First Aid Management: Impetigo

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The lesion of Impetigo is most commonly caused by the bacteria Staphylococcus Auereus and begins with numerous sores in the area around the nose, eyes and cheeks of the patient. It is also called Non-bullous Impetigo Contagiosa. It then rapidly transforms into a pustule, which is a lesion with pus inside, or a vesicle, which is a blister, that eventually ruptures leaving a dry, honey colored crust. Since the infection does not invade into the dermis, the infection heals spontaneously without scarring in about 2 weeks.

Rapid expansion of the lesion to other areas such as the exposed extremities is brought about by the introduction of the bacteria through scratching. Transmission of the infection to other children is often due to direct contact of infected children but transmission through fomites, or objects that are able to carry an infection, is also possible. The incidence of Impetigo is highest during summer months and occurs in households, schools or day care centers with poor hygiene and crowded living conditions. In a study in the United Kingdom, the annual incidence of impetigo was seen to be at 2.8 percent for children up to 4 years of age and 1.6 percent among children 5 to 15 years of age.

Cases of impetigo is highest during the summer months
Cases of impetigo is highest during the summer months

Signs and Symptoms of Impetigo

As mentioned above, the skin lesion of impetigo begins in the face that can eventually spread into the extremities. The classic signs and symptoms is the formation of the honey colored crust after eruption of the blister. However, another form of Impetigo, Bullous Impetigo, which is less common, is characterized by larger blisters in the body or diaper area of infants. The symptoms of fever, diarrhea and generalized weakness are usually absent in Non Bullous Impetigo Contagiosa but may be seen in Bullous Impetigo. The lesions are usually asymptomatic with occasional itchiness. Little to no surrounding erythema or edema is also present.

Treatment for Impetigo

Although an infection with Impetigo can resolve spontaneously, antibiotic treatment can shorten the infection and may limit spread. The goals of the therapy is as follows:

  • Resolution of skin manifestations
  • Elimination of infecting organism
  • Prevention of spread of infection

With that being said, your healthcare provider may recommend the usage of the following antibiotics:

  • Topical treatment:
    • Mupirocin ointment applied for 5 to 10 days
    • Fusidic acid
  • Benzathine Penicillin G for oral therapy
    • Alternatives for oral therapy: Erythromycin and Azithromycin

Prevention for Impetigo

If a family member or child is suspected to have Impetigo, the following pharmacologic and non-pharmacologic treatments are recommended to limit the spread.

  • Pharmacologic treatment:
    • Impetigo can be prevented by prompt application of Mupirocin or triple-antibiotic ointment (Bacitracin, Polysporin, and Neomycin) to sites of skin trauma
    • Patients who are carrier of Staphylococcus Aureus in their nares should be treat with Mupirocin ointment applied to their nares for 5 days
  • Non-pharmacologic treatment:
    • Fingernails should be cut and kept short
    • Patients should be advised not to scratch any lesions
    • Lesion should be cleaned and washed with soap and water
    • Salt solution compress can help dry the lesion
    • Cold compress can be used to soothe the lesion
    • The secretions and crust formed after rupture should be removed

To learn more about how to manage signs and symptoms of Impetigo and other bacterial infections, enroll in First Aid Courses.

Impetigo is a highly contagious superficial bacterial infection of the skin that is usually found in infants and children of 2 to 5 years old.

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