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Impetigo (Infantigo): Symptoms, Causes, and Treatments

Updated on January 24, 2017
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Trained in dentistry, Sree is currently pursuing lab sciences. She loves researching and sharing information on various health topics.

Impetigo: Beyond Skin Deep

Impetigo, also known as pyoderma or infantigo, is a debilitating skin disease that affects both children and adults. Not only does it mar the flesh, it also leaves deep emotional and psychological scars on those who are affected.

Unlike most skin diseases, the symptoms of impetigo are recurring. Thus, sufferers of this skin disorder are usually trapped in a frustrating cycle of remission and exacerbation. The worst thing about this skin disease is that it is highly contagious. Hence, affected individuals sometimes fear the social stigma more than the sleepless nights that comes with it.

But what is impetigo, really? What causes it? More importantly, how do you cure it? This article aims to hold your hand and walk you through the entire process, from determining how to avoid the disease to finding a way to live with it.

Learning More about Infantigo
Impetigo is categorized as a skin infection of bacterial origin. Impetigo appears as reddish blisters that erupt and ooze liquid. The liquid then forms a yellow-brownish or golden-brown or honey-colored crust. These blisters can be present anywhere on the surface of the body such as the arms and the legs. That said, they frequently appear on the affected person's face, particularly around the mouth and the nose.

There are several ways in which impetigo can spread. One is from one body part to another. If the affected individual scratches the infected area, the bacteria that cause impetigo will then embed themselves beneath the nails and spread to the person's fingers. If the person touches another part of his body, he then spreads the bacterial causative agent (and the disease) to that distal body part. This goes on and on until several parts of the person's body are infected.

One of the most common ways in which impetigo can be transmitted from person to person is through close contact. This can happen by touching an infected part of an affected individual's skin. Impetigo can also be transmitted through contact with the affected person's belongings such as clothes, bed linens, towels, clothing, and other personal articles.

Though impetigo can affect adults, it is more common in children, usually those between two to five years of age. In fact, it is considered as the most common bacterial dermal infection in kids in Canada, Northern Europe, and North America. In 2010, impetigo has affected more than 100 million individuals worldwide. One essential factor to consider here is the high communicability of this disease. Kids like to share stuff from food to toys. More than that, they experience direct physical contact with each other during playtime. They are rarely conscious about the consequences of not observing proper hygiene when they're having fun. This makes them highly susceptible to contracting the disease from their playmates, schoolmates, and friends.

In some instances, the blisters caused by impetigo turn into sores and gradually go away within a couple of weeks even without intervention. There are those that would say that impetigo is rarely serious but some medical professionals would beg to differ. After all, one must consider not just the physical effects of the disease but also its effects on the inflicted individual's self-esteem and social relationships.

Infantigo (Impetigo): Symptoms, Causes, Types, Diagnosis, Risk Factors, Treatment, Remedies and Prevention
Infantigo (Impetigo): Symptoms, Causes, Types, Diagnosis, Risk Factors, Treatment, Remedies and Prevention | Source

Risk Factors Associated with Impetigo

Impetigo is commonly contracted by persons dwelling in confined spaces. That includes army barracks, dormitories, and orphanages. Warm, humid environments also facilitate the spread of the disease.

Individuals with compromised immune systems are more at risk of developing impetigo than others. Such persons include diabetics, cancer patients receiving chemotherapy or radiation therapy, patients with AIDS, people with auto-immune diseases, and those taking immunosuppressive drugs.

Patients with chronic respiratory conditions such as emphysema and cystic fibrosis are also more likely to develop pyoderma. The same goes with patients with severe kidney problems who undergo dialysis.

Moreover, individuals with dermatitis are more predisposed to developing impetigo than others.

Other groups of people who are prone to contracting impetigo are those who are frequently in and out of the hospital. That includes healthcare professionals. Despite great measures taken to sanitize the hospital environment, it is nearly impossible to eradicate the presence of the bacterial causative agent of this skin infection. This places the following types of patients at risk:

  • The immunocompromised
  • Burn patients
  • Patients with surgical wounds
  • Patients with invasive devices such as feeding tubes, urinary catheters, and intravascular catheters

The presence of foreign objects in the body creates a bridge for the bacteria to pass from the outside world to your internal systems.

The Signs and Symptoms of Pyoderma

The initial signs of impetigo include an area of red skin that is itchy. They may multiply and grow bigger. They may range from the size of a pimple to a patch bigger than a quarter coin. After a while, the sores will erupt and begin oozing pus. The pus will then dry up resulting to the characteristic thick and honey-colored crust. Imagine moist granules of brown sugar that have clumped together. When the crusts disappear, they leave behind red marks. After treatment, these red marks can disappear leaving no scars at all.

Despite how it may look, the blisters caused by impetigo are not painful at all. However, they do cause a terrible itching that can keep a child or an adult awake all night. Nevertheless, the infected person must take care never to scratch or even touch the infected skin so as to lessen the risk of spreading it to other parts of his body. This, in itself, can be a pretty tough ordeal.

The Diagnosis of Impetigo
For an experienced medical professional, it's easy enough to diagnose impetigo just through visual inspection. As mentioned, its hallmark sign is the honey-colored crust. Other ways to visually confirm impetigo is to determine whether the changes in the patient's skin do not exceed a two palm surface and if the affected visible parts of the patient's body are less than five areas. When you see the doctor, expect him/her to ask about the development of the skin lesions. If it's impetigo, the progression is usually slow. In other words, impetigo has a pretty long incubation period.

There are also instances where the physician may request for a sample of the pus to be obtained. A healthcare provider will carefully wipe the crusted patch with a swab. In the laboratory, they will attempt to confirm the presence of the bacterial causative agent of the disease. As infantigo can be caused by one out of two possible species of bacteria, this lab exam can aid in determining which antibiotic must be prescribed. Moreover, impetigo tends to coexist with other skin infections. Thus, a swab will aid in determining the presence of other dermal infections like shingles or ringworm.

