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December 5, 2008
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Impetigo

Medical Author: Alan Rockoff, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What is impetigo? What causes it?

Impetigo (pronounced im-puh-TIE-go) is a superficial skin infection, caused by staphylococcus ("staph") and streptococcus ("strep") bacteria. Impetigo is more common in children than in adults.

What are the types and symptoms of impetigo? What does impetigo look like?

Two kinds of impetigo are:

  • Non-bullous impetigo: This is the common form, caused by both staph and strep. It appears as small blisters or scabs, which then form yellow or honey-colored crusts. These often start around the nose and on the face, but they also may affect the arms and legs. At times, there may be swollen glands nearby.

  • Bullous impetigo: This form is caused by staph bacteria which produce a toxin that causes a break between the epidermis and the lower levels of skin. ("Bulla" means blister.) Blisters can appear in various skin areas, especially the buttocks, though these blisters are fragile and often break and leave red, raw skin with a ragged edge.

Is impetigo contagious?

Impetigo is contagious, mostly from direct contact with someone who has it, but sometimes from towels, toys, clothing or household items. Once it starts, impetigo often spreads to other parts of the body. This is particularly common with impetigo in children. There may be mini epidemics in daycare centers. Bacteria that cause impetigo may enter through a break in the skin. At times, however, impetigo appears even if no one nearby has it and the skin seems unbroken.

How is impetigo diagnosed?

Diagnosing impetigo is mostly straightforward, though occasionally other conditions may be look something like it, such as tinea (fungus, "ringworm") or scabies (mites). It is important to note that not every blister or ooze means infection. At times, other infected and noninfected skin diseases produce blister-like skin inflammation. Such conditions include herpes cold sores, chickenpox, poison ivy, eczema, and insect bites. Secondary infection of these diseases does occur sometimes, but often blistering comes from the original condition and does not mean that actual impetigo has developed. Medical judgment—helped by culture tests, when necessary—is needed to decide whether antibacterial creams or pills should be used in addition to the remedies suitable for the original condition.



Next: What is the treatment for impetigo? »

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