OVERVIEW

What is impetigo? What are the common types of impetigo?

Impetigo is a common contagious skin infection caused by bacteria, characterized by the appearance of papules, blisters, and pustules on the skin; the blisters rupture easily and form crusts. It can spread in kindergartens and schools. Based on bacterial infection and manifestations, it is divided into bullous impetigo and non-bullous impetigo.

SYMPTOMS

What are the manifestations of bullous impetigo?

Bullous impetigo is caused by Staphylococcus aureus infection. Initially, scattered blisters appear, which rapidly enlarge within 1–2 days. The fluid inside the blisters is initially a clear yellow liquid but turns cloudy after a day, with pus settling at the bottom, forming a crescent-shaped pustule (one of the characteristic features of this type of impetigo).

What are the manifestations of common impetigo?

Common impetigo is caused by Streptococcus pyogenes infection and may also involve a mixed infection with Staphylococcus aureus.

Red patches appear on the skin, followed by thin-walled blisters that quickly turn into pustules with surrounding redness.

After the blisters rupture, thick yellow crusts form, which may merge with nearby affected skin. Due to itching and scratching, the infection often spreads to other areas, causing new rashes.

Will impetigo leave scars?

If treated promptly and cared for properly, impetigo generally does not leave scars. After treatment, scabs form and fall off within 6–10 days. Even if red marks remain, they will fade with age, so parents need not worry excessively. However, if the infection is severe or the child scratches vigorously, damaging deeper skin layers (reaching the dermis), scarring may occur. Therefore, efforts should be made to prevent scratching.

What are the manifestations of neonatal impetigo?

It commonly occurs in infants 4–10 days after birth, with sudden large blisters appearing on the face, torso, arms, and legs. The fluid inside the blisters changes from clear to cloudy.

The skin around the blisters may turn red, and the blister walls are prone to rupture. The infant may develop a fever and pass green, foamy stools. Immediate medical attention is required if these symptoms appear; delays should be avoided.

Can neonatal impetigo affect the body?

Neonatal impetigo progresses rapidly. If treated promptly, it leaves no sequelae. However, delayed treatment may lead to complications such as sepsis or meningitis, potentially causing lasting effects. Some parents may not provide adequate care for newborns, which warrants serious attention.

CAUSES

Is impetigo contagious?

Yes. Because it is a bacterial infection, the blister fluid contains a large number of bacteria, which can cause contact transmission and spread quickly. Therefore, prevention and isolation should be taken seriously.

What causes impetigo?

Some children are prone to eczema or insect bite dermatitis, leading to itching, skin scratches, and injuries that allow bacteria to invade. In summer, hot weather causes excessive sweating, making the skin macerated and unclean. Infants and young children have thin and delicate skin, and their underdeveloped immune systems make them more susceptible to bacterial infections.

DIAGNOSIS

How to identify impetigo?

Blisters that often appear in summer or autumn, rapidly enlarge with clear or cloudy fluid inside, and rupture easily; if the fluid spreads to healthy skin and causes infection, impetigo should be suspected, and medical attention should be sought immediately.

What tests are needed for impetigo?

Dermatologists can easily diagnose impetigo based on skin manifestations. If treated promptly, tests are usually unnecessary. For severe cases, doctors may prescribe empirical treatment while conducting bacterial culture and antibiotic sensitivity tests to select appropriate antibiotics for effective treatment.

Why is a urine test needed for impetigo?

Various bacteria can cause impetigo. Some infections (such as streptococcal infections in common impetigo) may produce substances that damage a child's kidneys. A urine test helps assess kidney function, making it a reasonable diagnostic step.

TREATMENT

Which department should a child with impetigo go to?

Children should visit the dermatology department of a children's hospital. If there is no children's hospital nearby, they should go to the dermatology department of a general hospital.

Considering that most hospitals do not have emergency dermatology services, if the child has critical symptoms or if it is unclear whether the situation is urgent, you can first go to the emergency department. If kidney damage occurs, they should visit the nephrology department.

How is impetigo treated? Does impetigo require medication?

• First, pay attention to isolation, as this disease is contagious. Seek medical attention promptly.
• Under sterile conditions, the doctor may puncture the blisters with a sterilized needle and absorb the fluid with sterile cotton balls, then apply an appropriate antibacterial solution. Avoid letting the fluid spread to healthy skin during the process. If it does, clean the skin with iodine or other topical disinfectants.
• If the impetigo is mild and the child is in good overall condition, medication may not be necessary—topical treatment alone may suffice.
• If the impetigo is extensive or severe, the doctor will determine the appropriate treatment, which may include oral antibiotics or intravenous therapy. If itching is severe, antihistamines may be given to prevent scratching.

The child with impetigo is already following the doctor's treatment, so why are the blisters still increasing?

Impetigo is a contagious skin infection caused by bacteria, and the blister fluid contains a large number of bacteria. If the child scratches and the fluid spreads unnoticed, it can infect healthy skin, leading to more blisters.

Another possibility is that the medication being used is ineffective in controlling the condition. In such cases, a follow-up visit is necessary. Therefore, preventing scratching is crucial. If scratching is avoided, the effectiveness of the medication can be more easily assessed.

Can impetigo recur?

Impetigo can recur because children's skin is thin and delicate, and they are prone to itchy skin conditions. Scratching can lead to infection, making children susceptible to repeated episodes of impetigo. Parents should promptly treat conditions like eczema or dermatitis in their children.

Is impetigo life-threatening?

Impetigo is caused by a bacterial infection and is not life-threatening if treated promptly. However, neonatal impetigo progresses rapidly, and due to the weak immune system of newborns, complications such as pneumonia, nephritis, or meningitis may occur, which can be life-threatening.

Can alcohol be used topically to disinfect impetigo?

There are many topical antibiotics available. If medical attention cannot be sought immediately after symptoms appear, an appropriate disinfectant can be used temporarily before visiting a doctor. Alcohol is highly irritating and should be avoided. Iodine, erythromycin ointment, or mupirocin are better alternatives.

Even if temporary use of these medications improves symptoms, medical attention should still be sought promptly. Inform the doctor about any medications used before the visit.

Can folk remedies be used for impetigo?

Do not use so-called "folk remedies." Some may appear effective but could contain unauthorized additives. While they might provide temporary relief, they may cause irreversible harm.

Most "folk remedies" lack scientific validation and should not be used casually. Therefore, seek medical attention promptly for impetigo. Doctors will provide appropriate treatment and may offer reliable clinical recommendations or prescriptions.

DIET & LIFESTYLE

What should patients with impetigo pay attention to in daily life?

Impetigo is contagious, so items used by patients should be disinfected. Changing clothes after sweating may also benefit treatment. Wash hands frequently, trim nails, and avoid scratching.

How to care for impetigo after discharge?

Monitor for recurrence of blisters or rashes. Bathe daily, change clothes, and wear loose, breathable cotton garments. Maintain cleanliness as much as possible.

For neonatal impetigo, what should the mother’s diet focus on?

There are no strict dietary restrictions, but it is generally advised to avoid spicy foods, fish, shrimp, and seafood.

What dietary precautions should children with impetigo take?

Moderate nutrition is sufficient. There are no strictly forbidden foods. Eggs, milk, and other non-allergenic foods can be consumed in moderation.

PREVENTION

How to prevent impetigo?

Prevention of impetigo focuses on personal and household hygiene, maintaining skin cleanliness, keeping children's nails trimmed, and promptly treating itchy skin conditions. Regularly disinfect clothing and other personal items, and seek medical attention if abnormalities occur.