Impetigo

Impetigo | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Impetigo Impetigo About impetigo Symptoms of impetigo Causes of impetigo Treating impetigo Complications of impetigo Preventing impetigo About impetigo Impetigo is a common and highly contagious skin infection that causes sores and blisters. Its not usually serious and often improves within a week of treatment or within a few weeks without treatment. Impetigois the most common skin infection in young children in the UK, but it can affect people of all ages. Symptoms of impetigo There are 2 types of impetigo: non-bullous impetigo  the most common type bullous impetigo Non-bullous impetigo The symptoms of non-bullous impetigo begin with the appearance of red sores  usually around the nose and mouth but other areas of the face and the limbs can also be affected. The sores quickly burst leaving behind thick, golden crusts typically around 2cm across. The appearance of these crusts is sometimes likened to cornflakes stuck to the skin. After the crusts dry, they leave a red mark that usually fades without scarring. The time it takes for the redness to disappear can vary between a few days and a few weeks. The sores arent painful, but they may be itchy. Its important not to touch or scratch the sores because this can spread the infection to other parts of the body, and to other people. Other symptoms, such as a high temperature (fever) and swollen glands , are rare but can occur in more severe cases. Bullous impetigo The symptoms of bullous impetigo begin with the appearance of fluid-filled blisters (bullae) which usually occur on the central part of the body between the waist and neck, or on the arms and legs. The blisters are usually about 1cm to 2cm across. The blisters may quickly spread, before bursting after several days to leave a yellow crust that usually heals without leaving any scarring. The blisters may be painful and the area of skin surrounding them may be itchy. As with non-bullous impetigo, its important not totouch or scratch the affected areas of the skin. Symptoms of fever and swollen glands are more common in cases of bullous impetigo. When to get professionaladvice Pharmacy First Scotland: Impetigo treatment from your local pharmacy Adults and children over 2 years with impetigo can get advice and treatment directly from a pharmacy. Find your local pharmacy on Scotlands Service directory. Search for a pharmacy near you Impetigo isnt usually serious and can be treated by a pharmacist. Your pharmacist may recommend that you contact your GP practice if required. Causes of impetigo Impetigo occurs when the skin becomes infected with bacteria, usually eitherStaphylococcus aureus orStreptococcus pyogenes. The bacteria can infect the skin in 2 main ways: through a break in otherwise healthy skin such as a cut , insect bite or other injury this is known as primary impetigo through skin damaged by another underlying skin condition, such as head lice , scabies or eczema  this is known as secondary impetigo The bacteria can be spread easily through close contact with someone who has the infection, such as through direct physical contact, or by sharing towels or flannels. As the condition doesnt cause any symptoms until 4 to 10 days after initial exposure to the bacteria, its often easily spread to others unintentionally. Children and peoplewith diabetes or a weakened immune system either due to a condition such as HIV or a treatment such as chemotherapy  are most at risk of developing impetigo. Treating impetigo Impetigousually gets better without treatment in around 2 to 3 weeks. However, treatment is often recommended because it can reduce the length of the illness to around seven to 10 days and canlower therisk of the infection being spread to others. The main treatments prescribed are antibiotic creams or antibiotic tablets. These usually have to be used for around a week. Read about treating impetigo . Preventing the spread of impetigo During treatment, its important to take precautions to minimise the risk of impetigo spreading to other people or to other areas of the body. Most people are no longer contagious after 48 hours of treatment or once their sores have dried and healed. Its important tostay away from work, school, nursery or playgroup until thispoint. The advice below can alsohelp to prevent the spread of the infection: do not share flannels, sheets or towels with anyone who has impetigo  wash them at a high temperature after use wash the sores with soap and water and cover them loosely with a gauze bandage or clothing avoidtouching or scratching the sores, or letting others touch them it may help to ensure your nails are kept clean and short avoid contact with newborn babies, preparing food, playing