Impetigo

Patient Education

What is Impetigo?

Impetigo is a bacterial infection which affects the upper layers of the skin. It is highly contagious and spreads easily. It usually causes itchy or painful, honey-coloured crusts over the face.

There are 2 types of impetigo, namely Bullous and Non-bullous impetigo. Majority of cases of impetigo are Non-bullous type while the minority present as Bullous impetigo.

What is the incidence of Impetigo?

Impetigo commonly affects pre-school children between ages 2-5 years.

Non-bullous impetigo presents in this age group while Bullous impetigo usually affects infant below 2 years of age.

What are the symptoms of Impetigo?

Non-bullous impetigo starts as multiple blisters over the face. These rupture and pus oozes from these lesions giving it a characteristic honey-coloured crust appearance. It rapidly spreads from the face to the hands and legs by scratching over the lesions.

Bullous Impetigo starts out by small blisters that swell up to form bullae. These bullae contain clear or yellow fluids. These do not appear honey coloured and don’t appear red. These lesions occur on folds and trunk. Fever usually accompanies bullous impetigo.

What are the treatment options available?

Impetigo usually resolves by itself in 2 weeks. However, treating with antibiotics reduces the duration of symptoms and further spread of lesions.

It also reduces possible complications.

Topical antibiotics like Mupirocin 2% ointment, Fusidic acid ointment work well as these can be applied over the lesion directly.

Oral antibiotics are required for all cases of Bullous impetigo and severe cases of Non-bullous impetigo. Oral Cephalexin, Amoxicillin-clavulanate or dicloxacillin are the commonly used oral antibiotics.

What are the possible complications of Impetigo?

Around 5% of patients with impetigo develop Post-streptococcal Glomerulonephritis. This can present 2 weeks after the infection, if it was caused by Streptococcus bacteria. It can present with protein and mild blood loss in the urine.

Other less likely complications include septic arthritis, scarlet fever, sepsis , cellulitis and staphylococcal skin syndrome.