Impetigo in Children

Skin conditions are common among children, not only because they have vulnerable skin, but also because they are exposed to bacteria and virus frequently at playgrounds and at school. Impetigo is one such skin condition symptomized by sores and patches on the skin.

What is Impetigo/Infantigo

Impetigo or Infantigo, also known as school sores, is the most common bacterial skin infection caused by the staphylococcus aureus or streptococcus pyogenes bacteria. It can infect both children and adults. Impetigo in kids causes red sores or blisters that break open, peel the skin, ooze fluid, and develop raw patches which dry to form brownish yellow or honey-coloured crust. Such sores are more common around the nose and mouth but can occur anywhere on the body.

Is Impetigo Common in Children?

Impetigo occurs commonly in kids – infants and children. It usually appears as red sores on the face, especially around the mouth and nose. Children in the age group 2-5 years are the most likely to get affected.

Who is at the Risk of Getting Impetigo?

The disease can infect anybody; however, it is not very common in adults. A newborn baby with a weak immune system is at higher risk of contracting Infantigo. It is the most common in pre-schoolers, school going, and socially active kids as they indulge in physical games and often come in close physical contact with other kids.

Different Types of Impetigo

Impetigo can be classified into three major types – Non Bullous, Bullous and Etchyma.

1. Non Bullous Impetigo

This is contagious in nature. It starts as red sores near the nose or mouth which eventually break open, ooze fluid and form honey-coloured crust / scab. This usually heals without leaving a scar. These sores are not very painful but may cause discomfort and irritation. You may notice a swelling of lymph nodes in the affected area. Fever is uncommon in this type of Impetigo. Scratching or touching the area may spread the sores quickly to other parts of the body.

2. Bullous Impetigo

This is common in kids above 2 years of age. It starts as little liquid-filled rankles that may become big, and once they break open, leave yellow scabs. They are generally found on the arms, legs, and torso. They are red in colour and can irritate the skin.

3. Ecthyma

In this case, sores filled with pus turn into ulcers and reach the dermis – the deeper layer of skin. Once they break open, they turn into thick, hard, dark yellow scabs and leave behind scars. Lymph nodes are formed in the affected areas.

Causes

Children are more likely to become infected with Infantigo as their immune system is not fully developed. Here are some of the causes of Impetigo in children:

• A cut, scrape, insect bites or lesions on the skin can allow bacteria to infect the child.
• Invasion of bacteria because of existing skin infection like scabies, eczema, body lice, etc.
• After they have had a cold, allergies can make the skin under the nose raw and vulnerable to bacterial invasion.
• Coming in contact with an infected person or touching things that an infected person has been in contact with can transmit the disease.
• Poor hygiene and unhealthy and unclean environment are predisposing factors for transmission of Impetigo.
• People living in areas with warm weather and moist and humid air are more likely to get infected by Impetigo.
• Scratching the infected area will spread it to other body parts.

Is Impetigo Contagious?

This disease spreads very quickly from one person to another. Though it is not airborne, it is highly contagious and spreads through close contact with the infected person. It can also spread by sharing toys, clothes, towel, bedding or any other items used by them. Scratching can spread it to other parts of the body as well.

Symptoms

If you are worried that your child may be afflicted, here are a few symptoms to watch out for:

1. Non-Bulbous Impetigo

• A visible patch of red, itchy skin or rash mostly around the nose and mouth
• Bruises which burst and ooze pus or fluids after a couple of days and form a yellow crust
• Patches around the nose and mouth which can be spread to different parts of the body by touching or scratching

2. Bulbous Impetigo and Ecthyma

• Rashes which are bothersome but not painful
• Patches which may swell and itch
• Bigger rankles appear on trunk or diaper areas of babies in bulbous Impetigo
• In cases of ecthyma, where the infection infiltrates deep into the skin, it causes pus-filled sores that may go on to become ulcers
• Swelling in lymph nodes

Diagnosing Impetigo in Children

Impetigo in kids can be diagnosed by a simple physical exam of the infected area. The doctor may inquire about health history, symptoms, recent insect bites, cuts, rashes, and contact with infected children or their belongings.

Further diagnosis may be required if symptoms are severe or recurring, or in case the child is not responding to treatment. A swab sample of liquid from the infected areas may be taken to determine the presence of any other skin infections. This is called culture and will help the doctor to determine the course of treatment required to cure the child.

