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How Can I Banish Impetigo?

Impetigo is a skin infection caused by a bacterium; the commonest ones are staphylococcus or streptococcus.

It usually starts as small blisters, anywhere on the body but often on the face, which join up forming bigger areas of pus under the skin. The skin often peels off leaving sore, red, raw patches which dry with bright yellow crusts.

These heal from the centre outwards and may leave red rings of skin around the edge as they do so.

Impetigo is very itchy and highly contagious. This is why it can whip through nurseries, playgroups and families, just as you have found. It occurs anywhere that individuals are in close contact - hence young children - are more at risk.

To reduce the spread at school affected children have to stay at home. But as you have found this does not reduce the risk of spread within your own family and the infection can be prolonged.

Treatment nearly always requires antibiotic cream (e.G. Fucidin) or in established or recurrent cases, antibiotics by mouth for up to ten days. You do not say if your children have had antibiotics.

There may be several reasons why your children have recurrent impetigo. The commonest is that the infection has not completely cleared and a longer course of antibiotics by mouth will be needed.

Their GP usually needs to send a swab first to make sure that the antibiotic will be effective against the particular bacterium involved.

Sometimes one or more of your children or another member of the family may continue to carry the bacterium in their nose. If they scratch their nose and touch areas of sore skin on themselves or other family members they will keep re-infecting healing patches of skin.

The nose itself is usually unaffected, it just acts as a carrier for the germs. The only way to detect the bacterium is to take swabs from the whole families' noses and send them to the lab for analysis.

If anyone is carrying the bacterium all immediate family should apply to their inner nostrils a cream specifically aimed at eradicating it such as Naseptin (which your GP can prescribe). After treatment for a week or more the carrier's nose needs to be re-swabbed to make sure the infection has gone.

Your next step is to ask your GP or practice nurse to take swabs from everybody's impetigo and from the inside of everyone's nostrils (including family members who do not have impetigo).

Once the results come back everyone with impetigo can then be given the appropriate antibiotic by mouth and if anyone is carrying the bacterium in their nose the whole family can be treated with naseptin and re-swabbed a week later.

We recommend readers seek personal medical attention in appropriate circumstances.

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What's The Best Cure For Impetigo?

Impetigo is a skin infection caused by a bacterium; the staphylococcus as in your son's case or the streptococcus are the main culprits. It usually starts as small blisters, anywhere on the body but often on the face, which join up forming bigger areas of pus under the skin. The skin often peels off leaving sore, red, raw patches which dry with bright yellow crusts. These heal from the centre and may leave red rings of skin around the edge as they do so.

Impetigo is very itchy and highly contagious. This is why it can whip through nurseries, playgroups and families; anywhere that individuals are in close contact hence young children are more at risk. To reduce the spread the affected child has to stay at home but as with your son this can be prolonged.

Treatment nearly always requires antibiotic cream (eg fucidin) or in established or recurrent cases such as your son's, antibiotics by mouth for up to ten days. You do not say if he has had antibiotics but I presume that if he has grown staphylococcus from swabs your GP will have prescribed these.

Sometimes impetigo can be recurrent ¿ there are several reasons. The commonest is that the infection has not completely cleared and a longer course of antibiotics by mouth will be needed, usually a swab is sent first to make sure that the antibiotic will be effective against the particular bacterium involved.

Sometimes the child himself or another member of his family may continue to carry the bacterium in his nose but if he scratches his nose and rubs his sores he will keep re-infecting healing patches of skin. The nose is usually unaffected and the only way to detect the bacterium is to take swabs from the whole families' noses (including your son) and send them to the lab for analysis. If anyone is carrying the bug your son and all immediate family should apply to their inner nostrils a cream specifically aimed at eradicating it such as Naseptin (which your GP can prescribe). After treatment for a week or more the carrier's nose needs to be re-swabbed to make sure the infection has gone.

In your son's case part of the problem may be the betnovate ointment you are using to 'control' the outbreaks. This ointment is a powerful steroid; it calms down the redness in the skin patches so the impetigo will appear to be improving, but it suppresses his own immunity in fighting off the skin infection making it more likely that he will continue to carry the bacterium and so re-infect himself.

I would suggest you throw the betnovate away and, if your son has already had a course of antibiotics by mouth, ask your GP to consider taking swabs from his and all the family's noses.

Impetigo – Symptoms, Treatments And Prevention

What is it?

Impetigo is a bacterial infection of the surface layers of the skin. It is not a serious condition but is highly contagious. There are two different types of impetigo – bullous and non-bullous.

What are the symptoms?

The symptoms of bullous impetigo are fluid-filled blisters, which usually appear on the arms, legs and above the waist but not the head and neck. The blisters can spread quickly and the area surrounding them may be itchy. After a few days the blisters will burst and form a yellow crust. These will then heal without scarring.

Non-bullous impetigo starts with the appearance of red sores around the nose and mouth. These sores burst quickly leaving thick, yellow-brown crusts, which will heal by drying up and again won't scar.

Fever symptoms and swollen glands can be common in cases of bullous impetigo, but are rare when your child has non-bullous impetigo.

Is impetigo common?

Yes. The bacterial infection is more common in children than adults because their immune system has not yet fully developed, says the NHS.

More like this Do you need to take your child to the doctor?

Yes. This means your doctor can diagnose whether your child has impetigo or another infection, which could be more serious. There are many characteristics of impetigo that are similar to other skin conditions, such as chickenpox, shingles and excema, so these have to be ruled out first.

If impetigo is confirmed, your doctor will give antibiotics, in either tablet or cream form, to treat the bacterial infection. With treatment, impetigo should clear up after a week.

If the doctor gives you antibiotic cream, make sure you wash any affected area of your child's body with warm, soapy water first. It's advisable to wear latex gloves when applying the cream so as not to catch the infection yourself.

It's important that your child takes the medication as prescribed by your doctor, or they may develop a more serious skin infection.

Should your child go to school?

No. It is best to keep your child at home until their sores have dried up or crusted over, or until two days after starting treatment to prevent the spread of infection.

What else can you do to prevent the spreading of impetigo?

When you look after your child, be sure to regularly wash your own hands. If you have any cuts or grazes, put plasters over them.

Wash any toys, towels, clothing and bedding that your child may have touched at high temperature, to prevent others in your family from catching the infection.

Also keep an eye on your child to make sure they don't scratch! If they scratch an infected area then touch a non-infected area of their body, the infection will spread.

What else may your child come into contact with during school?

Other infections like tonsillitis, verrucas, chickenpox, molluscum contagiosum, threadworms, ear infections, ringworm, diarrhoea and vomiting are also common for your child to catch during school.

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