What is Impetigo: Definition, Symptoms, Causes, Signs and What it Looks Like

Impetigo is a skin infection, common and very contagious but rarely serious unless complications occur. It is caused by bacteria of the staphylococcus and streptococcus strains. The infection is the most common type of infection in children aged 2-5 years. Adults too can get impetigo.

Signs usually appear on the face but can also be seen on the legs and arms or any other part of the skin. Infection is confined to the epidermis. This makes impetigo not as serious as infections like cellulitis. The first signs often involve small blisters which soon rupture to present red skin. When infection begins in healthy skin, it is referred to as primary impetigo, and secondary impetigo when infection starts in damaged skin.

Mild infections can clear up even without treatment. Regardless, medical attention is always necessary, especially to prevent spread and potential complications. Impetigo can easily spread from one part of the skin to another or from one person to another. In fact, parents are advised to keep their kids from school to avoid spread.

Impetigo definition and facts

So what is impetigo? Simply enough, it is a bacterial infection of the skin. Most cases are reported in children in the areas around the nose and mouth.


  • One can easily pass impetigo to others especially in crowded places. One can also increase intensity of the infection by scratching or touching the affected areas.
  • Children are the most common victims. In fact, impetigo accounts for most cases of skin infections in children in most places.
  • Incidence rate is higher in developed and industrialized countries compared to developing countries. This is largely because of the fact that the infection is very contagious.
  • Impetigo can be bullous or nonbullous. Either type is encouraged by warm and humid environmental conditions.
  • Tiny blisters that burst to form crusts with the color of honey are the common first indications of impetigo. Depending on severity and type, other symptoms such as itchiness may occur.

Types, signs and symptoms of impetigo


As hinted earlier, impetigo can be bullous or nonbullous.

  • Bullous – this type is caused by staphylococcus bacteria. These bacteria produce toxic substances that separate upper skin layers. Yellow clear fluid collects in the areas where separation has occurred resulting in formation of a delicate blister. The blister usually bursts, darkens and crusts over as it heals. It may be responsible for impetigo on buttocks.
  • Nonbullousnonbullous impetigo is caused by both strep and staphylococcus bacteria. It is more common than bullous impetigo. It presents with tiny pimples that soon turn into blisters on which brown scabs form.

See pictures for illustrations on impetigo meaning and what does it look like.

Signs and symptoms:

Most impetigo infections involve small red papules or sores. The sores soon rupture, release a clear or yellow fluid, and form a brown or yellow crust. Crusting over indicates later impetigo stages of healing. Patients may experience symptoms such as itchiness and soreness. If present, they usually are very mild.

In the case of bullous impetigo, large blisters will form. This type is not common especially on face. When it occurs, the trunk and buttocks are commonly affected.

Severe impetigo can lead to ecthyma. Here, not only will signs of impetigo include itchiness but also painful blisters which soon form large areas of ulceration.

Impetigo causes

Staphylococcus bacteria are the main causes of impetigo. But how do you get impetigo? The bacteria can be picked from other infections or surfaces that contain them. Although an infection can start in a healthy body area, injured areas are more likely to get infected. Insect bites can also introduce bacteria.

People with weakened immune systems are more likely to suffer from severe impetigo or develop the disease without prior skin damage. For example, experts are not quite sure why bacterial colonies sometimes form on healthy skin. It may have something to do with lacking strong immunity. In children, immune weakness can be avoided by breastfeeding and other measures that your doctor may suggest.

There are some factors that predispose an individual to impetigo. These are necessarily not impetigo causes. They include:

  • Age – very frequently, cases of impetigo occur in children between two and five years of age.
  • Poor hygiene – many healthy people are carriers of staphylococcus bacteria especially in the area between anus and genitals. These bacteria can spread to other body areas through normal activities such as scratching. Washing with medicated soap, not sharing clothes and wearing clean clothes are among preventive measures that may help.
  • Skin damage – there are many bacteria to be found on our skins. Rarely will these bacterial cause infections unless they enter the skin. Skin discontinuities and flaws provide for the needed portal of entry.
  • Direct contact – although one can pick bacteria from contaminated surfaces, chances of becoming infected are higher after direct skin to skin contact. This is very common in crowded places such as schools and during some sports.
  • Seasons – bacteria prefer warm and wet conditions. During summer, conditions are very favorable for bacterial proliferation and infections.

It is not clear whether an impetigo pregnancy link exists. Pregnant women should consult their doctors when taking medications meant to control or cure impetigo.

How is impetigo diagnosed?

Most impetigo cases will be recognized by a doctor during physical examination. The patient’s medical history may be required in order to confirm diagnosis.

If infection does not respond to treatments or appears more severe than impetigo, a liquid culture may be taken. This is usually not necessary. The problem is that some bacteria strains have been showing resistance to commonly used antibiotics.

How is impetigo treated?

Impetigo responds well to treatment with antibiotic ointments. Topical mupirocin is for example commonly used to cure this infection. Amoxicillin for impetigo is another good example. Antibiotics work very fast when taken for the right purpose. For example, impetigo barely lasts a week with medications. This is even when it is topical agents that are in use.

