What is impetigo?

Impetigo is a bacterial skin infection. It is highly contagious, but it’s not normally serious, and symptoms usually go away after 7 to 10 days of treatment. It typically affects children aged 2 to 5, but adults can sometimes get it too.

Impetigo occurs when skin – particularly broken and irritated skin – comes into contact with certain types of bacteria. It causes blisters and sores, usually around the nose and mouth, which burst and can be itchy and painful. Impetigo is very common in young children, and it is treated with antibiotics. For adults, impetigo is more common in men than women.

What are the symptoms of impetigo?

The early signs of impetigo are blisters and red sores. However, these can sometimes be more difficult to see on brown and black skin. These blisters or sores often appear in clusters and then break and leave a yellow or honey-brown crust.

The sores can get bigger and spread to other parts of your body, and they can sometimes be itchy and painful. After the crust clears, they become red marks which usually fade away without scarring. In some cases, impetigo can also cause a fever or swollen glands.

Another type of infection called bullous impetigo affects young children and infants, causing large blisters on the lower-body.

How long does impetigo last?

Impetigo normally lasts between 7 and 10 days if you get treatment.

It doesn’t normally have long lasting effects and mild cases normally heal without scars. However, it can rarely cause complications including:

• cellulitis, a potentially life-threatening skin infection that can spread into your bloodstream
• kidney damage, caused by the some of the types of bacteria that cause impetigo
• scarring, if sores are very deep, which is known as ecthyma

You should talk to your doctor straight away if you think you or your child have impetigo, as antibiotics are needed to treat it and can help to avoid more serious health problems.

What causes impetigo?

Impetigo is caused by two different types of bacteria:

• staphylococcus aureus, sometimes referred to as staph
• group A streptococcus, the same bacteria that causes cellulitis, strep throat, and other infections

Infection usually happens when these bacteria come into contact with broken or irritated skin such as from a rash, wound, scratch, cut, insect bite, or other skin condition. In some cases, it can infect normal skin. 

The bacteria that causes impetigo can travel on surfaces such as clothing, towels, bed linen, and toys, as well as via skin-to-skin contact. Once you are infected, the bacteria multiply, causing the symptoms to occur.

Sometimes impetigo infections can happen repeatedly because the bacteria that cause it are present in your nose. Your GP can take a swab from your nose to check, and may prescribe a nasal cream to get rid of the bacteria and stop the infections from recurring.

What increases the risk of impetigo?

The main factor increasing the risk of impetigo is close contact with another person who already has the infection. However, there are a number of other risk factors for impetigo, including:

• age, as impetigo is most common between age 2 and 5
• having frequent skin-to-skin contact with others in crowded places or whilst participating in contact sports
• attending childcare facilities
• hot and humid weather, which help facilitate infection
• having broken skin or other skin conditions which cause broken or irritated skin
• having burns on your skin, including sunburn
• insect bites, poison ivy
• itchy infections like lice, scabies, herpes, or chickenpox
• being an older adult, having diabetes, or a weakened immune system

Poor personal hygiene is also a risk factor for impetigo. Keeping your body, hands, and face clean will help reduce the chances of infection.

How is impetigo diagnosed?

If you have symptoms that look like impetigo, you can get a skin diagnosis online with Superdrug Online Doctor. All you need to do is submit some photos of your skin, and one of our doctors can provide a diagnosis and advice on next steps. 

You can also make an appointment with your GP to get a diagnosis and treatment. They can examine any sores on your face and body. Further testing is not normally needed, unless they suspect impetigo is being caused by a resistant bacterium like MRSA, or if symptoms are continuing beyond 10 days. In this case, your doctor might take a bit of liquid that comes out of one of the sores and send it for testing to find out which antibiotics will be most effective.

Because impetigo is highly contagious, you should let your GP surgery know if you suspect impetigo when booking your appointment. Sometimes, a phone or video call appointment is sufficient and helps to prevent spreading the infection to others.

Is impetigo similar to other conditions?

Yes, impetigo is similar to other conditions and can be confused with other skin infections.

Blisters on the lips or around the mouth can be due to cold sores. Itchy, dry, cracked, and sore skin can occur with eczema, and itchy blisters could be shingles or chickenpox.

Because these symptoms can be confused with impetigo, it is better to get a proper diagnosis.

How is impetigo treated?

Mild impetigo is normally treated by applying over-the-counter or prescription strength topical antibiotics onto sores several times a day for 5 to 10 days, as well as regularly washing them with soapy warm water. Cleaning your sores before applying the antibiotics helps get rid of the infection.

Sometimes, if the infection is widespread or persistent, then oral or intravenous (injected) antibiotics may be required. Or if your sores are particularly deep and you have ecthyma, your GP might give you an oral antibiotic.

For impetigo, we offer Fucidin Cream, which is an antibiotic cream that tackles the infection by killing the bacteria that causes impetigo.

How do these treatments work?

Topical antibiotics work by stopping or slowing down the growth of the bacteria. They can also reduce any itching, redness, and swelling in your skin through activation of natural substances in your body.

How effective are impetigo treatments?

Impetigo treatments are generally quite effective and symptoms usually clear up in 7 to 10 days. However, it is important you follow your treatment program properly. If you are taking oral antibiotics you should finish the course, even if you start to feel better. Or if you are applying a topical antibiotic you should always clean your skin before applying it.

Natural home remedies can sometimes help to relieve impetigo symptoms. However, they should not be used instead of antibiotics.

Aloe vera, chamomile, garlic, ginger, grapefruit seed, eucalyptus, neem, honey, tea tree, turmeric, and usnea have been shown to have some effect in fighting the bacteria which cause skin infections.

How to prevent impetigo

Impetigo normally occurs when your skin is already damaged. To reduce the risk of getting it you should:

• keep your skin clean using soap and warm water when it is damaged, such as due to a cut, bite, scratch, or existing skin condition
• covering damaged skin like cuts, scratches, and bites
• get treatment if you have other skin conditions, such as eczema
• keeping your hands clean using soap and water or hand sanitizer
• clipping fingernails to avoid scratching, especially for children
• daily bathing, particularly for children with eczema
• keeping fabrics such as linen, towels, and bedding clean

These actions will reduce the risk of the bacteria that cause impetigo getting into the skin.

Sources

Impetigo VeryWellHealth [accessed 9th August 2022]

Impetigo NHS [accessed 9th August 2022]

Impetigo Mayoclinic.org [accessed 10th August 2022]

Impetigo in adults Healthline [accessed 10th August 2022]

Impetigo Skinsight [accessed 10th August 2022]

Ecthyma DermNet NZ [accessed 10th August 2022]

How do topical antibacterials work? RxList [accessed 10th August 2022]

Home remedies for Impetigo Healthline [accessed 10th August 2022]

Impetigo Cleveland Clinic [accessed 10th August 2022]

Impetigo National Institute for Health USA [accessed 10th August 2022]