Germs like warm, moist, and dark environments. I think that’s why I see so much impetigo during the summer months. Kids are outside more so they’re a little dirtier, sweatier, and itchier. Years ago, impetigo used to be a strep skin infection, as in the same germ that causes strep throat. But it seems to have transitioned to more of a staph skin infection. I typically see kids come in with an infected bug bite or scrape that progressively gets worse until it can no longer be ignored.
What does it look like?
The infection starts when germs get under the skin. It’s warm, moist, and dark under there, and the immune system doesn’t “see” the germ. A red bump forms, progresses to a blister, and then becomes a pustule (basically a pimple). The pustule opens up, and a crust is left on the raw skin. Gross, I know. Some kids even have swollen lymph nodes close to the infection. Different strains of the infection cause different specifics: on the face is usually a honey-colored crust, on the body is usually a brown crust, and another strain causes “punched-out” ulcers with a dark crust. But ultimately, it’s all a variety of the same kind of skin infection.
How do you fix it?
Generally, when there are only a few, minor spots, impetigo goes away with topical prescription antibiotic ointment. If there are a bunch of infected spots, or they are particularly gnarly, an oral antibiotic is best. I offer my patients two options: one antibiotic that kills more germs but is harder to take, or another antibiotic that is easy to take but doesn’t kill as many germs. I also recommend taking a quality probiotic, with at least two different strains, for two weeks after finishing the antibiotic. It just helps build back up the good bacteria and make your immune system a little more resilient.
Good hand hygiene with soap and water, or alcohol-based hand sanitizer is a good way to prevent spreading skin infections like impetigo. But sometimes, despite our best efforts, a cut, scrape, or bug bite gets infected. Let the kid experts at KidMed help!