contact sports, or going to the gym until the risk of infection has passed wash your hands frequently particularly after touching infected skin washable toys should also be washed wipe non-washable soft toys thoroughly with a cloth that has been wrung out in detergent and warm water and allowed to dry completely If you think that the infection has spread to someone else, make sure theyre seen by a pharmacist as soon as possible. Preventing recurrentimpetigo Toreduce the risk of impetigo returning, make sure any cuts, scratches or bites are kept clean. Ensure any condition that causes broken skin, such as eczema, is treated promptly. If you develop impetigo frequently, your doctor may suggest taking a swab from around your nose to see if you carry staphylococcal bacteria. These bacteria can live in the noses of some people without causing problems, although they can lead to impetigo if they infect broken skin nearby. If youre found to carry these bacteria,you may be prescribed an antisepticnasal cream to apply several times a day for 5 to 10 days in an attempt to clear the bacteria and reduce the chances of impetigo recurring. Complications of impetigo Complications of impetigo are rare, but they can sometimes occur and can be serious. Tell your pharmacist if you have impetigo and your symptoms change or get worse. Some complications associated with impetigo include: cellulitis  an infection of the deeper layers of the skin and underlying tissue scarlet fever a rare bacterial infection that causes a fine, pink rash across the body guttate psoriasis a non-infectious skin condition that can develop in children and teenagers after a bacterial infection septicaemia (a type of sepsis ) a bacterial infection of the blood Staphylococcal scalded skin syndrome (SSSS)a serious skin condition that looks like the skin has been scalded with boiling water post-streptococcalglomerulonephritis an infection of the small blood vessels in the kidneys In very rare cases,impetigo may lead to some scarring, particularly if you scratch at the blisters, crusts or sores Symptoms of impetigo Impetigo does not cause any symptoms until 4 to 10 days after you first become infected. This means that people can easily pass the infection on to others without realising it. There are 2 main types of impetigo, known as non-bullous and bullous impetigo, which have different symptoms. Most people with impetigo have the non-bullous type. Non-bullous impetigo The symptoms of non-bullous impetigo begin with the appearance of red sores  usually around the nose and mouth but other areas of the face and the limbs can also be affected. The sores quickly burst leaving behind thick, golden crusts typically around 2cm across. The appearance of these crusts is sometimes likened to cornflakes stuck to the skin. After the crusts dry, they leave a red mark that usually heals without scarring. The time it takes for the redness to disappear can vary between a few days and a few weeks. The sores are not painful, but they may be itchy. It is important not to touch, or scratch, the sores because this can spread the infection to other parts of your body, and to other people. Other symptoms, such as a high temperature (fever) and swollen glands , are rare but can occur in more severe cases. Bullous impetigo The symptoms of bullous impetigo begin with the appearance of fluid-filled blisters (bullae) which usually occur on the trunk (the central part of the body between the waist and neck) or on the arms and legs. The blisters are usually about 1cm to 2cm across. The blisters may quickly spread, before bursting after several days to leave a yellow crust that usually heals without leaving any scarring. The blisters may be painful and the area of skin surrounding them may be itchy. As with non-bullous impetigo, it is important that you do not touch or scratch the affected areas of the skin. Symptoms of fever and swollen glands are more common in cases of bullous impetigo. Causes of impetigo Impetigo occurs when the skin becomes infected with bacteria, usually either Staphylococcus aureus or Streptococcus pyogenes. These bacteria can infect the skin in 2 ways: through a break in otherwise healthy skin, such asa cut, insect bite or other injury  this is known as primary impetigo through skin damaged by another underlying skin condition, such as head lice , scabies or eczema  this is known as secondary impetigo The bacteria can be spread easily through close contact with someone who has the infection, such as through direct physical contact, or by sharing towels or flannels. As the condition does not cause any symptoms until 4 to 10 days after initial exposure to the bacteria, it is often easily spread to others unintentionally. Impetigo stops being infectious after 48 hours of treatment starting or after the sores have stopped blistering or crusting. Increased risk In addition to the situations mentioned above, there are a number of other factors that can increase your chances of developing impetigo. These include: being a child  impetigo is thought to be more common in children because their immune system has not yet fully developed and because they tend to spend time in places where the infection can easily be spread, such as schools and nurseries having diabetes being a carrier of Staphylococcus aureus bacteria  these bacteria can live in the noses of some people without causing problems, but they can sometimes cause impetigo if they get into damaged skin nearby warm and humid weather  impetigo tends to be more common during the summer months in the UK, possibly because the warm and moist weather is a better environment for the bacteria to grow and/or because the skin is more likely to be exposed to insect bites and cuts at this time of year having a weakened immune system, either due to a condition such as HIV or a treatment such as chemotherapy Treating impetigo Impetigo isnt usually serious and often clears up without treatment after 2 to 3 weeks. Treatment is often recommended as it can help clear up the infection in around 7 to 10 days and reduce the risk of the infection being passed on to others. If impetigo is confirmed, it can usually be effectively treated with antibiotics . If the infection is being caused by an underlying skin condition, such as eczema , this may also need to be treated. Antibiotic cream For mild cases of impetigo that cover a small area, antibiotic cream is often recommended. This usually needs to be applied 3 or 4 times a day for 7 days. Before applyingthe cream, wash anyaffected areas of skin with warm, soapy water and try to clean off any crusts that have developed. To reduce the risk of spreading the infection, its also important that youwash your hands immediately after applying the cream or, if available, wear latex gloves while applying the cream. Side effects of antibiotic cream can include: irritation redness itchiness in the area where the cream is applied If symptoms havent improvedafter seven days of starting treatment,ask your pharmacist about other possible treatment options. Antibiotic tablets Antibiotic tablets may be prescribedif the infection is more severe and widespread, orif the symptoms dont improve after using antibiotic cream. These usually need to be taken 2 to 4 times a day for 7 days. If a course of oral antibiotics is prescribed for you or your child, its very important that the course is finished even if the symptoms clear up before youve takenallthe tablets. Common side effects of oral antibiotics include: feeling sick vomiting diarrhoea Speak to your pharmacist if your symptoms havent improved after 7 days of treatment with antibiotic tablets. Further testing and treatment Further tests are usually only required in cases where the infection is severe or widespread, doesnt respond to treatment, or keeps recurring. In these circumstances, your GP may refer you to a dermatologist (skin specialist) for further tests or they may take a swabof the affected skinthemselves for testing. This can help to rule out or confirm other skin conditions that may be responsible for your symptoms and can detect whether you carry one of the types of bacteria responsible for theinfection inside your nose. If your doctor thinks you may keep gettingimpetigo because you naturally have these bacteria inside your nose, they may prescribe you an antiseptic nasal cream to try to clear the bacteria. Complications of impetigo Complications of impetigo are rare, but they can sometimes occur and can be serious. Tell your pharmacist if you have impetigo and your symptoms change or get worse. Cellulitis Cellulitis occurs when the infection spreads to a deeper layer of skin. It can cause symptoms of red, inflamed skin with fever and pain. It can usually be treated with antibiotics, andpainkillers can be used to relieve pain. Guttate psoriasis Guttate psoriasis is a non-infectious skin condition that can develop in children and teenagers after a bacterial infection. It is usually more common after a throat infection, but some cases have been linked to impetigo. Guttate psoriasis causes small, red, droplet-shaped, scaly patches on the chest, arms, legs and scalp. Creams can be used to control the symptoms and in some casesthe condition will disappear completely after a few weeks. Scarlet fever Scarlet fever is a rare bacterial infection that causes a fine, pink rash across the body. Associated symptoms of infection, such as nausea, pain and vomiting, are also common.The condition is usually treated with antibiotics. Scarlet fever is not usually serious but it is contagious. Therefore, its important to isolate an infected child and avoid close physical contact. Keep your child away from school and other people untilthey havebeen takingantibiotics for at least 24 hours. Septicaemia Septicaemia (a type of sepsis ) is a bacterial infection of the blood. It can cause: diarrhoea cold, clammy skin a high temperature (fever) rapid breathing vomiting low blood pressure (hypotension) confusion feeling faint and dizzy losing consciousness Septicaemia is a life-threatening condition and requires immediate treatment with antibiotics in hospital. Scarring In rare cases, impetigo may lead to some scarring. However, this is more often the result of someone scratching at blisters, crusts or sores. The blisters and crusts themselves should not leave a scar if left to heal. The red mark left after the crusts and blisters clear up should also disappear by itself. The time it takes for the redness to disappear can vary between a few days and a few weeks. Staphylococcal scalded skin syndrome Staphylococcal scalded skin syndrome (SSSS) is a serious skin condition in which one of the causes of impetigo  Staphylococcus bacteria  releases a toxin (poison) that damages the skin. This leads to extensive blistering that looks like the skin has been scalded with boiling water. Other symptoms of SSSS include: painful skin a high temperature (fever) large areas of skin peeling off or falling away redness of the skin which usually spreads across the entire body SSSS usually requires immediate treatment in hospital with antibiotics given directly into a vein (intravenously). Post-streptococcal glomerulonephritis Post-streptococcal glomerulonephritis is an infection of the small blood vessels in the kidneys. Its a very rare complication of impetigo. The symptoms of post-streptococcal glomerulonephritis include: a change in the colour of your urine to a reddish-brown or cola colour swelling of the abdomen (tummy),face, eyes, feet and ankles a rise in blood pressure visibleblood in your urine a reduction in the amount of urine you would normally produce People with post-streptococcal glomerulonephritis will usually require immediate hospital treatment so their blood pressure can be carefully monitored and controlled. Post-streptococcal glomerulonephritis can be fatal in adults, although deaths in children are rare. Preventing impetigo As impetigo is a highly contagious condition, it is important to take precautions to reduce the risk of the infection spreading. Stoppingthe infection spreading To help to prevent the spread of the infection to other people or to other areas of the body you should: stay away from work, school, nursery or playgroup until the sores have dried up, blistered or crusted over, or until 48 hours after starting treatment not share flannels, sheets or towels with anyone who has impetigo, and wash them at a high temperature after use wash the sores with soap and water, and cover them loosely with a gauze bandage or clothing if possible avoidtouching the sores, or letting others touch them, whenever possible not scratch the affected areas  it may help to ensure your or your childs nails are kept clean and short to reduce the risk of further damage caused by scratching avoid contact with newborn babies, preparing food, playing contact sports, or going to the gym until the risk of infection has passed (when the rash has crusted over, or after at least 48 hours of treatment with antibiotics) wash your hands frequently, particularly after touching infected skin washable toys should also be washed, and wipe non-washable soft toys thoroughly with a cloth that has been wrung out in detergent and warm water and allowed to dry completely If you think that the infection has spread to someone else, make sure theycontact their pharmacist as soon as possible. Preventing re-infection Toreduce the risk of impetigo returning, make sure any cuts, scratches or bites are kept clean, and ensure any condition that causes broken skin, such as eczema, is treated promptly. If you develop impetigo frequently, your doctor may suggest taking a swab from around your nose to see if you carry staphylococcal bacteriainside your nose. These bacteria can live in the noses of some people without causing problems, although they can lead to impetigo if they infected broken skin nearby. If you are found to carry these bacteria,you may be prescribed an antiseptic nasal cream to apply several times a day for 5 to 10 days in an attempt to clear the bacteria and reduce the chances of impetigo recurring. Source: NHS 24 - Opens in new browser window Last updated: 04 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. 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