Impetigo

Impetigo, the most common childhood infection in summer

Impetigo is a superficial and localized skin infection caused by bacteria that are commonly found on the skin surface, primarily Streptococcus pyogenes and Staphylococcus aureus, as defined by the Spanish Association of Pediatrics (AEP). “These two bacteria usually coexist on our skin surface without causing any problems under normal conditions. The infection occurs when we have a wound or abrasion, and the bacteria take advantage to invade that previously healthy area,” explains Dr. Silke Bianca Kirchschläger Nieto, a pediatrician from Dr. Ordovás’ team.

It is a very common infection during summer since both humidity and heat are its breeding grounds. Additionally, there is greater exposure of the skin, leading to more cuts, wounds, and insect bites (you can find information on how to treat them here).

What are the symptoms of impetigo?

Usually, the lesions begin as red pimples that transform into blisters. When the blisters burst, typical yellowish crusts known as “honey-colored crusts” form, resembling the color of honey. “Sometimes we may not observe the blister stage and only see the crust,” clarifies the doctor.

Parents, don’t worry because these crusts do not leave scars. However, impetigo is highly contagious. “It is common for satellite lesions to appear in contiguous areas or other locations due to scratching. They can appear anywhere on the body, although they are more common around the nose and chin and on the extremities,” assures the doctor.

Impetigo is typically common in children between 2 and 6 years old because they are more prone to scratching. These lesions can be quite uncomfortable, causing itching, burning, and even pain. Dr. Kirchschläger adds, “Fever is rarely associated with impetigo, but an increase in the size of the lymph nodes in the area due to the inflammatory response to the localized infection is common.”

Can its appearance be prevented in any way?

As Dr. Kirchschläger explained at the beginning of the post, impetigo usually occurs when bacteria take advantage of a wound or insect bite to penetrate our skin and cause infection. “For this reason, the best preventive measure, without a doubt, is to maintain proper hygiene. Frequent hand washing is important, and any superficial wound should be immediately washed with water and soap, followed by the application of an antiseptic solution (such as chlorhexidine),” she advises.

Children with atopic dermatitis are more susceptible to this type of infection. Therefore, the main recommendation is to “maintain adequate skin hydration with emollients and keep nails short and clean in these patients,” says the doctor.

How is impetigo treated?

To alleviate the itching and burning sensation caused by skin lesions, it is advisable to gently wash them with water and soap several times a day. “Your doctor will also prescribe a topical antibiotic cream that is usually applied to the affected area 2-3 times a day for 7 days. The most commonly used ones are mupirocin or fusidic acid. Occasionally, if the lesions are extensive, do not respond adequately to cream treatment, or if general symptoms such as fever occur, oral antibiotic treatment may be necessary. Healing should begin within 2-3 days of starting antibiotic treatment,” notes Dr. Kirchschläger.

Advice for parents to consider

If you notice any lesions that could be impetigo in your child, you should consult their pediatrician for evaluation and take special care by following the following recommendations provided by the doctor:

• It is contagious until the rashes disappear or until two days have passed since the start of antibiotic treatment with evidence of improvement. During this time, it is important to keep the area clean and dry, maintain good hand hygiene, keep nails short, and prevent the child from touching the lesions.
• If there is contact with the lesions, proper hand washing and washing of the exposed area with water and soap should be done afterwards.
• It is also advisable to wash dirty clothes, sheets, and towels that come into contact with the lesions daily.
• Avoid bathing in pools and at the beach until improvement is noticed.