or blood poisoning, and toxic shock syndrome. Unfortunately, staph bacteria are extremely hard to control as they are able to survive exposure to high temperature, stomach acid and drying.22

Strep bacteria, on the other hand, can be divided into two groups: group A and group B. Group A strep is responsible for more common ailments like strep throat and scarlet fever, while group B strep causes more severe conditions, such as pneumonia, meningitis and blood infections.23 Unlike staph, strep bacteria cannot survive too long away from the human body. These bacteria are usually found in the mucous membranes or areas with damaged skin.24

As mentioned above, impetigo has been linked to a third type of bacteria. Because of the overuse of antibiotics for the treatment of these infections, this has paved the way for the development of a drug-resistant strain of staph.25 Methicillin-resistant Staphylococcus aureus, or MRSA, cannot be killed by a variety of drugs, making it more complicated to treat.26

Practices That Heighten Your Risk of Impetigo

Some of your most ordinary habits may be exposing you to a higher risk of this skin condition. Impetigo is primarily transmitted through direct skin-to-skin contact, but in some cases, it may also be transmitted through other materials. Some of the habits that might be increasing your risk include:27

  • Sharing personal items — Towels, clothes and other personal belongings should be exclusively for your use only.
  • Not washing your hands — You touch hundreds of different things at all times, meaning that you come into contact with millions and millions of bacteria each day. Failing to wash your hands on a regular basis may be adding to your susceptibility to impetigo.

Bullous Impetigo Versus Non-Bullous Impetigo: What’s the Difference?

Impetigo cases may be divided into two categories based on the appearance of the rash and the bacteria responsible. These are non-bullous impetigo or bullous impetigo. Differentiating between these two types is usually easy, but it may be challenging in some cases as they share symptoms with other skin conditions.28 Here’s how to set these two categories apart:29

Non-bullous impetigo is the more common type of impetigo. It may be caused by either a staph or strep bacterial infection, and is characterized by red marks on the skin that may be reminiscent of multiple insect bites. Small blisters may start to form before finally scabbing over.

The whole process of healing usually takes about a week and typically leaves no permanent scars. This type of impetigo is typically found on the face, specifically near the mouth and nose. In some cases, it may also appear on the arms and legs of the patient.

Bullous impetigo is characterized by the appearance of large blisters in the affected area. This is caused by a toxin produced by staph that causes the separation of the epidermis from the dermis. The blisters are extremely delicate to the touch and may pop at the slightest touch. Upon breaking, the lower layer of your skin becomes exposed, leaving you with raw and painful sections.

Another type of this skin condition you should be looking out for is secondary impetigo, which is also referred to as impetiginous dermatitis.30 This subtype may be triggered by other skin issues and conditions, including simple insect bites to eczema, as long as they entail breaks in the skin.  This may prove to be especially problematic for patients with systemic diseases, such as diabetes and immunodeficiency syndrome.31

In a 2009 study done in Japan, it was found that patients with poorly managed atopic dermatitis were at higher risk of contracting severe secondary impetigo, with the abundance of the S. pyogenes bacterium playing a significant role in the severity of its symptoms.32

How to Treat Impetigo

In most cases, impetigo cases may heal without needing any medical intervention. After the scabs fall off, these sores usually don’t leave any permanent marks. With treatment, impetigo typically heals within seven to 10 days, taking a little longer if patients choose to just let the condition run its course.33 However, some treatments may be needed to minimize the risk of spreading it to other people.

Conventional Treatments for Impetigo

In conventional medicine, impetigo treatment typically relies on antibiotics to combat bacterial load in the sores. These include:

Topical mupirocin — Mupirocin refers to an antimicrobial agent used to treat certain soft tissue infections. This is the typical conventional treatment prescribed by conventional physicians.34

However, note that the effectiveness of mupirocin is not foolproof. There are certain individuals who are resistant to this topical antibiotic. In a 2014 study, about 14.7 percent of children in the Houston area were found to be mupirocin-resistant.35

Topical disinfectants — Disinfectants may be used to treat impetigo. However, their effectiveness remains in question because of studies that show they are as ineffective as placebos.36

Oral antibiotics — In severe cases, antibiotics may be prescribed, such as amoxicillin, cephalexin and dicloxacillin. But because of the existence of drug-resistant strains of bacteria responsible for impetigo, these antibiotics may not work. Also note that there are numerous contraindications for antibiotics, including pregnancy and other medication intake. If you suspect that you are suffering from impetigo, never self-prescribe with antibiotics.