How is Impetigo in Children Treated?

Impetigo may clear on its own in a few weeks. Treatment of the same will also depend on the child’s age, general health condition and severity of symptoms.

Treatment may include antibiotics or anti-microbial drugs in the form of solid dosage or topical cream application to infected areas in order to heal the disease faster. You will be required to clean the infected area with warm water and medicated soap or sanitizer. Clean the area on and around the scabs tenderly to allow the anti-microbial ointment to penetrate deeper into the skin. You may want to wear gloves while handling the infected areas. Wash your hands thoroughly before and after handling the infected areas to avoid spreading the disease to other body parts. Make sure that you complete the prescribed medicine course even if you see the results visually. This is to prevent recurrence of the disease.

It is recommended to keep your kid at home and avoid school, daycare or playtime until he or she is recovered, typically 24 to 48 hours after you start treatment. This is to ensure that other children do not get infected.

Proper hygiene and cleanliness are important to avoid spreading the infection to other parts of the body. Impetigo is contagious, so keep your kids away from infected individuals. Currently, no vaccine is available for immunisation against this disease.

Home Remedies

You will need to take care to ensure that kids do not spread the infection to others or worsen their own condition. The following home remedies can speed up recovery:

• Ensure that kids do not scratch or touch the infected areas; if required, loosely wrap a clean dressing bandage around it. In case of infants, cover the hands with mittens. Ensure that kids do not touch the sores. Keep their fingernails short to prevent scratching and spreading of the infection.
• Wash and disinfect clothes, bedding, toys, towels, etc., of the infected person and avoid sharing the same.
• Prepare antibiotic by mixing one tablespoon of refined white vinegar and some water. Apply this mixture to affected areas for 15 minutes.
• A mixture of olive oil, myrrh, and tea tree can be applied to control the spreading of bacteria.
• Isolate the child from others till they are completely cured to avoid spreading the infection to other members of the family.

Complications

Children are primary victims as well as carriers of Impetigo. Some children may develop complications resulting from this infection:

• The gravest possible complication of Impetigo is a severe kidney disease called ‘poststreptococcal glomerulonephritis’
• Rheumatic fever that can involve the heart, joints, skin and brain
• Spreading and worsening of infection to other body parts
• Scarring – this is common with ecthyma type of Impetigo
• Other skin related problems like eczema, body lice, fungal infection, scabies, dermatitis

How To Protect Your Child From Getting Impetigo Again

There may be several reasons for recurrent Impetigo in a child.

• The most common reason is incomplete treatment or incomplete course of recommended antibiotics. It is important that your child completes the prescribed treatment even if you can see physical healing.
• Disinfect all the items that have come in contact with the kid when he/she was infected with Impetigo. Hygiene and cleanliness play an important role in completely clearing the infection.
• Since the disease is highly contagious and can spread among the family members and other children, isolation of the infected person is very crucial to avoid them from getting infected again.
• If required, get the swab samples of entire family checked in order to find out the source of recurrence and have the entire family take appropriate treatment. Another round of checking can ensure that the infection has been cleared completely.

How to Prevent Impetigo Kids Spreading Infection to Others

Some basic discipline in terms of hygiene will ensure that kids do not spread this infection to others or make it worse for themselves

• Keep them isolated from other children and family members as Impetigo can spread very easily.
• Do not let anyone else share or use their belongings like clothes, toys, bedding, towels, etc., to avoid spreading the infection to others.
• Disinfect everything that the child has come in contact with while having Impetigo.
• Keep their nails short to avoid scratching and spreading the infection to other body parts.
• Wrap the wounds in a loose and clean bandage to prevent the child from touching the infected areas often.

Can I Stop My Child From Getting Recurrent Impetigo?

If you observe recurrent impetigo in child, it is advisable that you find the source of recurrence. Here are a few tips to avoid recurrent impetigo attacks in kids:

• Swab the samples of the entire family or those who come in frequent contact with the child to find the source of recurrence. Take treatment accordingly.
• Ensure that your kid completes the prescribed treatment even if there are visual signs of healing of impetigo. This is to ensure that it is completely cured and will not recur.
• Hygiene is very important. Disinfect everything that has been in contact with the kid during the infection.

Impetigo is an infectious condition that is common among children. Maintaining hygiene goes a long way in preventing the incidence of the disease, and in ensuring swift recovery if it is contracted.