Taking the Mystery out of Impetigo

Taking the Mystery out of ImpetigoImpetigo is a bacterial skin infection caused primarily by Staphylococcus aureus and sometimes by Streptococcus pyogenes. It usually manifests as red sores or blisters that can rupture, ooze, and form a characteristic honey-colored crust. While it can occur anywhere on the body, impetigo is most commonly found on the face, especially around the nose and mouth, as well as on the hands and feet.While it is more common in children, adults can contract impetigo under certain conditions.

Symptoms of Impetigo

The symptoms of impetigo can vary depending on the type, which includes non-bullous and bullous impetigo:

  • Non-bullous impetigo. This is the more common form and starts as small red spots that quickly evolve into blisters. These blisters burst and leave behind red, raw skin covered with a golden-yellow crust.
  • Bullous impetigo. This form primarily affects infants and young children. It causes larger blisters filled with a clear or yellowish fluid that can remain unbroken longer than those of non-bullous impetigo. These blisters eventually burst and leave a yellow crust.

Other common symptoms include itching and soreness at the infection site, and in more severe cases, swollen lymph nodes near the infected area.

Risk Factors for Impetigo

Several factors can increase the risk of developing impetigo, including:

  • Impetigo is most common in children aged 2 to 5 years.
  • Close Contact. Activities or environments that involve close contact, such as schools and daycare centers, can facilitate the spread of impetigo.
  • Skin Injuries. Cuts, insect bites, and other minor skin injuries can provide an entry point for the bacteria causing impetigo.
  • Poor Hygiene. Infrequent handwashing and inadequate personal hygiene can increase the risk of impetigo.
  • Existing Skin Conditions. Conditions like eczema or dermatitis that compromise the skin’s integrity can predispose individuals to impetigo.

Contracting Impetigo

Impetigo is typically contracted through direct contact with infected sores or by coming into contact with items contaminated with the bacteria, such as towels, clothing, or bedding. However, there are some less common ways you might contract impetigo:

  1. Secondary Infection

A secondary bacterial infection can occur in areas where the skin is already compromised by other conditions, such as eczema, psoriasis, or dermatitis. The bacteria that cause impetigo can take advantage of these pre-existing conditions, leading to an infection.

  1. Insect Bites

Insect bites, including mosquito bites, can break the skin and create an entry point for bacteria. Scratching these bites can further damage the skin and increase the risk of developing impetigo.

  1. Animal Bites or Scratches

Bites or scratches from pets or other animals can introduce bacteria into the skin. If the animal’s mouth or claws carry Staphylococcus aureus or Streptococcus pyogenes, this can lead to impetigo.

  1. Contact Sports

Participation in contact sports like wrestling, rugby, or football can increase the risk of impetigo due to frequent skin-to-skin contact and the potential for minor skin injuries that provide an entry point for bacteria.

  1. Hot, Humid Climates

Living in or traveling to hot, humid climates can increase the likelihood of impetigo. The heat and moisture can create an environment conducive to bacterial growth on the skin, especially if there are minor abrasions or insect bites.

  1. Public Pools and Showers

Using public pools, showers, or locker rooms can expose individuals to bacteria on communal surfaces. Inadequate hygiene practices in these settings can lead to the spread of impetigo-causing bacteria.

  1. Compromised Immune System

Individuals with weakened immune systems, such as those with diabetes, HIV, or those undergoing chemotherapy, may be more susceptible to infections, including impetigo. Their bodies may not be as effective at fighting off the bacteria that cause the condition.

  1. Shared Athletic Equipment

Using shared sports equipment, such as helmets, mats, or gym gear, can facilitate the transmission of bacteria. Ensuring that this equipment is regularly cleaned and sanitized can help reduce the risk.

  1. Household Pets

Pets can carry the bacteria responsible for impetigo on their fur or skin. Close contact with pets, especially if they have skin infections or wounds, can be a less common way to contract impetigo.

  1. Tattooing or Piercing

Getting tattoos or piercings in non-sterile environments or with improperly sanitized equipment can introduce bacteria into the skin, potentially leading to impetigo.

How is Impetigo Diagnosed?

Diagnosing impetigo typically involves a physical examination by a healthcare provider. The characteristic appearance of the sores and blisters often makes it easy to identify. In some cases, a sample from the affected area may be taken and cultured to determine the specific bacteria responsible, which can guide effective treatment options.

Treatment Options for Impetigo

Treatment for impetigo focuses on eliminating the infection, relieving symptoms, and preventing the spread to others. Options include:

  • Topical Antibiotics. Mupirocin (Bactroban) or retapamulin (Altabax) ointments are commonly prescribed to apply directly to the infected areas.
  • Oral Antibiotics. In cases of extensive impetigo or if topical treatments are ineffective, oral antibiotics such as dicloxacillin or cephalexin may be prescribed.
  • Hygiene Measures. Keeping the affected area clean and covering it with gauze or a bandage can help prevent the spread of infection.

Prevention Strategies

Preventing impetigo involves several proactive steps:

  • Good Hygiene. Regular handwashing with soap and water, especially after touching the affected area, is crucial.
  • Avoid Sharing Personal Items. Do not share towels, clothing, or other personal items with someone who has impetigo.
  • Proper Wound Care. Clean any cuts, scrapes, or insect bites promptly and keep them covered to reduce the risk of bacterial infection.
  • Clean Environment. Regularly clean surfaces and objects that may come into contact with the infected person.
  • Practice Good Pet Hygiene. Ensure pets are clean and healthy, and avoid close contact with their wounds.
  • Be Judicious. Choose facilities where it’s clear they use clean, sterile equipment for tattoos and piercings. Be cautious in public pools and showers, ensuring you rinse off and clean your skin afterward.


At Arizona Dermatology, our goal is to provide comprehensive care and support for all your skin health needs. If you suspect you or your child has impetigo or need guidance on preventing it, don’t hesitate to contact us. Our team is here to ensure you receive the best possible care to maintain healthy skin.