Obtaining a pus sample is not always necessary but the physician may order it in the following instances:

  • If the symptoms are more severe than usual and has spread to various parts of the patient's body
  • If the patient shows failure to respond to treatment
  • If the impetigo is recurrent

In cases of recurrent impetigo, the physician may also order for a sample to be taken from the patient's nose. This way, he'll be able to know if the causative bacterial agent originates from there.

It's also possible for the doctor to order a urinalysis and blood tests if the presence of other types of infections are suspected. A blood test that's ordered in case of extensive impetigo may reveal neutrophilic leukocytosis. This pertains to an abnormally high level of neutrophil (a kind of white blood cell).

Warning!

Extreme pain, swollen glands, and fever are usually indicative of a more severe infection. Seek medical care immediately. Also, call your doctor if the redness or swelling worsens, and if you experience loss of appetite.

Three Types of Impetigo

1. Non-Bullous Impetigo
This is what medical professionals refer to as impetigo contagiosa. It is the more common type of impetigo. In fact, it makes up about 70% of all cases of impetigo.

This ordinarily begins as patches of red skin around the oral and nasal skin areas. The rashes show up 4-10 days after the person has been infected by the bacterial causative agent. Blisters form but they aren't always noticeable as they erupt quickly, leaving clusters of yellowish pus in their wake. They dry up to form the crusty surface that impetigo is known for. Imagine moist but crunchy cornflake crumbles. After these crusts fall off, the affected areas become hyperpigmented for up to six months or less. That said, the discoloration is thankfully only temporary.

Non-bullous impetigo is very itchy and complications usually result from skin injury due to the scratching of the infected blisters. Compared to the bullous type of pyoderma, the patches of non-bullous impetigo are small, usually about a centimeter or slightly bigger. Though they may not grow larger than that, it's not uncommon for satellite patches to form around an existing patch. From there, these newly formed patches will continue to multiply and spread outward.

The causative agent of non-bullous impetigo can be either the Staphylococcus aureus or the Streptococcus pyogenes. In the past, non-bullous impetigo was caused mainly by strep but nowadays, majority of the cases of impetigo are caused by a combination of these two bacteria. Staphylococcus aureus normally resides on the surface of the skin. Thus, it can easily make its way into the deeper layers of the skin through even the smallest openings such as minor cuts and mosquito bites. This happens particularly when they are scratched or left uncleansed. The incubation period for staphylococcal impetigo is four to ten days after exposure to the bacteria. Because of the long incubation period, it's possible for an affected individual to be contagious even when he hasn't yet shown any obvious sign or symptom of pyoderma.

It's possible for children to contract non-bullous impetigo from school, camp, or daycare. It's also not uncommon for adults who engage in contact sports like wrestling to contract this highly contagious skin disease. This is also true with athletes who share bathrooms, locker rooms, and sports equipment. You can even get impetigo from day spas. In fact, any activity that involves skin-to-skin contact can facilitate the transfer of impetigo from one person to another. What's more, you can acquire it from contaminated food prepared by handlers who have failed to wash their hands. The thing about food contaminated with strep or staph is that they taste quite normal so you don't get any warning sign at all. Once the staph has successfully entered the bloodstream, this could lead to a fatal complication known as sepsis.

Two of the most severe complications of non-bullous impetigo are cellulitis and post-streptococcal glomerulonephritis. The latter occurs when the causative agent of the skin infection is the Streptococcus pyogenes.

Non-bullous impetigo is not just transmitted through direct contact but also via nasal carriers. The latter is true particularly with impetigo caused by the strep. This means that when your skin is not intact and then it is exposed to streptococci bacteria in the air, it's possible for you to develop impetigo. It's also possible for the impetigo to spread when one person scratches his nose and then touches his own skin or other people's compromised skin. While it was mentioned here that impetigo usually goes away on its own, it's also possible to keep re-infecting healing patches of skin by re-introducing the bacteria to them.

Note that the nose itself may not be infected but instead serves as a carrier for the bacteria. One sure way to determine whether the impetigo was caused by nasal carriers is through taking nasal swabs. In a household, for instance, if any one of the family members is identified as a positive carrier, all immediate family members will be advised to apply Naseptin or any other antibacterial cream into their inner nostrils. This is done for a week or so to stop the spread of the infection. After the treatment, re-swabbing of the nostrils may be requested.

The incubation period for streptococcal impetigo is one to three days after exposure to the bacteria.

2. Bullous Impetigo

This less common type of impetigo typically occurs in infants and babies younger than two years. Unlike its more popular sister, bullous impetigo does not start off on the face but begins in the extremities and sometimes all over the torso. They may also break out on an infant's bottom and be mistaken for diaper rash. They can also show up in skin folds such as the axilla, the groin, and the neck.

The blisters or bullae are medium to large (5mm or more) in size and are surrounded by red skin. They spread quickly. The skin on top of the blisters are very flimsy and can fall off easily. When they peel off, they expose big, red, and raw patches beneath.

The skin disease manifests itself as pus-filled blisters which erupt after a few days. Like impetigo contagiosa, a yellowish crust is left on the skin. After they heal up, no scarring or discoloration occurs. It causes itching but not pain. However, the child may experience fever and swelling of the glands. Some infants and toddlers also suffer from diarrhea. Considering the age of the patient, prompt medical care is required.

The causative agent of bullous impetigo is a specific strain of Staphylococcus aureus. This type of staph discharges a unique toxin (exfoliative toxin A) which attacks the skin layer. This bacteria reduces the adhesion of the cells and thus, weakens the skin. When the bullous impetigo is severe, this results to the separation of the epidermis (the external layer of the skin) from the dermis (the inner layer of the skin). This complication is known as SSSS or staphylococcal scalded skin syndrome. It is characterized by widespread areas of peeling. Usually, there is flaking and cracking on the skin around the mouth. When the outer layer of the skin comes off, it exposes raw and red skin that looks not too different from burns. SSSS typically affects kids below six years of age but may also occur in adults especially those who are immunocompromised or are suffering from renal failure.

Bullous infantigo tends to coexist with another skin disease such as eczema. One of the most severe effects of chronic bullous impetigo is kidney disease. The mortality rate for infants and children is 3% or less while the mortality rate for adults is a whopping 60%.

But how do babies get this kind of skin disease? One possibility is that the bullous impetigo may be a nosocomial (hospital-acquired) infection passed from the healthcare provider to the newborn. As mentioned, Staphylococcus aureus is a normal resident of the human skin. Thus, infection may occur as a result of poor hygiene rendered by the child's caregiver. It is also important to note that the immune systems of newborns are not yet fully developed and this makes them more susceptible to contracting pyoderma.

After 48 hours of being cured by antibiotic treatment, the bullous impetigo can safely be declared as non-contagious.

Infantigo Types: Non-Bullous Impetigo, Bullous and Ecthyma
Infantigo Types: Non-Bullous Impetigo, Bullous and Ecthyma | Source

3. Ecthyma

Ecthyma is yet another rare type of impetigo. This is more severe than the two previous types as it penetrates deeper into the tissue. It is sometimes referred to as ulcerative pyoderma. As the name suggests, this type of impetigo causes ulcer formation or deep level skin erosions extending to the dermis.

This type of impetigo usually affects the lower extremities particularly the legs, the thighs, the feet, and the ankles. They may also break out on the buttocks. Apart from the lesions, other symptoms include swollen and painful lymph nodes.

The lesions associated with ecthyma start off as vesicles. These are small blisters such as those seen in chickenpox. These blisters grow in inflamed parts of the skin. After a while, you'll notice a hardened crust covering the blister. The crusts are thick and difficult to scrape off. But once they are removed, an indurated ulcer will be exposed. The ulcer will appear reddish and inflamed. It usually exudes pus.

The lesions related to ecthyma are not expected to grow any bigger than a diameter of 0.5cm to 3cm. Like the first two types of impetigo, it's possible for ecthyma to go away on its own. However, unlike the first two, this type of impetigo leaves permanent scars. Apart from the scarring, the most severe complications associated with ecthyma are cellulitis, gangrene, erysipelas, and bacteremia. One rare complication is post-streptococcal glomerulonephritis.

The causative agent of ecthyma is the group A beta-hemolytic streptococci. However, this may also be caused by a staph.

Who is at risk for developing this severe form of impetigo?

Ecthyma may affect people of all ages and sexes. Even so, kids, the elderly, and immunocompromised individuals are the ones most at risk for contracting this skin infection. The latter includes patients suffering from any type of malignancy, HIV, or neutropenia. Other risk factors include poor hygiene, dwelling in crowded spaces, and high humidity and temperature particularly in tropical environments. The presence of existing skin injuries and diseases (ex. insect stings, dermatitis) can also predispose a person to develop ecthyma.

When left untreated, non-bullous and bullous impetigo may worsen and become ecthyma. This is true especially in impetigo patients who fail to observe good hygiene.

To form a positive diagnosis of ecthyma, the doctor may order skin biopsy besides physical examination. That is, a tiny amount of the skin will be obtained from the patient to be studied in the laboratory. Oftentimes though, collecting the fluid from the blister to be examined in the lab is enough.

Causes of Impetigo

Streptococci, staphylococci, what's the difference? Both are able to cause impetigo. Both are round as the name (cocci) suggests. Another similarity is that they are both Gram-positive microbes. This means that they yield positive results in the Gram stain test. Both strep and staph are non-motile and non-sporing anaerobic bacteria. This means that they do not thrive where oxygen is present. The fact that they are non-sporing means that they are pathogenic or that they have the ability to cause disease. Non-motile bacteria are unable to move towards more optimal environments to guarantee their survival. That is, they lack the ability to move away from inhospitable areas towards areas rich in nutrients. This means that impetigo caused by strep and staph are definitely treatable. To spot the main differences between these two causative agents of impetigo, view the table below.

Difference Point
Staphylococci
Streptococci
Appearance
Grape-like bunches
A chain consisting of round cells
Manner of Division
They divide in multiple axes or several different directions.
They divide in a single axis. That is, they divide in one linear direction.
Fastidious
No
Yes
 
 
This means that strep requires enriched media whereas staph does not.
Habitat
The human skin
The human respiratory tract
Hemolysis
None
Alpha/ Beta/ Gamma hemolysis
 
 
This means that strep destroys red blood cells.
Pathogenesis
Most types out of 40 species do not usually cause diseases.
Most types out of 50 species tend to cause disease.
Diseases
Impetigo, skin diseases, infection of wounds and surgical sites, cellulitis, conjunctivitis, meningitis, food poisoning, and toxic shock syndrome
Impetigo, cellulitis, necrotizing fasciitis, infections in the blood, meningitis in infants, strep throat, pneumonia, scarlet fever, and toxic shock syndrome

These causative agents start off by colonizing intact and healthy skin. Then, like true opportunists, they wait for the skin to lose its integrity. In case the skin sustains a break such as from a cut or an animal bite, that's when the staph or the strep is inoculated into the wound and does its damage. The infantigo that results is known as primary impetigo. If the skin's integrity is already compromised by an existing skin condition such as lice infestation or eczema, the kind of impetigo that develops is considered as secondary impetigo. This is why good hygiene is essential in the prevention of the disease.

Streptococcus pyogenes is derived from the Greek word pyo which translates to pus and genes which means forming. This makes sense because the infections caused by this bacteria, like impetigo, generates pus. Strepto means chain and coccus translates to berries. That's because the cells of streptococci are connected together in chains of round berry-like cells.

