Impetigo – Causes and Treatment

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Skin infection that causes a painless red rash with many small, itchy blisters, some of which contain pus. When the blisters break, characteristic yellow crusts form. Some people also have a slight fever with impetigo. Occasionally, bullous skin ulcers develop, creating a condition called ecthyma, which is likely to cause scarring. The infection, which is most common in infants and children, is caused by either streptococcal or staphylococcal bacteria. In some instances, the bacteria come from an infection elsewhere in the body, usually the nose or ears. In other cases, the bacteria invade the skin through a minor cut or an insect bite that has become infected by scratching. Less commonly, it can be contracted by direct contact with an infected person or a shared personal item, such as a razor or washcloth. Other precipitating factors that increase a person’s risk of infection with impetigo include:

  • Skin sensitivity to friction, chemicals, sun, and other irritants.
  • Resistance weakened by fatigue, poor nutrition, or illness, especially diabetes or leukemia.
  • Use of steroids or anticancer drugs.
  • Poor hygiene and crowded, unsanitary living conditions, especially in a moist and warm climate.

Most impetigo infections are mild and easily cured. In some cases, however, streptococcal impetigo can result in kidney inflammation, a serious condition called acute glomerulonephritis, which can be life threatening if it is not treated immediately. Staphlococcal bullous impetigo can lead to scalded skin syndrome, in which large areas of skin separate and are shed, leaving raw, oozing patches . This complication occurs most often in babies, especially newborns.

Other Causes of Skin Infections

A herpes infection can cause skin lesions similar to those of impetigo.

Diagnostic Studies And Procedures

A doctor can make an initial diagnosis of impetigo by inspecting the lesions, but confirmation requires scraping a sample of cells from the sores for laboratory examination.

Medical Treatments

If the infection is in an early stage at the time of diagnosis and affects only a small area, removal of the scabs with a coarse gauze sponge followed by application of a topical antibiotic ointment may be sufficient. The ointment must be applied as instructed, which is usually at least three applications a day. Mupirocin (Bactroban), an antibiotic ointment, is particularly effective with certain staphylocccal and streptococcal strains. In some cases, however, a topical antibiotic is not enough, and an oral medication, such as a cephalosporin or a penicillin, is prescribed. As an alternative, some doctors treat the infection with a single injection of long acting penicillin. In addition, a doctor may also recommend use of a nonprescription antibiotic ointment containing bacitracin or neomycin. Antibiotic therapy should completely cure the infection within about 10 days. (During that period, the patient usually cannot spread it to others by direct contact.) If it persists longer, or if the sores continue to spread or don’t start to heal within three days of the beginning of treatment, the causative organism may be antibiotic resistant. Trying a different antibiotic usually works.

Alternative Therapies

Herbal Medicine

Garlic, eaten raw or swallowed in capsule form, has natural antibacterial effects. Applications of aloe vera gel soothe skin sores and promote healing.

Nutrition Therapy

Some nutritionists advocate high doses of vitamin C to strengthen the immune system and fight infection. They often recommend high doses of vitamin B complex when antibiotics are being taken, and also yogurt that contains natural cultures or acidophilus capsules or liquid to prevent digestive problems and an over growth of yeast. Vitamin E oil applied to the sores may hasten healing.

Self Treatment

  • Self care is unlikely to cure the infection, but it can speed healing when antibiotics are used, and prevent spreading of the infection to others.
  • Wash the rashy areas with antiseptic soap. Use disposable gauze or paper towels instead of a washcloth or towel. The causative bacteria can spread to others on shared towels.
  • When blisters break open, remove crusting areas to expose and cleanse the lesions. Then cover the sores with gauze to keep from touching or scratching them.
  • Women with blisters under their arms or on their legs and men with facial blisters should refrain from shaving or do so carefully. While the infection persists, use a new blade every day, rather than an electric razor, and use an aerosol shaving cream, instead of a shaving brush. These measures help avoid possible reinfection. Even if you discontinue using an electric razor and shaving brush until the infection clears up, be sure to wash them thoroughly in an antibacterial solution, such as Betadine or Hibiclens, before resuming their use after the infection has been cured.
  • Never use an over the counter cortisone cream on any skin rash that might be impetigo. Cortisone can worsen it.
  • To protect other household members from infection, wash the infected person’s bed linens and clothing separately, using the hottest water available, if possible, presoak the articles in boiling water. All other household members should bathe daily with an antibacterial soap or solution.

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