Whether they’re in daycare or school, kids can bring a lot of different bugs home with them. So as a parent, you’ve likely seen your child with a wide range of symptoms – from a scratchy throat to skin rashes. But if your child has a skin rash that you don’t recognize, it’s important to find out what it is. Many different conditions can cause similar-looking rashes, and they aren’t all treated the same way.
Impetigo is one very common cause of skin rashes in children. So here, we explain what it is, its key symptoms and how they compare to other conditions. We also cover treatment and tips for limiting the spread of impetigo at home.
Impetigo is a common bacterial skin infection
Impetigo occurs most frequently in children 2-5 years old, but adults can catch it, too. It’s generally characterized by blistery sores that develop a distinctive crust.
Causes of impetigo
The two main types of bacteria that cause impetigo are Staphylococcus and Streptococcus. Impetigo can occur when these bacteria enter the skin through cuts, scrapes, insect bites or through areas of skin that are damaged by other conditions like eczema, or a cold that leaves your nose dry and raw.
How contagious impetigo is and how it’s spread
The bacteria that cause impetigo can be spread by touching the sores directly or by handling objects that an infected person has touched. Impetigo is considered contagious until all the sores have dried and healed, which can take several weeks. However, people with impetigo can often return to group settings after 24 hours of antibiotic treatment, as long as they keep the sores covered.
Types of impetigo and what symptoms look like
Sores are the primary symptom of impetigo. The appearance of the sores can vary depending on the type of impetigo causing them. More serious cases of impetigo can also involve fever and swollen lymph nodes. Here’s what impetigo symptoms look like depending on each type.
Non-bullous impetigo symptoms
Non-bullous impetigo is the most common type of impetigo. The sores it creates take the form of small, red blisters that pop easily, leaving behind a crusty honey-colored scab. The sores may be itchy and typically form around the nose and mouth first. However, they can spread to other areas of the body – particularly the arms and legs – especially if your child touches or scratches the sores.
Bullous impetigo symptoms
Bullous impetigo is less common, and its sores differ from non-bullous sores in a few ways. The blisters tend to be larger and take longer before they pop. The blisters themselves may be painful, and the skin around them may itch. They typically form on the torso, arms or legs.
Bullous impetigo is also more likely to cause fever and swollen lymph nodes.
Ecthyma (deep impetigo) symptoms
Ecthyma is a rarer and more severe form of impetigo that’s more likely to form in people who are immunocompromised or have impetigo that’s been left untreated. It usually forms on the lower body and may start out with a similar appearance to non-bullous impetigo, but the infection goes deeper into the skin. The resulting sores are larger with hard crusts, which reveal crater-like ulcers if removed.
The difference between impetigo and other skin conditions
There are a number of skin conditions that can cause sores like impetigo. But in most cases, they can be distinguished from each other by comparing their symptoms. For example, both impetigo and cold sores tend to form near the mouth. The difference is that impetigo also tends to cause sores around the nose and possibly on the limbs, while cold sores tend to stay on or around the lips – although they can also spread up to the cheeks and nose. In children, a first case of cold sores can also cause flu-like symptoms, including fever, head and body aches, a sore throat and general feelings of unwellness.
Other skin conditions with symptoms similar to impetigo
- Hand, foot and mouth disease (HFMD) – HFMD symptoms also include mouth sores, but they tend to form inside the mouth. These sores typically appear alongside flu-like symptoms and a skin rash on the palms and soles.
- Scabies – Scabies can cause a rash that may include small blisters that appear visually similar to impetigo. However, scabies rashes are generally very itchy, look more like pimples, appear all over the body and may be paired with raised lines on the skin where the scabies mites burrow.
- Chickenpox – Chickenpox is another condition characterized by a rash that turns into blisters, but it affects the entire body, starting with the chest, back and face. Chickenpox can also cause fever, fatigue and headaches a day or two before the rash starts to form.
- Contact dermatitis – Sometimes, skin can react to direct contact with an allergen or irritant. This is called contact dermatitis. The symptoms of a reaction depend on the cause but may include an itchy rash or blisters. However, these kinds of reactions are often limited to the area that came in contact with the allergen or irritant.
How impetigo is diagnosed
A doctor can usually diagnose impetigo with a visual examination. In certain cases, such as if treatment doesn’t appear to be effective, a fluid sample or culture may be taken from one of the sores to determine what bacteria is causing them. It’s important to get a diagnosis for suspected impetigo, as other common skin conditions can cause similar sores.
Impetigo treatment involves antibiotics and good hygiene
Antibiotics are the main treatment for impetigo. For mild cases of non-bullous impetigo, a doctor will typically prescribe a topical antibiotic ointment to apply to affected areas. For more widespread or serious cases, a doctor may prescribe oral antibiotics. If you use antibiotics as instructed, most impetigo sores will be healed in 7-10 days. Your doctor may recommend a follow-up visit if symptoms don’t improve within seven days.
In addition, daily soaks in warm, soapy water can help remove crusts and make antibiotic ointment more effective. After a bath, use a patting motion to dry the skin and use a clean towel every time.
How to prevent impetigo from spreading
Antibiotic treatment reduces the risk of spreading impetigo, but it’s still considered contagious until the sores are healed. Until then, it’s important to maintain especially good hygiene. This includes:
- Frequent handwashing with soap, especially after caring for anyone infected
- Avoid sharing objects
- Discourage scratching by clipping fingernails short and covering or bandaging affected skin
- Wash the clothes, bedding and towels of anyone infected with hot water every day
Think you’re seeing signs of impetigo? Get a diagnosis
If you or your child are experiencing sores that could be caused by impetigo, it’s time to seek care. Knowing whether you have something contagious – and if you do, whether it’s viral or bacterial – is key to treating it effectively. Your primary care doctor can rule out other possible causes and ensure that you get the right treatment.