Parents often have to deal with rashes and skin irritations in toddlers and young kids. Usually, these aren’t a big deal—often the side effect of a cold or mild allergy. But sometimes they signal something contagious that needs to be taken seriously. Impetigo is one of those things. It’s a common skin infection that typically affects children aged two to five. “It’s more common in younger children, from toddlers to five-year-olds,” says Sheilagh Maguiness, a paediatric dermatologist in Minneapolis, Minnesota. “Certainly, adults can get it, but they don’t seem to as much as children do.”
Impetigo is usually caused by staphylococcus or streptococcus bacteria, and the symptoms are similar for both types. It typically appears as sores or blisters and tends to show up on exposed skin, such as the hands and face, but can also appear on the legs, diaper area and other exposed areas of the body.
Children who have certain skin conditions, such as atopic dermatitis (a form of eczema), are at higher risk of developing impetigo. They already have “colonized” staph bacteria on their skin, which means that the bacteria is present in higher quantities but doesn’t cause an overt infection.
There are two main kinds of impetigo: bullous and non-bullous. Non-bullous impetigo (also known as impetigo contagiosa) is the most common—about 70 percent of cases—and the less severe of the two. It usually appears as skin redness, discoloration or small blisters that eventually burst and leave honey-crusted dots on the skin. With bullous impetigo, the blisters are larger and last longer on the skin and it spreads more quickly. Once they pop, the larger, crusty sores may look similar to cigarette burns.
“The bullous type is a little worse,” says Maguiness. “When you have bullous impetigo, there’s a toxin in the staph that’s cleaving this top layer of skin, and that area of cleavage is where blisters form.”
While impetigo can certainly look unpleasant, it usually isn’t very painful, says Maguiness, though the bullous form is likely to be more uncomfortable than the non-bullous type.
The infected area should be kept clean and moist with Vaseline or an over-the-counter ointment. A long soak in a bathtub can help as well. “A soaking tub bath is actually very cleansing for the skin and acts as a natural way to debride the skin of that top layer of bacterial or dead skin,” she says.
Left alone long enough, it’s likely that impetigo will go away on its own. But Maguiness still recommends a visit to a dermatologist or paediatrician, who will likely prescribe a topical treatment, such as an antibiotic ointment. If symptoms remain for too long or the infection spreads, it might be time for oral antibiotics.
Impetigo is pretty contagious, so parents should be careful about exposing other children and adults. That doesn’t necessarily mean quarantining a sick child, but precautions should be taken.
“I think you should definitely avoid skin-to-skin contact with others,” says Maguiness, “and don’t share towels and other items.” Also, avoid putting your child in a crowded situation where they’re likely to come in contact with others—in other words, maybe pass on the bouncy castle until it goes away. If your child is in daycare or school, they’ll likely have a policy on whether or not your child should stay home.
For other situations with children in close quarters, such as large families, dermatologists sometimes recommend diluted bleach baths, which may sound extreme but are about the same concentration as a swimming pool and can help reduce bacteria on the skin without the need for antibiotics, says Maguiness. If the impetigo comes back, particularly in children with atopic dermatitis, regular diluted bleach baths can help prevent recurrence.
According to the Canadian Paediatric Society, impetigo can be passed on through bed sheets, towels and clothing that have come in contact with infected skin, so keeping up with the laundry can help keep it from spreading.
Impetigo is one of those things that may look frightening but shouldn’t be a major disruption, provided that simple precautions are taken. “I could see how some parents would want to restrict activities until it’s cleared up, and I’m sure it’s something that other parents would appreciate,” says Maguiness. “But impetigo itself is common and not dangerous.”