The thing about staphylococcus bacteria is that they have the ability to survive temperature extremes, dehydration, and even exposure to high amounts of salt.

When should you seek medical advice?
You are advised to seek medical care immediately upon suspecting that you have caught or developed impetigo. Though this skin disease may go away on its own, it is essential to obtain treatment to eliminate the cause and thus, prevent re-infection of your own skin as well as transmitting the infection to others. Moreover, having a professional look at your skin will ensure proper diagnosis as other more severe skin conditions like cellulitis may be mistaken for impetigo.

Prior to your appointment with your doctor, prepare the following data:

  • A list of symptoms that you (or your child) are experiencing
  • A list of the drugs and supplements that you (or your kid) have been taking
  • Any existing medical conditions or skin conditions

Likewise, when seeking treatment, do not neglect to ask the healthcare professional these important questions:

  • What are the possible causes of the impetigo?
  • What tests are required to make a final diagnosis?
  • What measures should you take to aid in treating the infection and halting its spread?
  • What skin care routines should you follow while waiting for the blemishes to heal up?

Prepare to be asked pertinent questions by the physician such as:

  • When the sores began to show up
  • The appearance of the sores when they first showed up
  • The presence of breaks, cuts, wounds, or insect bites on the affected site prior to infection
  • Whether pain or itching is present
  • Factors that cause the sores to worsen
  • If someone else in your school or household has impetigo
  • If you've had the same concern in the past

To prevent the spread of impetigo to other patients, call your physician's clinic first to schedule your appointment. Ask whether there are any measures that you must observe to prevent passing the infection to others in the reception area.

How to Treat Impetigo

Unfortunately, there is still no known prophylactic treatment or vaccine for pyoderma. Prevention and early detection and treatment still play a huge role in the eradication of the infection. While impetigo may go away in two to three weeks' time, treatment is still recommended as it can cut down your almost month-long suffering to one week. The primary focus of the treatment of impetigo is the management of symptoms while keeping the complications at bay.

Antibiotics
Depending on the type and the severity of your impetigo, your physician may prescribe an antibiotic in topical or oral form. If the affected areas are small and few and the impetigo has not penetrated into the dermis, an antibiotic cream or ointment such as mupirocin may suffice. Apply the antibiotic ointment only to affected areas of the skin and exactly as prescribed by the physician.

Usually, these creams are applied thrice or four times daily for a whole week or more. Prior to application, make sure that you wash the affected area gently with soap and water. Remove as much dried up crusts as you can without breaking the skin any further. Apply the cream and then wash your hands thoroughly afterwards. When applying the cream to another person (such as an infant or your child), you can make use of sterile latex gloves. Antibiotic creams to treat impetigo are not without side-effects. Some of these unpleasant effects are irritation and redness of the skin and itching on skin patches where the cream was applied. Usually, these side-effects are tolerable. After seven days of using the topical antibiotic with zero to minimal improvement, contact your physician to explore other treatment options.

If the infantigo proves to be more extensive, then antibiotic pills may be ordered. Antibiotic pills are usually taken twice to four times daily for seven to ten days. Side-effects of oral antibiotics include nausea, vomiting, and diarrhea. Inform your physician immediately after observing these symptoms so that s/he can check whether these are just normal side-effects or if you're allergic to the drug.

Whether you've been asked to take oral antibiotics or topical antibiotics, you'll have to follow the whole course of the treatment to stop the infection from coming back. In other words, don't stop taking or applying your meds just because you've experienced some relief. Otherwise, the bacteria will develop resistance to the drug and you and your physician will have a hard time treating the disease the second time around. As it is, the number of impetigo cases caused by antibiotic-resistant bacteria are continuously increasing.

What if Your Impetigo has Progressed to Ecthyma?

First, it is necessary to treat any existing skin condition that occurs along with the impetigo. A topical antibiotic such as fusidic acid may be prescribed if the ecthyma is localized. That said, a topical cream may be unable to penetrate the deeper layers of the blisters. In some cases, the crusted areas are soaked with a sterile compress for about ten minutes and then gently wiped off. After the crusts have been removed, the ointment or any other antiseptic such as povidone iodine may be applied. This process is to be continued for several days even after the blisters have healed.

More often, oral antibiotics are recommended for cases of ecthyma particularly when the patient shows poor or slow response to antibiotic creams or ointments. The oral antibiotic of choice is a penicillin such as flucloxacillin. Penicillin is effective in combating both streptococcal and staphylococcal impetigo. The treatment of ecthyma may take weeks.

What if the causative bacterial agent is resistant to penicillin?
The thing about staph bacteria is that they're very adaptable. Before, staph infections can easily be combated through the use of penicillin. However, by the 1950's, many infections have proven to be resistant to penicillin. And today, only 10% of staph infections can be treated with it. In the 60's, methicillin was discovered and used to treat infections caused by bacteria that are resistant to penicillin. Yet, in the recent years, more and more infections have shown to be invulnerable not just to penicillin but also to methicillin.

The highly evolved microorganisms which cause these infections are referred to as methicillin resistant staphylococcus aureus or MRSA, otherwise known as the "super bug". This has a lot to do with the excessive use and abuse of antibiotics by people today. Physicians may be partly to blame for prescribing powerful antibiotics just to treat a patient's snotty nose. While strains of MRSA may not be more virulent than strains that are still resistant to methicillin or penicillin, they are more difficult to treat.

MRSA is usually found on the skin, in the throat, and inside the nostrils. This means that it's possible for you to be carrying colonies of MRSA without manifesting any signs or symptoms for several weeks to several years. Even so, MRSA has the potential to cause skin infections such as impetigo and boils any time your integumentary system or your immune system are compromised.

