Impetigo is a highly contagious bacterial infection of the surface layers of the skin. There are two forms: bullous impetigo, which is characterised by large, painless, fluid-filled blisters, usually affecting the trunk and limbs, and the more common non-bullous impetigo, which causes sores that quickly burst, leaving behind a yellowish-brown crust.
Why has my child got it?
Impetigo is more likely to affect children than adults, because it can be easily spread once it hits a nursery or school, and because they have underdeveloped immune systems - about three per cent of children up to the age of four and two per cent of children between 5 and 14 get it each year.
It occurs when bacteria invades the skin through a cut, bite or other injury, or where the skin is vulnerable because of another, underlying condition such as eczema, scabies, or head lice. The symptoms don't develop until four to ten days after exposure to the bacteria, which is why it can spread like wildfire in the meantime.
How is my child likely to be affected?
With bullous impetigo, the fluid-filled blisters may spread quickly across the skin before bursting after several days to leave a yellow crust which heals without scarring. Sufferers may also be affected by a fever and swollen glands. In non-bullous impetigo, red sores develop, usually around the nose and mouth, but sometimes elsewhere on the face and body. They'll soon crust over and dry up, leaving a red mark, but no scarring. Both types of impetigo are likely to cause irritation.
Is it definitely impetigo?
It's easily confused with a number of other conditions that have similar symptoms, for instance, scabies, chicken pox, shingles, herpes simplex virus, and eczema, your GP may have to rule all these out first before making a diagnosis of impetigo.
How can it be treated?
Left to its own devices, impetigo will usually clear up and disappear on its own. However, as it's so contagious, it's best to help it on its way with the aid of antibiotic cream. Wash your hands well after applying it, or better still, wear latex gloves. For more severe or persistent cases, your GP may prescribe a course of oral antibiotics.
How should we deal with it in the meantime?
Because the infection is so easily spread to other areas of the body, it's important for your child to avoid touching and scratching. If hands have come into contact with it, make sure they are washed well afterwards, and avoid bath, bed, towel or flannel sharing with anyone who's affected. Keep your child off school or nursery until they are no longer infectious, which should usually be after two days of treatment – or once the spots have crusted over and dried up.
Could any complications arise?
It's rare for any complications to crop up, but when they do, they can be serious. Among them are cellulitis, which occurs when the infection goes deeper into the skin; scarlet fever, a bacterial infection that causes a fine pink rash across the body and symptoms that include pain and vomiting; and septicaemia, a bacterial infection of the blood which can be fatal. So be vigilant and do seek medical help immediately if the symptoms change or worsen.
"My children had impetigo"
Katy Langton, 40, is a full-time mum to Harry, nine, Alex, seven, and twins Olivia and Joseph, three.
"When I first noticed that Harry had some spots on his head we were about to go on holiday, so I told myself if they hadn't gone by the time we got back I'd take him to the doctor. We went off to Thailand, and after a couple of days I noticed he had a really sore nose. Then the spots appeared under his armpits and in his groin area, and that's when I knew it wasn't good.
"It looked awful, and he was obviously very uncomfortable. Back home, we went straight to our GP. He recognised it as impetigo straight away and prescribed antibiotic shampoo, oral antibiotics and antibiotic cream, which seemed to work within a few days. He'd advised us to be careful about passing it on but unfortunately, no sooner had Harry's started to clear up, I had to go back with the rest of the family!
"Alex's spots were different to Harry's, so I guess they had the two different types of impetigo, although no-one really identified the difference. Olivia had just one spot on her tummy, and Joseph just a few. Even my husband had a couple, at the top of his legs. They were all given antibiotics and thankfully they kicked in quickly, and after a few days everyone was clear.
"Meanwhile, on the doctor's advice we did our best not to spread it any further, using paper towels after showers and baths, spraying Dettol everywhere, and using anti-bacterial hand wash all the time. I washed all their sheets and clothes at a really hot temperature to kill it off once and for all. The boys were on holiday anyway but the twins weren't, so I kept them off for school for a week as I was paranoid about them spreading it. The downstairs area in our apartment block is communal so I had to be careful they didn't mix with any other kids. They couldn't go swimming, and I spent all week trying to think of places to take them where there wouldn't be too many other people.
"All in all, it's not a very pleasant condition and a real hassle trying to keep it contained, so I was very glad when the episode was over."