Home Remedies for Impetigo

While you might think that conventional treatments would be best for you, there are numerous holistic and safe alternatives that are just as effective. Some of the things that you can use for treating impetigo are:

  • Manuka honey contains wound healing and antimicrobial properties, which may help promote faster skin recovery.37
  • Tea tree oil is widely known for its antibacterial and anti-inflammatory properties. In a 2010 animal study, it was found that tea tree oil helps inhibit the growth of Streptococcus bacteria in strep-induced fasciitis.38
  • Olive oil contains both moisturizing and antibacterial properties, which may help in speeding up impetigo healing.39
  • A combination of grapefruit seed extract and geranium oil was found to be effective in inhibiting MRSA infections, with MRSA being one of the potential causes of impetigo.40

How Does Impetigo Spread?

Like other infectious diseases, impetigo may be hard to contain, especially in settings where physical contact is unavoidable . As a bacterial infection, impetigo is primarily transmitted through direct physical contact with infected patients or through materials that patients came into contact with.41

How Long Is Impetigo Contagious?

The most contagious stage of impetigo is during the draining phase, when the sores are draining fluid.42 Patients with sores usually absentmindedly touch their sores and touch other materials or other people. This is usually the way that bacteria spread from person to person, and is one of the reasons why children or adults with this skin condition should avoid crowded places.43

Are Certain Groups More Susceptible to Impetigo?

Most people have equal susceptibility to the bacteria responsible for impetigo. However, there are certain subgroups in the population that may be at heightened risk due to increased exposure or amplified skin permeation. If you belong to the following groups, consider employing preventive measures to lower your risk:44

  • Patients with disrupted skin barrier function — People with eczema and dermatitis are more predisposed to impetigo due to the skin openings that the sores accompanying these conditions cause.
  • Nasal and perineal colonization — S. pyogenes and S. aureus bacteria usually inhabit the nasal area. In cases where there is susceptible skin around these areas, impetigo may be triggered.45
  • Minor physical trauma — Minor scrapes and cuts on the skin allow bacteria to enter the skin, heightening your risk for infection.

Impetigo Prevention Tips to Consider

Impetigo is very contagious, and may be hard to avoid, especially if you frequent densely populated places. However, it all boils down to hygiene. Follow these tips to lower your or your child’s risk of contracting this skin condition:46,47

  • Avoid sharing towels, clothing or other personal things with people — Sharing personal items paves the way for faster bacteria transmission. This may significantly heighten your and your family’s susceptibility to impetigo.
  • Wash your hands frequently — One of the easiest ways to transmit bacteria is through the hands. Patients may be absentmindedly touching their sores and then other materials, spreading the bacteria faster. Wash your hands with mild soap and water whenever you get the chance.
  • Treat and cover cuts and scrapes with wound dressing as soon as possible — Cuts and scrapes may render you vulnerable to infections as they provide bacteria with an entry way into your body.
  • Keep your nails clean and clipped — Always keep your nails short and clean to avoid dirt, and therefore bacteria, from accumulating in your nailbeds.
  • Take a bath regularly — Taking a bath with mild soap will help keep the bacteria found on the surface on your skin in check.

How to Stop Impetigo From Spreading

If you’ve contracted this skin condition from your workplace or from coming into contact with an infected patient, you should be careful not to spread it any further. To prevent your friends and loved ones from getting the infection themselves, here are some of the things you can do:48

  • Clean the infected area with mild soap and water.
  • Loosely cover impetigo sores.
  • Wash your hands before touching other people.

Impetigo Diet: What Foods Should You Eat?