One thing you need to know about staphylococcus is that as long as it remains on the skin, it can only cause mild to moderate infection. That said, once it enters through the break in your skin, invades your bloodstream, and comes into contact with your internal organs, it can cause more severe systemic infections. For instance, if the staph finds its way to your heart though a heart valve or a pacemaker, the infection can start there. If the bacteria finds its way to your bone through a replacement joint, the infection may start there. The first symptoms would be observed as high temperature, generalized fatigue, and pain or swelling in the affected area.

There are many ways in which you may be colonized with MRSA. One is through skin-to-skin contact (contact sports, an ordinary handshake, etc.) and the other is through contact with contaminated surfaces (countertops, doorknobs, phones, etc.) Risk factors that can increase a person's susceptibility to developing MRSA-related impetigo includes the recent use of antibiotics, prolonged hospitalization, weakened immune system, and prolonged exposure to individuals who are colonized with MRSA. The latter may consist of hospital patients or healthcare workers. Before, MRSA was more prevalent in hospital environments, taking advantage of individuals with IV lines, postoperative clients, and the chronically ill. Studies in the past also revealed that patients undergoing hemodialysis are more susceptible to acquiring MRSA than any other type of patients in the hospital.

However, today, MRSA has found its new home outside the hospital setting. By 2006, 50% of skin diseases caused by MRSA are found in the community, infecting healthy individuals. It infects persons with burn injuries and cuts. You may get it when you get a tattoo or pierce your bellybutton or when you cut yourself while shaving. You can get it when you hug an infected person or borrow another someone else's sports pads. You can get it just from touching or being touched by a person with an open sore. As with impetigo caused by MSSA (methicillin susceptible staphylococcus aureus), impetigo caused by MRSA is spread easily in confined living quarters such as in the military or in prison. Thus, skin infections caused by MRSA have earned their name as the new impetigo.

Diagnosis of MRSA takes 2 to 3 days after analysis of the culture. If involvement of other parts of the body are suspected (such as the bones, the heart, and the lungs) then a CT scan, an echocardiogram, an x-ray, or a series of blood tests may be ordered.

Treatment of infantigo caused by MRSA involves the use or alternative antibiotics such as vancomycin. Your doctor may ask you to stay at home for ten days while taking antibiotics such as clindamycin, doxycycline, or trimetophrim-sulfamethoxazole. The downside of this alternate treatment route is that such drugs are usually accompanied by more side effects.

Erythromycin is another drug which is still used in the treatment of impetigo. However, it is useless in cases where the skin infection is caused by strains of erythromycin-resistant Staphylococcus aureus and Streptococcus pyogenes.

Hospitalization

In case the antibiotic treatment does not work, you'll have to be admitted to the hospital. Once admitted to the hospital, you will be treated with medication introduced via the IV route. The antibiotic treatment will continue after your discharge from the facility. This can be in the form of continuous IV or oral antibacterials given for up to two months. The IV meds can be administered in an outpatient department or by a visiting nurse at the comfort of your own home.

Extra measures will also be taken at the hospital to prevent the spread of impetigo caused by MRSA. This includes the application of mupirocin ointment or washing with chlorhexidine soap.

There are some even more serious skin infections caused by MRSA which may be mistaken for impetigo but are actually completely different. For this reason, you must refrain from self-diagnosing a skin disease as impetigo and then expect it to disappear after a couple of weeks or so. A skin infection associated with MRSA may look like a spider bite. It may manifest itself as a small, reddish pimple or a group of pimples. Sometimes, it appears as a carbuncle or a big pus-filled lump that's tender to the touch. The surrounding areas are elevated and reddened and the center usually exudes pus. In such cases, the doctor may insert a needle into the affected area or create an incision in order to drain the discharge. This will allow the tissue to heal. Never, under any circumstance, must you attempt to drain the fluid on your own.

Other patients that require hospitalization are those infected with bullous impetigo covering large areas of the skin, especially if the bullae has erupted or the skin has become denuded. It's possible that IV fluid resuscitation is necessary to make up for the fluid loss. The fluid treatment is provided at the same rate and volume as those given to burn victims.

Infants with widespread impetigo need to be hospitalized especially if they're at risk for dehydration related to skin loss. Another complication that may be avoided through prompt hospitalization is sepsis. In the hospital, the patient will be placed under contact isolation.

If the staph infection has spread to a prosthetic or an internal device, it must be removed. This might require surgery.

Manual Removal of Crusts
In case topical antibiotics are being used for treating non-bullous impetigo, it is necessary to remove the golden-brown crusts so that the medicine can be properly absorbed by the underlying infected. As mentioned, the crusts may be removed with the use of a washcloth or an antibacterial soap. Alternatively, a wet dressing may be applied on the affected area. A sodium hypochlorite bath may be ordered.

Complications Associated with Impetigo: Cellulitis, Septicemia and Sepsis, Scarlet Fever, Guttate Psoriasis
Complications Associated with Impetigo: Cellulitis, Septicemia and Sepsis, Scarlet Fever, Guttate Psoriasis | Source

Home Treatment of Impetigo

In mild cases of impetigo, topical antibiotics and home management are usually enough. In case you're wondering what the definition of mild is, it's when the infection remains localized to one area and has not spread to other areas. In this case, an over-the-counter antibiotic with bacitracin may be used. Putting a non-stick bandage on the affected part may also help lessen the likelihood of scratching and spreading the sores.

Keep your fingernails trimmed. As mentioned, impetigo spreads easily since the bacteria embeds itself beneath your nails. Moreover, keeping your nails short will prevent further skin injury from scratching.

You'll need to wash the impetigo sores every time before you apply your medication. At home, you can soften the crusts by soaking the affected part in warm water. Pat gently (and never rub) it dry with a clean towel afterwards. If you're using oral meds instead of topical meds, then you'll still need to wash the affected area with clean running water and mild soap every day. Remember to wash your hands well after cleansing or applying medication to the infected skin. Alcohol-based sanitizer works well too but nothing beats meticulous hand washing. Refrain from touching other areas of your body or face before you've washed your hands.

