Impetigo

Overview

What is impetigo?

Impetigo (im-pa-TIE-go) is an itchy, sometimes painful, skin infection.

Who gets impetigo?

Impetigo usually happens to children between ages 2 and 6. Older children and adults can also get it.

You may also be at higher risk if you:

  • Live in a tropical climate, with hot, humid summers and mild winters.
  • Have a scabies infection.
  • Do activities or sports where cuts and scrapes are common.
  • Live in close contact or crowded situations. Infections often happen to people living in the same house or children in day care.

How does someone get impetigo?

When you get a cut, bite or scratch that opens the skin, bacteria can enter and cause an impetigo infection. But impetigo can infect the skin even if it’s not broken or punctured.

Impetigo happens more often in warmer months when children are outside more.

Where does impetigo occur?

Typically, the first signs of impetigo are sores and blisters on the mouth and nose. Impetigo can also appear on the legs and arms.

What is bullous impetigo?

Bullous impetigo is a rare type of impetigo. It has larger blisters that don’t break open as easily. It often appears on the neck, torso, armpits or groin.

How common is impetigo?

Impetigo is the most common skin infection in kids ages 2 to 5. It happens much less in adults. Every year, Staphylococcus aureus, the bacteria that causes impetigo, causes 11 million skin and soft tissue infections.

Symptoms and Causes

What causes impetigo?

The main cause of impetigo is a bacterial infection. The bacteria usually enters the skin through a cut, scrape, rash or insect bite.

Most of the time, the cause is the Staphylococcus aureus (“staph” bacteria). Sometimes, group A Streptococcus bacteria can cause it. This type of bacteria also leads to strep throat and fever.

Certain strains of strep bacteria that cause impetigo can also cause glomerulonephritis. This inflammatory kidney disease can produce high blood pressure and blood in the urine.

Is impetigo contagious?

Impetigo is mild but highly contagious. You can spread impetigo by coming into contact with the sores or mucus or nasal discharge from someone who has it. People can also spread impetigo by sharing items such as towels, clothing or other personal items with someone who’s infected.

When do impetigo symptoms start?

Typically, once the infection happens, symptoms occur within three days. Scratching the sores can spread the infection. Symptoms first start around the mouth and nose.

What are the symptoms of impetigo?

Symptoms of impetigo include:

  • One or more pus-filled blisters that burst easily, causing red, raw skin.
  • Itchy blisters containing fluid (yellow or tan) that seeps out and forms a crust.
  • A rash that spreads.
  • Skin lesions (wounds) on the lips, nose, ears, arms and legs. The lesions can spread to other parts of the body.
  • Swollen lymph nodes near the infected area.

If you or your child has impetigo caused by staph bacteria, you may notice:

  • Reddish skin surrounding red blisters, full of liquid or pus that eventually looks cloudy.
  • Blisters that burst easily and leak.
  • Raw, shiny areas that scab over with a yellow/brown crust.

Diagnosis and Tests

How is impetigo diagnosed?

A healthcare provider can diagnose impetigo based on how the sores look. The provider may take a skin sample to send to a laboratory. Pathologists can figure out which bacteria is causing the disease, which can help determine the right antibiotic to use.

If you notice or your child notices any blood or odd color in urine, tell your healthcare provider right away.

Management and Treatment

How is impetigo treated?

Antibiotics can treat impetigo. A provider may prescribe topical antibiotics to put on the skin. Your child may need to take oral antibiotics (a liquid or pill) if the condition covers a large area of skin or multiple body parts.

Examples of antibiotic treatments include:

  • Topical mupirocin (Bactroban® or Centany®) ointment.
  • Oral antibiotics such as cephalosporins, clindamycin (Cleocin®) and sulfamethoxazole (Bactrim™).

Will impetigo go away on its own?

Impetigo often disappears within about three weeks, even without treatment. But it may take longer. Until it goes away, your child is contagious.

Are there complications of impetigo?

Complications are rare. They include:

  • Rash that spreads to deeper skin layers.
  • Kidney problems, called post-streptococcal glomerulonephritis.

Prevention

Can I prevent impetigo?

The best ways to prevent infection are to stay clean and healthy. Other tips to avoid impetigo include:

  • Keep hands clean: Wash hands regularly. Use alcohol-based sanitizer if you don’t have soap and water.
  • Practice good hygiene: Clip your (and your child’s) fingernails regularly to avoid scratching. Sneeze into a tissue and then throw the tissue away. Bathe daily (or as often as possible), especially for children with eczema or sensitive skin.
  • Avoid scratching: Don’t scratch cuts or wounds. If your child gets a cut, scratch or wound, keep them from scratching it.
  • Clean wounds: Clean cuts, scrapes and injuries with soap and water. Then put an antibiotic cream or ointment on the wound.
  • Keep linens clean: Wash underwear, towels and sheets in hot water.

Outlook / Prognosis

What’s the outlook for someone who gets impetigo?

Antibiotics can cure impetigo, but the condition can return, especially in small children. Getting it once doesn’t protect someone from getting it again.

How long until the sores go away?

The sores may take some time to heal completely. The good news: The infection rarely leaves scars.

How long is impetigo contagious?

Without treatment, impetigo can be contagious for weeks. After starting impetigo treatment, the condition is contagious until:

  • The rash disappears.
  • Scabs fall off.
  • You have finished at least two days of antibiotics.

Can a person get re-infected?

Re-infection happens. Children are especially prone to scratching and opening their scabs, putting them at a higher risk of re-infection.

Living With

How can I take care of myself if I have impetigo?

If your healthcare provider diagnosed you or your child with impetigo, these treatment tips can help:

  • Keep sores covered: Bandage sores or wear long sleeves and pants.
  • Take all medication: Use your antibiotics for the full length of me your provider prescribed them to prevent re-infection.
  • Stay clean: Wash the skin gently a few times a day using antibacterial soap. Doing so will remove crusts and drainage.
  • Avoid touching the rash: If you do touch it, wash your hands and the exposed area with soap and water.
  • Isolate children: If your child has impetigo, keep them away from other children until they finish treatment. They shouldn’t go to school or day care.
  • Avoid hot tubs and swimming pools: The rash can spread if others come into contact with your child’s skin, swimsuit or towel.

A note from Cleveland Clinic Impetigo is a common skin condition that mostly affects young children. Impetigo symptoms include blisters and red sores that typically start around the mouth and nose. If you notice signs of impetigo, talk to your healthcare provider. Impetigo treatment is usually antibiotics, either oral or topical (a cream). Impetigo is very contagious, so keep children home until they’ve had at least two days of antibiotics. The medicine will clear up the rash. To prevent impetigo, practice good hygiene. Clean and cover any cuts or scratches to keep them from getting infected.

Last reviewed by a Cleveland Clinic medical professional on 10/22/2020.

References

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy