7 Key Signs and Symptoms of Impetigo You Should Know

Impetigo is a highly contagious bacterial skin infection that primarily affects infants and young children, though it can occur in people of any age. This common skin condition is caused by bacteria that enter the body through breaks in the skin, such as cuts, insect bites, or areas affected by other skin conditions. Recognizing the symptoms of impetigo early is crucial for prompt management and preventing its spread to others.

The infection typically appears on the face, particularly around the nose and mouth, but can develop anywhere on the body. Understanding the characteristic signs of impetigo can help you identify the condition quickly and seek appropriate medical attention. In this comprehensive guide, we’ll explore the seven key symptoms of impetigo, their causes, prevention strategies, and answers to frequently asked questions.

1. Red Sores and Blisters

The most recognizable symptom of impetigo is the appearance of red sores or small blisters on the skin. These lesions typically start as tiny blisters that may be filled with clear or cloudy fluid. The blisters are often fragile and tend to rupture easily, even with minimal contact or friction.

In early stage impetigo, these sores commonly appear around the nose and mouth, but they can develop on any part of the body, especially in areas where the skin has been broken or irritated. The sores may vary in size from a few millimeters to several centimeters in diameter.

Key characteristics of impetigo sores:

• Begin as small red spots or tiny blisters
• Rupture quickly, leaving raw, moist areas
• Most common on face, especially around nose and mouth
• Can spread to other body parts through scratching or touching
• May be itchy but are not usually painful

2. Honey-Colored Crusty Scabs

Perhaps the most distinctive and diagnostic feature of impetigo is the development of honey-colored or golden-yellow crusty scabs. After the blisters burst, the fluid that oozes out dries and forms these characteristic crusts on the skin surface. This symptom is so typical of impetigo that it’s often the first sign that helps healthcare providers make a diagnosis.

These crusty formations develop because the fluid from the ruptured blisters contains bacteria, white blood cells, and other cellular material that dries on the skin. The honey-colored appearance is quite specific to impetigo and helps distinguish it from other skin conditions.

Characteristics of impetigo crusts:

• Golden or honey-colored appearance
• Form after blisters rupture and fluid dries
• May be thick or thin depending on the amount of fluid
• Can be gently removed, revealing red, moist skin underneath
• Tend to spread outward from the original site

3. Skin Lesions That Spread Rapidly

Impetigo is highly contagious and has a tendency to spread quickly across the skin. The infection can spread to new areas of the body through direct contact, when a person touches the infected area and then touches healthy skin elsewhere. This rapid spreading is one of the hallmark features of impetigo and a key reason why early recognition and proper hygiene are so important.

The bacteria responsible for impetigo can be easily transferred from one location to another through scratching, touching, or contact with contaminated objects like towels, clothing, or toys. Children are particularly susceptible to spreading the infection because they may scratch the itchy areas and then touch other parts of their body or share items with playmates.

Spreading patterns:

• New sores appear near the original infection site
• Can spread to other body parts within hours to days
• Scratching accelerates the spreading process
• May affect multiple family members or classmates
• Areas of skin-to-skin contact are most vulnerable

4. Itching and Discomfort

While impetigo is generally not a painful condition, it does cause significant itching and discomfort for most people affected by it. The itching sensation can be mild to moderate and may be particularly bothersome for children, who may have difficulty resisting the urge to scratch the affected areas.

The itching occurs as part of the body’s inflammatory response to the bacterial infection. As the immune system responds to the bacteria, it releases chemicals that stimulate nerve endings in the skin, creating the itching sensation. Unfortunately, scratching provides only temporary relief and actually worsens the condition by spreading the bacteria to new areas and potentially introducing additional germs into the broken skin.

Managing itching:

• Avoid scratching to prevent spreading
• Keep fingernails short and clean
• The sensation may worsen at night
• Cool compresses may provide temporary relief
• The affected area may feel slightly tender to touch

5. Swollen Lymph Nodes

In some cases of impetigo, especially when the infection is more extensive or involves deeper skin layers, the lymph nodes near the affected area may become swollen and tender. Lymph nodes are small, bean-shaped structures that are part of the immune system and help fight infections. When bacteria from impetigo enter the lymphatic system, nearby lymph nodes may enlarge as they work to filter out and destroy the bacteria.

For impetigo on the face, you might notice swollen lymph nodes in the neck or under the jaw. If the infection is on the arms or legs, the lymph nodes in the armpit or groin area may become enlarged. While swollen lymph nodes are not always present with impetigo, their appearance indicates that the body is actively fighting the infection.

Lymph node involvement indicators:

• Small, tender bumps near the infected area
• Most commonly felt in the neck, behind ears, or under jaw
• Usually pea-sized or slightly larger
• May feel slightly warm to touch
• Typically resolve as the infection clears

6. Redness and Inflammation Around Sores

The skin surrounding impetigo lesions typically shows signs of inflammation, appearing red, slightly swollen, and warm to the touch. This redness, known medically as erythema, extends beyond the actual sores and crusty areas, creating a halo effect around each lesion. The inflammatory response is the body’s natural reaction to the bacterial infection.

The impetigo rash pattern is distinctive, with the central crusty or oozing sore surrounded by an area of reddened skin. The degree of redness can vary from person to person and may be more pronounced in some cases than others. In individuals with darker skin tones, the redness may be less obvious but the area may still appear darker or discolored compared to surrounding healthy skin.

Inflammatory signs include:

• Red or pink coloration around lesions
• Slight swelling of the affected skin
• Warmth when touched compared to surrounding skin
• The reddened area may expand as the infection spreads
• May be accompanied by a feeling of tightness in the skin

7. Oozing and Weeping Lesions

Active impetigo lesions often produce a clear to yellowish fluid that oozes or weeps from the sores. This discharge occurs when the blisters rupture or when the crusts are removed or fall off. The fluid is highly contagious as it contains large numbers of bacteria, making this symptom particularly important in terms of infection control.

The weeping nature of impetigo lesions is one reason why the condition spreads so easily. The fluid can contaminate clothing, bedding, towels, and any surfaces or objects that come into contact with it. When this fluid dries, it forms the characteristic honey-colored crusts mentioned earlier. The cycle of oozing and crust formation may continue until proper treatment is implemented.

Characteristics of discharge:

• Clear to yellow or amber-colored fluid
• May be continuous or intermittent
• Increases when crusts are disturbed or removed
• Highly contagious to others
• Can stain clothing and bedding
• Eventually dries to form honey-colored crusts

Main Causes of Impetigo

Impetigo is caused by bacterial infection, and understanding these causes can help in prevention and early recognition of the condition.

Bacterial Infection

Impetigo is primarily caused by two types of bacteria:

• Staphylococcus aureus (staph): This is the most common cause of impetigo in most countries. These bacteria normally live on the skin and in the nose without causing problems, but can cause infection when they enter through broken skin.
• Streptococcus pyogenes (group A streptococcus): This bacteria can also cause impetigo, either alone or in combination with staph bacteria. It’s the same bacteria that causes strep throat.

Entry Points for Bacteria

The bacteria that cause impetigo typically enter the body through breaks in the skin, including:

• Cuts, scrapes, or abrasions
• Insect bites or stings
• Chickenpox lesions
• Eczema or other skin conditions that cause breaks in the skin
• Burns or wounds

Risk Factors

Certain factors increase the likelihood of developing impetigo:

• Age: Impetigo in kids is most common, particularly in children aged 2 to 5 years
• Close contact: Settings like schools, daycare centers, and sports activities where people are in close contact
• Warm, humid weather: Impetigo is more common in summer and in tropical climates
• Poor hygiene: Infrequent bathing or washing
• Crowded conditions: Living in crowded environments increases transmission risk
• Weakened immune system: Certain medical conditions or medications that suppress the immune system
• Diabetes: People with diabetes may be more susceptible to skin infections
• Contact sports: Activities involving skin-to-skin contact like wrestling

Prevention Strategies

Preventing impetigo involves good hygiene practices and taking precautions to avoid spreading the infection:

Personal Hygiene

• Regular handwashing: Wash hands frequently with soap and water for at least 20 seconds, especially after touching the affected area
• Keep skin clean: Bathe or shower regularly with soap and water
• Trim fingernails: Keep nails short and clean to minimize damage from scratching
• Cover wounds: Keep cuts, scrapes, and insect bites clean and covered with bandages until healed
• Don’t share personal items: Avoid sharing towels, washcloths, razors, clothing, or bedding

Preventing Spread

• Avoid touching: Don’t touch or scratch the infected areas
• Isolate infected items: Wash towels, bedding, and clothing used by the infected person separately in hot water
• Clean surfaces: Disinfect surfaces and objects that may have been contaminated
• Stay home: Keep children with impetigo home from school or daycare until they are no longer contagious
• Avoid close contact: Minimize skin-to-skin contact with others until the infection clears

Managing Existing Skin Conditions

• Properly treat eczema, chickenpox, and other skin conditions that cause breaks in the skin
• Keep affected areas moisturized and protected
• Seek medical attention promptly for any signs of skin infection

Environmental Measures

• Maintain clean living spaces, especially in shared environments
• Ensure proper ventilation in humid climates
• Regular cleaning of sports equipment and shared facilities
• Educate children about not sharing personal items

Frequently Asked Questions

What is impetigo?

Impetigo is a highly contagious bacterial skin infection that causes red sores and honey-colored crusty scabs, most commonly on the face, particularly around the nose and mouth. It primarily affects children but can occur at any age.

How contagious is impetigo?

Impetigo is extremely contagious. The infection can spread through direct contact with the sores or fluid from the blisters, as well as through contaminated items like towels, clothing, or toys. It can be transmitted until the sores have healed or after appropriate medical management has been started.

How long does impetigo last?

Without treatment, impetigo may take 2 to 3 weeks to resolve on its own. However, with appropriate medical care, symptoms typically begin to improve within a few days, and the infection usually clears within 7 to 10 days. The condition is generally no longer contagious after 24 to 48 hours of proper treatment.

Can adults get impetigo?

Yes, adults can get impetigo, although it is less common than in children. Adults with weakened immune systems, diabetes, or those who participate in contact sports are at higher risk. The symptoms and treatment are similar to those in children.

Is impetigo the same as infantigo?

Infantigo is simply a colloquial or alternative name for impetigo. They refer to the same bacterial skin infection. The term “infantigo” likely comes from the fact that the condition commonly affects infants and young children.

Can impetigo leave scars?

In most cases, impetigo heals without leaving scars, especially when treated promptly. However, a more severe form called ecthyma, which affects deeper layers of skin, may leave scars. Avoiding scratching and following proper care instructions can minimize the risk of scarring.

When should I see a doctor for impetigo?

You should consult a healthcare provider if you notice symptoms of impetigo, especially the characteristic honey-colored crusts and spreading sores. Seek immediate medical attention if the person develops fever, the infection spreads rapidly, shows signs of deeper infection (increased pain, swelling, warmth), or if symptoms don’t improve within a few days of home care.

Can impetigo spread to other parts of the body?

Yes, impetigo can easily spread to other parts of the body through touching or scratching the infected area and then touching healthy skin. This is why it’s crucial to avoid scratching, practice good hand hygiene, and keep the affected area covered when possible.

What’s the difference between impetigo on face and other body areas?

The symptoms of impetigo are the same regardless of location, but impetigo on face is most common because the bacteria easily enter through small breaks in facial skin, and the face is frequently touched. Facial impetigo, especially around the nose and mouth, is the classic presentation of the condition.

Is impetigo related to poor hygiene?

While poor hygiene can be a risk factor, impetigo can affect anyone regardless of cleanliness. The infection occurs when bacteria enter through breaks in the skin, which can happen even with good hygiene practices. However, regular handwashing and keeping skin clean can help prevent the condition and reduce its spread.

References:

• Mayo Clinic – Impetigo
• Centers for Disease Control and Prevention (CDC) – Impetigo
• American Academy of Dermatology – Impetigo
• NHS – Impetigo
• National Center for Biotechnology Information (NCBI) – Impetigo