Isolation of the infected individual may or may not be necessary depending on the severity and extensiveness of the impetigo. That said, it would be best to limit physical contact with other members of the family after the antibiotic course has been completed or the blisters have healed. As a rule, if your sores are weeping, then you are highly contagious, so refrain from touching others.

The affected individual's clothes, towels, and bed linens must be changed and washed daily, thoroughly, and separately from those of other members of the family. Other personal articles (combs, toys, etc.) may be washed in hot water with an antiseptic solution. Non-washable objects may be sanitized with antibacterial sprays or wiped with a wet cloth, warm water, and detergent or bleach. Just make sure that you wipe the bleach and soap off with water afterwards. This is essential especially if the type of impetigo is secondary such as ones resulting from an existing case of eczema. Individuals with eczema usually have sensitive skin. An allergic reaction to bleach and harsh cleansers can cause further skin irritation and breakage and consequently, further spread of the disease.

Even when your hands are not inflicted with impetigo, it would help a lot to observe hand washing regularly. Just make sure that you use a mild soap. Harsh soaps used in excessive hand washing can dry the skin, causing it to break. Thus, creating yet another entry point for opportunistic strep or staph microorganisms.

Kids who have suffered from infantigo must be kept away from school or daycare until all the lesions have dried out or until the physician says that it's okay. Likewise, adults should stay away from work and other social activities. For mild impetigo, this can take up to 48 hours after the initiation of antibiotic treatment.

One focus of home treatment of impetigo is preventing the spread of the infection to others. Refrain from sharing towels, clothes, sheets, and other personal belongings with other people, even pens and eating utensils. Keep sores covered with loose gauze bandage. The person with an active case of pyoderma is also discouraged from preparing meals for himself or for other members of the family.

Home Remedies for Impetigo

As mentioned, the use and abuse of antibiotics for every minor injury can suck you into an endless cycle of quick relief followed by drawn-out suffering as the causative bacterial agents become immune to the antibacterial medication that you're taking. For this reason, you might wish to explore alternative methods for managing mild cases of impetigo at home.

Garlic: Some sufferers of impetigo swear by this kitchen staple. Garlic is best known for its antibacterial compound called allicin. Garlic also has powerful detoxifying properties. Try eating three cloves of raw garlic daily as soon as the first signs of impetigo sets in.

Another thing you can do is to stir fry three finely chopped garlic cloves in a couple of tablespoonsful of sesame oil. Let it cool. Afterwards, strain the mixture through a sieve. Then, dip a cotton ball into the mixture and dab onto affected skin twice daily.

In some cases, garlic can relieve the itching. If you have sensitive eczema-prone skin, refrain from handing the raw garlic directly as its juices may irritate your fingertips. You can use plastic cloves or a spoon.

  • Garlic side effects: Eating raw garlic can cause irritation and burning sensation in mouth and stomach, vomiting, gas formation, heartburn and bad breath and can even cause diarrhea in some. During pregnancy and breastfeeding regular intake of garlic is fine but, consuming garlic in terms of medicinal amounts is probably considered as unsafe. So, avoid taking garlic in high amounts or in medicinal amounts during pregnancy and breastfeeding. Considerably taking high amounts of garlic can decrease blood pressure so, patients with low blood pressure should avoid taking it.

White Vinegar: Organic white vinegar is another kitchen staple with potent antibacterial characteristics. To create an antibiotic solution, just combine a tablespoonful of vinegar with 16 oz. warm water. Dip a clean cotton ball into the antibacterial solution then apply gently onto affected parts of the skin. Dab the solution instead of rubbing it on the skin as the latter will inevitably lead to further irritation.

  • White vinegar side effects: When vinegar applied on the skin make sure to apply it in a diluted form as it is acidic can cause severe irritation and burns on the skin.

Orangeroot: This perennial herb is also known as goldenseal and it belongs to the Ranunculacea family. Like the previous ingredients, it has powerful antibacterial properties. To create an herbal antibiotic ointment, mix ground orangeroot with a bit of clean water then apply it directly on the lesions.

  • Orange root side effects: There aren't any notified side effects when applied to skin, so it is probably safe for use. But, however whenever taken orally should be considered as it can cause issues in pregnant and lactating mothers.

Tea Tree Oil: If the infantigo lesions are found on your face, you will need something that possesses both an antibacterial feature and an anti-inflammatory action. You can dilute pure tea tree oil in olive oil and then apply it directly onto the affected surface. Then, wash the area with clean water after half an hour. You can also dilute the tea tree oil in warm water and then dab it over the infected skin surface. Refrain from applying tea tree oil full strength as this will cause irritation.

  • Tea tree oil side effects: It can cause skin irritation leading to burning, drying eczema, itching, rashes in allergic people. So, use it cautiously when applied on the skin and be careful not to use in boys who are before their puberty stage as it raise gender issues like development of breast tissue when the tea tree oil is combined with lavender oil. Pregnant and lactating women should be careful. Tea tree oil when combined with lavender oil can lead to many allergic reactions on skin. Patients with linear IgA disease should be careful as it can cause blistering disorder.

Echinacea: This well-known herb helps in boosting the immune system to prevent the development of complications associated with impetigo. That's thanks to the amount of phytochemicals that it carries. Not only does it combat the bacteria that causes impetigo but it also hastens the recovery of broken skin. You can take the echinacea as a tea daily. Alternatively, you may dip a clean washcloth into a basin of cooled echinacea tea and use it as a compress. Apply the compress on affected areas for about ten minutes. This is to be done three times a day. Don't forget to wash the cloth with hot water after performing each compress.

  • Echinacea side effects: When taken orally can lead to dryness of mouth, unpleasant taste, numb feeling in your tongue, and can also cause headaches, dizziness and confusion, insomnia. When applied to the skin it can cause a red skin rash. Taking this medicine for a short term is fine but prolong usage of this drug can cause the above side effects.