Impetigo is a skin condition that is characterized by isolated infection and inflammation. While there are no specific diets for impetigo recovery, it’s pretty obvious that you should modify your current diet to include foods that may strengthen your immune system, and avoid foods that may aggravate inflammation.

What Foods Should You Avoid During the Onset of Impetigo?

Foods in the standard American diet are filled with sugar, vegetable oil and refined flour that can all trigger inflammation. These foods can also compromise your immune function, which would be counterproductive to recovery. Foods that you should eliminate are:

  • Refined carbohydrates — One of the culprits for the rising obesity rates in the country is the abundance of refined carbohydrates being sold in the market today. Because of their high-glycemic index, refined carbohydrates trigger the production of AGEs, or advanced glycation end products, which may negatively affect skin health, worsening impetigo.49,50
  • Sugar-loaded foods and drinks — Refined sugar is one of the leading causes of chronic inflammation. If your diet consists of high amounts of sugar, you may be speeding up aging because of its effect on collagen production.51

Foods to Eat if You Have Impetigo

The good news is that there are numerous healthy foods that may help soothe inflammation and strengthen your immune system in times of infection. Some of the foods you should consider adding to your meals today are:52

  • Vitamin A-rich foods — Vitamin A is essential for maintaining skin health and mucous membranes, aiding the body by keeping out bacteria and other harmful organisms from entering. It also helps in promoting better immune system function, and combatting infections and other problems that arise from bacterial and viral issues. Some examples of vitamin A-rich foods are organ meats, dairy products, carrots, pumpkins and dark green leafy vegetables.
  • Vitamin C-rich foods — Vitamin C plays an important role in the maintenance of skin health, aiding in faster wound healing. In fact, vitamin C deficiency has been linked to the inability to form scar tissues. Eating vitamin C-rich foods may provide the body with enough material to speed up impetigo recovery. Some examples of foods that are rich in vitamin C include citrus fruits, green leafy vegetables and broccoli.
  • B-vitamins — This group of vitamins is crucial in energy expenditure and distribution throughout the body. With the help of B-vitamins, nutrients absorbed by the body are efficiently directed to the tissues that require repair. Some of the best sources of B-vitamins include milk and dairy products, organic grass fed beef, organ meats and green leafy vegetables.

Frequently Asked Questions (FAQs) About Impetigo

Q: Is impetigo contagious?

A: Impetigo is a very contagious skin condition as the bacteria that causes the sores can be easily transmitted from person to person. It is often contracted in crowded places, where physical contact cannot be avoided. This skin condition may also be spread through indirect contact, usually by touching a material that has touched a patient’s sores. This is usually caused by the staph bacteria as it can stay longer on surfaces away from the body.

Q: What does impetigo look like?

A: Impetigo sores usually start off as a rash that slowly develops into small blisters. These blisters are very easily punctured, which then dry to yellowish scabs. Impetigo sores usually appear near the mouth and the nose, but may also be found on the buttocks and other areas of the body.

Q: How long does impetigo last?

A: Impetigo rashes usually develop three to 10 days after contracting the bacteria from an infected source. The rashes will usually heal in about two weeks and typically leave no permanent marks. This healing process may be sped up using numerous treatment options, which may help the body fight off the infection faster.

Q: How does impetigo spread?

A: Impetigo is spread by either direct or indirect contact. Direct transmission refers to physical contact with an infected patient, either by touching the sores or getting touched by the patient after he/she touched the sores. Indirect transmission happens when you contract the bacteria through clothing or other materials that the infected patient touched.

Q: Is impetigo painful?

A: Impetigo rashes are not usually painful, but they may be extremely itchy. In some cases, when the blisters become punctured, the raw skin that becomes exposed may be sore.

Q: Can adults get impetigo?

A: Yes. While impetigo usually occurs during childhood, adolescents and adults can still get this skin condition, especially patients with compromised immune systems or other systemic conditions that may interfere with normal immune function.

Q: What causes impetigo rashes?

A: Impetigo rashes are caused by an infection of the skin by the Staphylococcus aureus, Streptococcus pyogenes and MRSA, or methicillin-resistant staphylococcus aureus.

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