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Impetigo Information - Bullous Impetigo in adult and child

Impetigo is a highly infectious skin disease most common in children. It presents as weeping, exudative areas with a typical honey-coloured crust on the surface. It is spread by direct contact. The term 'scrum pox' is impetigo spread between rugby players. Occasionally this infection can cause blistering ('bullous impetigo') due to bacterial toxins. Staphylococcus aureus is implicated in over 90% of cases but rarely group A Streptococcus can be responsible. Therefore skin swabs should always be taken.

People who play close contact sports such as rugby, American football and wrestling are also susceptible, regardless of age. Impetigo is not as common in adults.

Impetigo is dealt with through the use of antimicrobials, supported by alternatives and tonics with external applications of a lotion of echinacea, marigold, myrrh and wild indigo, which can be used to combat the infection and help to rebuild ecological barriers. Scrupulous hygiene and a wholesome diet are essential.

Impetigo Picture

Causes of Impetigo

Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA) is becoming a common cause. A child may be more likely to develop impetigo if the skin has already been irritated by other skin problems, such as eczema, poison ivy, and insect bites

Breaks in the skin may occur with:

  • Animal bites
  • Human bites
  • Injury or trauma to the skin
  • Insect bites

Types of Impetigo

  • Bullous impetigo - large blisters
  • Ecthyma - crusted impetigo

Symptoms of Impetigo

  • A single or possibly many blisters filled with pus; easy to pop and when broken leave a reddish raw-looking base (in infants) Also check out the Impetigo Symptoms

How is impetigo diagnosed?

Infections such as tinea ringworm or scabies may be confused with impetigo. At times, other infected and noninfected skin diseases produce blister-like skin inflammation. Such conditions include herpes cold sores, chickenpox, poison ivy, skin allergies, eczema, and insect bites. Medical judgment and occasionally culture tests, if necessary, are used to decide whether topical antibacterial creams will suffice or whether oral antibiotics will be necessary.

Treatment of Impetigo

Localized disease is treated with topical fusidic acid (three times daily) and the antiseptic povidone iodine for 1 week. Extensive disease is treated with oral antibiotics for 7-10 days (flucloxacillin 500 mg four times daily for Staphylococcus; penicillin V 500 mg four times daily for Streptococcus ). Other close contacts should be examined and children should avoid school for 1 week after starting therapy. If impetigo appears resistant to treatment or recurrent, take nasal swabs and check other family members. Nasal mupirocin (three times daily for 1 week) is useful to eradicate nasal carriage. Its use in hospitals should be avoided if possible.

In adults, local measures are usually enough, except in extensive cases and ecthyma. Septran (P) or broad-spectrum antibiotics by mouth should be given in such cases.

In infants, penicillin injections or broad-spectrum antibiotics by mouth are given as a routine. This procedure has reduced the mortality rate considerably. As for local measures, blisters are aspirated aseptically, the flaccid roofs clipped away and the raw surface by soframycin (P) cream.

The treatment must be continued until all the lesions have healed up completely and have stayed so, for at least a week.

Prevention of Impetigo

  • Good hygiene practices can help prevent impetigo from spreading.
  • Do not share towels, clothing, razors, and and other personal care products with other family members.
    Wash your hands thoroughly after touching the skin lesions.
    You can also use a mild antibacterial soap.
  • Impetigo is contagious, so avoid touching the draining (oozing) lesions.
  • Soak a clean cloth in a mixture of half a cup of white vinegar in a litre of tepid water. Apply the compress to moist areas for about ten minutes several times a day. Gently wipe off the crusts.

When will my child interact freely?

A preschool child should not return to nursery school or playgroup until the scabs have fallen off and he or she is no longer contagious. Small children generally touch and scratch their scabs hence the high risk of infection.

Schoolchildren can return to their normal classes after one week from the start of topical treatment, or after 48 hours from the start of oral antibiotic therapy, even with scabs. Above all, they must remember to wash hands regularly and only use their own comb, brush, facecloth or towel.

Impetigo Remedy

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