Infected Sores (IMPETIGO)

Definition and Diagnostic Findings
  • Sores are less than 1 inch in diameter.
  • Sores begin as small red bumps that rapidly change to cloudy blisters, then to pimples, and finally sores.
  • Sores (any wounds that don't heal) increase in size.
  • Sores are usually covered by a soft yellow-brown scab.
  • Scabs may be draining pus.
  • Sores may increase in number.
  • First sores are usually near the nose or mouth.
Cause
Impetigo is a superficial infection of the skin, caused by Streptococcus bacteria (60%) or by staphylococcus bacteria (40%). It is more common in the summer when the skin is often broken by cuts, scrapes and insect bites.

Expected Course
With proper treatment, the skin will be completely healed in one week. Some blemishes will remain for 6 to 12 months, but scars are unusual unless your child picks the sores.

Home Treatment
Antibiotic (oral or injectable): Most children with impetigo need an antibiotic. If required, your doctor will prescribe which one and how much.

Removing the Scabs: The bacteria live underneath the soft scabs, and until these are removed, the ointment cannot get through to the bacteria to kill it. Scabs can be soaked off using a warm 1:120 water and bleach solution (1 tablespoon of bleach to 2 quarts of water). The area may need to be gently rubbed but should not be scrubbed. A little bleeding is common if you remove all the crust.

Antibiotic Ointment: After the crust is removed , the antibiotic ointment should be applied to the raw surface 3 times a day. You can get Betadine Ointment or Bacitracin Ointment at your drug store without a prescription. Apply the ointment for 7 days (or longer if necessary). The area should be washed with an antibacterial soap (Dial or Safeguard) before each time the ointment is applied. Any new crust that forms should not be removed since this delays healing.

Preventing the Spread of Impetigo
Every time your child touches the impetigo and then scratches another part of the skin with that finger, he can start a new site of impetigo. To prevent this, discourage your child from touching or picking the sores. Keep his cut short, and wash his hands often with one of the antibacterial soaps.

Contagiousness
Impetigo is quite contagious. Be certain that other people in the family do not use your child's towel or washcloth. Your child should be kept out of school until he has taken the oral antibiotics for 24 hours or until you have used the antibiotic ointment for 48 hours.

CALL YOUR DOCTOR
Immediately if:
  • The urine becomes red or cola colored.
  • The face becomes bright red and tender to the touch.
  • Any big blisters (more than 1 inch across) develop.
Within 24 hours if:
  • Other family members develop impetigo.
  • The impetigo increases in size and number of sores after 48 hours of treatment.
  • A fever or sore throat occurs.
  • You have other questions or concerns