Impetigo (cont.)

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Is impetigo contagious?

Impetigo is contagious, primarily from direct contact with someone who has it but sometimes from towels, toys, clothing, or household items. Impetigo often spreads to other parts of the body. This is particularly common with impetigo in children. There may be mini epidemics in day-care centers. Bacteria that cause impetigo may enter through a break in the skin, such as that which comes from cuts and scrapes. A common toddler impetigo experience is the development of impetigo at the nasal openings inflamed by the prominent nasal drainage associated with a cold. In this situation, skin integrity is often disrupted by the continuous covering of purulent nasal discharge. Adults often develop impetigo from close contact with infected children. Heat, humidity, and the presence of eczema predispose a person to developing impetigo. Recurrent impetigo infections may be associated with staph or strep bacteria residing in the nose and spreading from to other parts of the skin.

How is impetigo diagnosed?

Diagnosing impetigo is generally straightforward and based on the clinical appearance. Occasionally, other conditions may look something like impetigo. Infections such as tinea ("ringworm") or scabies (mites) may be confused with impetigo. It is important to note that not every blister means an impetigo infection. 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. Secondary infection of these other skin lesions may sometimes occur. Medical evaluation and occasionally culture tests are used to decide whether topical antibacterial creams will suffice or whether oral antibiotics will be necessary.

What is the treatment for impetigo?

Impetigo is not serious and is very treatable. Mild impetigo can be handled by gentle cleansing, removing crusts, and applying the prescription-strength antibiotic ointment mupirocin (Bactroban). Nonprescription topical antibiotic ointments (such as Neosporin) generally are not effective. More severe or widespread impetigo, especially of bullous impetigo, may require oral antibiotic medication. In recent years, more staph germs have developed resistance to standard antibiotics. Bacterial culture tests can help guide the use of proper oral therapy if needed. Antibiotics which can be helpful include penicillin derivatives (such as Augmentin) and cephalosporins such as cephalexin (Keflex). If clinical suspicion supported by culture results show other bacteria, such as drug-resistant staph (methicillin-resistant Staphylococcus aureus or MRSA), other antibiotics such as clindamycin or trimethoprim-sulfamethoxazole (Bactrim or Septra) may be necessary. Treatment is guided by laboratory results (culture and sensitivity tests).

Medically Reviewed by a Doctor on 6/27/2014

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