Patients are advised against going for impetigo treatment over the counter. One main problem is that such medications are not strong enough to be used on staph and strep infections. Another issue is that using antibiotics without prescription can make infections worse in the future. This is being observed in worldwide today, where bacteria are now becoming more resistant to antibiotics. Applying topical agents without instructions from a doctor may also work by spreading infection.

Severe impetigo infections can be treated with oral antibiotics. Rarely are IV antibiotics necessary but may be considered in case of complicated impetigo toddler infection.  Your doctor will determine which form of medications to prescribe after diagnosis. Recurring impetigo can be caused by bacterial living in nasal regions. Such can be controlled with antiseptic nasal creams, especially for recurrent impetigo in nose.

It is important that everyone in the household gets to regularly wash with medicated soap and water. This will help flush out bacteria that may have been picked up from the patient or contaminated surfaces.

Home treatments and how to prevent impetigo

Home treatments:

The main home treatment that may help with impetigo is heat therapy.  Bacteria prefer warm environments but cannot survive in excess heat. Heat therapy also encourages blood circulation, which in turn aids in delivering immune cells to the site of infection.

Heat therapy requires simple tools that can easily be accessed. First, you will need to warm some water to near boiling point. Soak a thick piece of cloth and wring out to get rid of excess water. After that, press the cloth on the affected area for several minutes.

You can always re-heat the cloth if necessary. Be careful however not to cause unnecessary discomfort or pain. Treatment with heat therapy 3 times a day may quicken recovery process and keep infection from spreading.

Impetigo can be treated with the following home remedies:

  • White vinegar – vinegar mainly works by stopping the bacteria from spreading. It works as a natural antiseptic. The vinegar should be mixed with water before use. For best result, add a tablespoon to 2 cups of water.
  • Tea tree oil – tea tree oil is one of the most popular home remedies used for different skin conditions. It has powerful antimicrobial and anti-inflammatory properties. The essential oil can therefore be used to treat impetigo and relieve its symptoms. Like other essential oils, it is important that carrier oil such as olive oil be used to prevent skin irritation. Water can also be used to dilute the tea tree oil. Patients should not drink tea tree oil, for it is potentially dangerous.
  • Garlic – garlic works by fighting infection and relieving symptoms such as pain. For the best results, crushed garlic cloves should be fried in sesame oil. The resulting mixture is then to be applied directly. Garlic can as well be consumed in the diet.
  • Turmeric – turmeric is yet another powerful antibacterial home remedy. It particularly excels in controlling staphylococcus bacteria. For best results, mix a teaspoon of turmeric with a tablespoon of coconut oil and apply the resulting paste directly. Coconut oil can also be used on its own. It helps fight pathogens as well as relieve pain.
  • Honey – honey has from ancient times being known to enhance recovery from infections and cure burns. More research has been done on manuka honey for it is believed to be most beneficial. If not accessible, you can use raw honey for the same effects. Just apply a thin coat on the affected areas several times a day.

Note that home remedies are not conventional treatments. They may or may not work. It is advisable that you check with your doctor before using home treatments, especially if no other treatment is available.

How to prevent:

You can prevent impetigo by avoiding contamination or keeping it from spreading. Once scabs have formed on impetigo blisters, the infection becomes noncontiguous. This is also true two days after the first dose of prescription medications. Below are some measures that may help prevent impetigo:

  • Keep wounds clean and dry – cleaning wounds flushes out bacteria that may end up causing infection. Medicated soap is recommended although similar results may be achieved with ordinary soap and water. Afterwards, ensure that wounds are kept dry. This keeps bacteria from forming colonies since the pathogens can only survive in wet conditions.
  • Stay away from congested places – if you have impetigo, it is advisable that you keep off congested places. This prevents spread to other people. Parents should keep their children from attending school.
  • Clean contaminated surfaces – if your child has impetigo, remember to clean the surfaces they have come into contact with. This includes clothing, towels and toys.
  • Cover with loose bandages – loose bandages may help keep impetigo bacteria from being passed from one person to another or to other body areas.

Complications of impetigo

Most impetigo patients recover without complications. If symptoms are to worsen or fail to improve with treatment, check with your GP. Below are the possible complications of impetigo.


Cellulitis is another bacterial infection of the skin. Unlike impetigo, cellulitis develops much deeper in the skin. This makes it potentially dangerous since bacteria can easily reach blood and lymphatic vessels. The infection is characterized by a red rash, swelling, pain and fever.

Scarlet fever:

Scarlet fever is not common. It is a bacterial infection that results in a pink rash. Patients also experience symptoms such as nausea and pain.

Guttate psoriasis:

This is a form of psoriasis that occurs after impetigo. It is characterized by formation of small, scaly and red patches, mostly on scalp, legs, arms or chest. This condition is not contagious and common after throat infection.


This is a serious complication caused by presence of toxins released into blood by bacteria. The condition can send patients to septic shock and death if severe. Early signs include diarrhea, dizziness, fatigue, difficulty breathing and low blood pressure. It should be treated as a medical emergency.

Post-streptococcal glomerulonephritis:

This is an infection that affects the blood vessels in the kidneys. It is not common but is a potential impetigo complication. Some of its signs include blood in the urine and widespread swelling.


Blisters that result from impetigo usually heal without scarring. Scratching may lead to larger sores and therefore scarring.