A Handle on your Health: Impetigo aka 'School Sores'

Impetigo, or “school sores” as it is called in some places because of its high occurrence in school children, is an annoying skin infection that can make you miserable for a few weeks while you have it.  

The word, “impetigo,” comes from a Latin word which means “attack” and that is exactly what it does; it attacks your skin forming red bumps that are painful and itchy and lasts up to 3 weeks. Can you imagine dealing with that misery for three weeks?

Who gets impetigo?

Well, school children — most commonly babies and very young children — but it can also infect adults. Daycares and schools are breeding grounds for these types of infections. Any crowded environments are a risk factor for its spread as is playing contact sports like football or wrestling. People with any kind of decreased immunity, like diabetics, are especially susceptible. Warm humid conditions, like summertime in Texas, can cause an increase in impetigo infections.

What causes impetigo?

The bacteria staph and strep are the offenders. Most people have heard of staph infections but the same strep that causes sore throats also causes impetigo; it’s actually the most common cause of impetigo.  Staph is the cause of the more serious type of impetigo called bullous impetigo. Bullous impetigo is when the infection causes large blisters to form and burst. Most cases are the non-bullous form and infect only the superficial layers of our skin.

Diagnosing impetigo

It usually starts out as a cluster of red bumps that open up and ooze then forming a honey crust on its surface. The little pustules are moderately irritating causing pain and itching. It can occur anywhere but it particularly likes the face around the nose and mouth. In babies, it also likes the buttocks and lower back region. Usually, there is no fever. Usually, all that is needed for making the diagnosis is for a doctor to look at it. If confirmation is needed wound cultures can be taken of the lesions.

Preventing the spread of impetigo

This stuff can spread like wildfire. So if you have it, you have to try to resist scratching it or you will spread it to other areas on your body and other people. You have to wash your hands repeatedly throughout the day. Clean all surfaces you’ve come in contact with thoroughly as well as washing clothing and bedding and towels. Open wounds should be cleaned with antibacterial soaps and if possible, covered with a bandage. Prevention is key here folks.

Treating impetigo

Well, you could do nothing and your immune system will likely cure it within three weeks – I think that’s an awful idea, though. Topical antibiotics are usually required, like Bactroban to speed recovery. Topical antibiotics like Neosporin are not effective, however. You will need a doctor’s prescription to get the Bactroban ointment.    Apply it two to three times a day and you should see improvement within 48 hours and complete resolution within a week. For more serious cases, oral antibiotics may be needed. Your doctor might prescribe you Keflex or Augmentin or Biaxin, especially if they are worried the infection has gone into deeper layers of skin and is causing cellulitis. For those of you into alternative medicines, tea tree oil or honey might help. In the days before antibiotics “crystal violet” was used as a topical antiseptic with good success.  

There aren’t usually any serious complications. The bumps heal without scarring.  Sometimes it can become a more serious infection like cellulitis. Rarely it can also cause inflammation in your kidneys resulting in glomerulonephritis. Only Strep causes the type of impetigo that can involve the kidneys and it usually resolves completely.  

The take-home message here is prevent the spread of this by frequent washing and avoid contact with others until your infection resolves. If you suspect impetigo, go to your doctor immediately.  

As physician and author James J. Walsh once said, “It is sometimes as dangerous to be run into by a microbe as by a trolley car.”

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Dr. John Turner is a family medicine and emergency medicine doctor with 25 years of experience. He is also the owner of My Primary Care Clinic and My Emergency Room 24/7 here in Hays County. Dr. Turner may be reached at 512-667-6087.