What to do if your child has impetigo...

OUR children are prone to all types of infections, especially when attending creche or school. One such type, that we don’t necessarily consider, is impetigo. This is an infection of the skin, that can happen to anybody but is most common in younger children, on exposed areas of skin. It can look quite alarming, but for the most part isn’t serious.

When skin gets damaged, the protective layer is broken and bacterial infection can enter. The skin can be broken for a number of reasons, such as a cut, scratch or insect bite, or due to a skin condition such as eczema or psoriasis.

Without treatment, impetigo can usually resolve itself after a number of weeks, but treatment greatly shortens the time-frame that you need to wait for it to heal.

It’s also very contagious, so treatment reduces the risk of spreading it further.

Impetigo can occur in a couple of forms, and can show up anywhere on the body, but the more common form usually presents on the face, nose, or mouth. It starts off as small red sores or blisters, that burst. When they dry, a yellow golden crust appears. After this crust falls away, red marks remain which fade over time. It’s not usually very painful but can be quite itchy and spreads outwards. Stopping children from scratching and spreading it is a challenge. It can be mistaken by parents for a cold-sore or even chicken pox at times.

Risk factors for getting impetigo include those pre-existing skin conditions that compromise the skin’s barrier, as well as warmer weather and crowded areas.

If immunocompromised, you’re more prone to complications developing and should be prompt in getting it treated.

Treatment for impetigo is from the GP, with an antibiotic cream. This should be applied as regularly as you’re directed, and the course completed, even if the impetigo seems to be gone. 

If the infection keeps returning, the doctor may complete a nasal swab to check if there’s a particular bacteria present that is causing the impetigo. This can be addressed by using a specific nasal cream.

Although not usually serious, impetigo can rarely lead to complications. Very occasionally, the infection can get into the system and cause fever or swelling which would need further treatment. If the skin gets red, hot and painful then cellulitis may be present, which requires more than just a topical treatment, and urgent review is required.

Other alarm signs would include the condition getting rapidly worse, fever, diarrhoea or swollen lymph nodes.

If oral antibiotics are needed, there are options with or without penicillin, and suitable to use with other medications or conditions.

There are plenty of measures you can take to reduce the spread of impetigo to others. Basic hand hygiene is the mainstay of infection control. Keep children off school or creche due to how contagious it is. Keep the lesions clean, dry and cover with gauze if possible.

You should wash sheets and towels at a higher temperature and don’t share cutlery or other utensils. Toys or anything else that the child has regular contact with should be washed down also.

Scratching leads to scarring, so avoid this as much as possible is important. Cutting nails short and putting socks on their hands overnight can help.

Impetigo is just one of many conditions most commonly experienced in childhood, and thankfully is not usually one that should cause too much concern. Appropriate treatment to minimise the time suffering from it, along with good hygiene measures to prevent spread, will ensure its effects are limited and your little one can quickly return to their regular routine.

ABOUT THE AUTHOR

Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company.

Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally.

See www.intuition.ie