Turnip: First, wash the turnip then cut it up. Afterwards, immerse the turnip slices in cooked rice water. Leave it there for approximately five hours. Next, eat it up. You may also soak the turnip in vinegar.

  • Turnip side effects: Patients suffering from Enterocolitis and hepatitis should avoid using this turnip as a medicinal value.

Myrrh Oil: Like echinacea, myrrh oil has immune system boosting properties. More than that, it has anti-inflammatory features. Thus, it can help lessen the redness and inflammation associated with impetigo. Combine a few drops of organic myrrh essential oil with raw, wild honey. The latter has natural antibacterial properties as well. When combined and applied directly onto skin, myrrh oil and natural honey will yield a soothing effect. It can also speed up the healing process. Leave the solution on for about 25 minutes before rinsing it off with warm water. Then, pat the skin dry and use a loose gauze to keep it covered. This is to be done two times a day until the blisters heal up.

  • Myrrh oil side effects: People who are allergic to this oil should be kept far as well as pregnant and lactating women. Myrrh oil when applied directly on the skin can cause irritation and when taken orally can effect your health. Patients with diabetes should avoid it as it can drastically decrease your blood sugar level. Taking heavy doses can effect your kidneys.

Olive Oil: This oil has great moisturizing properties and is perfect for combating dry skin. Keeping the skin well-moisturized is essential for preventing dryness and skin breakage. More than that though, olive oil has shown to possess a couple of antimicrobial compounds which are known as rutin and oleuropein.

To use olive oil as a remedy for impetigo, put three drops into the infected skin surface up to six times a day. This oil also aids in clearing up the lesions.

  • Olive oil side effects: It can lead to several allergies when applied topically such as dermatitis, eczema, respiratory allergies. There many cases showing acute allergic reactions to the olive oil. So, be careful before using it.

Ginger and Turmeric: This powerful duo makes a powerful antibacterial and anti-inflammatory concoction. You can drink three cups of ginger tea every day. All you need to do is to pour a cupful of hot water on a thumb-sized slice of raw ginger and allow it to steep for about 5 minutes. You can also mix a tablespoonful of ground turmeric into 8 oz. warm milk to be taken once a day.

Another thing you can do is to dissolve the turmeric powder in a moisturizing oil like olive or virgin coconut. Dip a cotton ball into the mixture and then dab onto afflicted surfaces. Leave on for half an hour prior to rinsing it off with clean lukewarm water. This is to be done at least twice daily.

  • Ginger and turmeric side effects: Turmeric when applied to skin is safe in most people but it can cause itching and burning sensation in some. Turmeric is safe for pregnant and lactating mothers when taken orally but only in small amounts, but it is likely to be unsafe when taken medicinal amounts. Drinking ginger tea is not suggested during the last few weeks of your pregnancy. People suffering from gall bladder, diabetes, and bleeding disorders should avoid taking both ginger and turmeric as it can only worsen the situation. Turmeric can worsen GERD in some.

Grapefruit Seed Extract: Grapefruit seed extract boasts of antibiotic and antioxidant features. All you need to do is to combine a few drops of grapefruit seed extract with a couple of tablespoonsful of water and then you have yourself a potent anti-impetigo solution. Just dip a clean cotton ball into the solution and apply directly on the affected skin surface for three to six times daily. Some patients report experiencing itching after the initial introduction to the solution but this tends to go away quickly.

If you don't like the idea of putting anything herbal on your skin, then you may choose to take grapefruit seed extract supplements orally. Before taking oral supplements, make sure that you consult first with your physician especially if you're taking prescribed antibiotic tablets.

  • Grapefruit extract side effects: It is safe when taken orally in normal amounts but, in higher amounts can lead to breast cancer and hormonal disorders in women. It is quite unsure whether it is safe for pregnant and lactating mothers to use so, it is better if you avoid it during your times.

Goosegrass: This is also known as cleaver or cliver or stickyweed. It can be taken orally to minimize lymphatic inflammation and abscess related to pyoderma. Some people prefer not to ingest this plant so they simply crush the herb and apply it as a compress on affected skin surfaces.

It is important to note that contact with certain herbs can cause dermatitis in certain individuals. If you have sensitive eczema-prone skin, avoid using herbs like goosegrass as a home remedy or at least refrain from handing the herb directly.

  • Goose grass side effects: Excessive application on the skin cause irritation and can lead to dermatitis in some.

Aloe Vera: The juice or the gel of aloe vera not only has wonderful moisturizing properties but also helps in providing relief from the itching due to impetigo. It also aids in fast-forwarding the healing process. Simply apply the gel onto affected parts of the skin. You will immediately feel the cooling effect. Alternatively, you can just drink the aloe vera juice.

  • Aloe vera side effects: Aloe vera is probably safe when taken in small quantities orally and also when applied on the skin foe a short term. It is unsafe during pregnancy and lactation period. It can causes issues for those who are suffering from diabetes, Crohn's disease, ulcerative colitis, kidney problems and hemorrhoids.

Colloidal Silver: Hospitals have been using colloidal silver for preventing bacterial and viral infections for a long time. Microorganisms die in the presence of silver. It's for this reason why there are silver-coated bandages. All you need to do is to instill a few drops of the silver into infected skin surfaces. This is to be done thrice daily. The silver will aid in drying up the lesions within a couple of days. That said, home remedies work differently for each person. Again, consult with your healthcare provider before pursuing alternative forms of treatment.

  • Colloidal silver side effects: It is unsafe for pregnant and lactating women. It is unsafe when taken by mouth or applied topically. It deposits in the vital organs like skin, kidneys, spleen liver muscle and brain. it can lead to an irreversible bluish discoloration of skin.

Pot Marigold: Generally, pot marigold or calendula is skin-friendly and yields a soothing effect. You can apply calendula cream, calendula ointment, or calendula gel directly on affected areas of the skin. Or you may create a compress with the fresh herb.

  • Pot marigold side effects: It is unsafe for pregnant women as it can lead to miscarriage. It is better if lactating mothers avoid it as there is no particular information on it. People who are allergic to the Asteraceae family should avoid using it.

Apple Cider Vinegar: To use raw, unfiltered, and organic apple cider vinegar for treating impetigo, dilute one part of ACV with four parts of water. Apply the antibacterial solution directly onto the lesions several times daily. This will also help in drying up the lesions.

  • Apple cider vinegar side effects: Patients with diabetes should cautiously use as it can lower the blood pressure. It is safe not to use apple cider vinegar as medicine by pregnant and lactating mothers as there is no particular information regarding it. Long term usage of apple cider vinegar can lead to osteoporosis.

Manuka Honey: If you (or your child) are not up for consuming bitter herbal remedies, then you'll be pleased to know that honey is a sweet alternative to other home cures for impetigo. You can drink a spoonful of manuka honey several times a day or you can apply it directly onto the infected skin. Leave it on for 20 minutes before rinsing it off with water.

  • Manuka honey side effects: It is safe when taken in small quantities. However, people who are allergic to bees can show some reactions. Diabetic patients should be considerate while taking this as medicine as their blood sugar levels might increase to higher levels.

Heat Therapy: Heat therapy sometimes helps although as mentioned, staph has the ability to survive even when exposed to high temperatures. Even so, the heat can aid in drying up the sores. Dip a clean washcloth in hot water and then wring out the excess liquid. Afterwards, press the cloth gently against the infected skin. Keep it in place for about a couple of minutes. Then, rinse the area off and repeat. This is to be done thrice daily and you are advised to use a new washcloth each time.

Dietary Modifications: While there are no concrete studies that can support the effectiveness of dietary changes in treating impetigo, there can be no harm in eating healthier. After all, impetigo develops at times when your immune system is compromised. Hence, boosting your body's immune defenses through healthy living is one huge step towards combating this debilitating skin condition.

Consume a healthy, balanced diet which consists mostly of fresh and organic fruits and veggies. A healthy dose of citrus fruits daily will strengthen your immune system. Take 16 oz. of grapefruit juice or orange juice daily. Introduce lots of omega 3 fatty acids into your body. Great sources are wild-caught fish like salmon, tuna, and halibut. Three servings per week will suffice.

Stay away from sugary snacks and fried foods. Eat minimal red meats. During an infection, refrain from incorporating red meats into your daily diet.

Stress-relief Activities: As mentioned, some cases of impetigo are aggravated by periods of severe stress. This means that learning how to manage stress effectively helps greatly in preventing and managing bouts of pyoderma. Moreover, these activities can provide you with much-needed distraction so you won't end up scratching the lesions and spreading the bacteria all over your body.

Such activities include meditation, breathing exercises, guided imagery, walking (or walking around the house if you're still contagious), Tai Chi, yoga, and music therapy.

Note that these home remedies usually work only on milder cases of impetigo. Whichever home remedies you choose, always consult with your doctor to ensure that it won't interfere with your treatment.

Note that these home remedies usually work only on milder cases of impetigo. Whichever home remedies you choose, always consult with your doctor to ensure that it won't interfere with your treatment.

Complications Associated with Impetigo

Despite the fact that infantigo is a common enough skin disease, it needs to be treated promptly because it can pave the way to a host of severely debilitating and even fatal complications.

Cellulitis
Cellulitis affects not just the surface of the skin but also its deeper layers particularly the subcutaneous fat. The progression is sudden and the spread is quick. Though it usually affects the lower extremities, the infection may extend itself to various parts of the body. This complication is potentially fatal. If you're suffering from impetigo and you notice that the skin becomes red and hot and painful, then call your physician immediately. Seek emergency care when you have a temperature that's 100.5 F or above. Extreme cases of cellulitis are accompanied by other distressing symptoms like confusion, vomiting, and intense tremors.

While the treatment of cellulitis can be done through antibiotic therapy at home, hospitalization is often necessary. You'll be asked to take antibiotics for seven days and you may expect the symptoms to improve after a few days of taking your meds. When hospitalization is necessary, antibiotics are introduced via the intravenous route through an injection or an IV drip.

Once you've had cellulitis, it's possible for this condition to recur. You can minimize recurrence by treating impetigo, eczema, and other skin diseases promptly. If you have dry skin, apply moisturizer after showering. Obesity increases your risk of developing cellulitis again and again so a healthy, balanced diet and a regular fitness program can help a great deal.

When cellulitis is left untreated, it could lead to bacterial septicemia, leg ulcers, and renal damage.

Septicemia and Sepsis

Septicemia related to impetigo may come about as a result of untreated cellulitis. Or it may simply occur as the bacteria enters a cut in the flesh and makes its way to the bloodstream. It is otherwise known as blood poisoning. Sepsis occurs when the human body's natural response to infection ends up harming its very own structures. If you have pyoderma, seek medical care immediately once you start manifesting severely high or severely low body temperature. Other signs and symptoms you should look out for include chills, a rapid heartbeat, and a high respiratory rate.

One goal of treatment is to prevent sepsis from turning into septic shock. In the latter, the person's blood pressure falls to dangerously low levels. The toxins manufactured by the bacteria ends up damaging delicate blood vessels. Thus, they end up leaking fluid to surrounding tissues. The heart's power to pump blood to the vital organs of the body is affected and the blood pressure is then extremely lowered. When blood is unable to reach vital body organs such as the liver and the brain, they cease to function properly.

Once you notice symptoms like diarrhea, dizziness, slurring of speech, loss of consciousness, a change in your mental state, and extreme muscular pain, call for emergency care promptly. Other warning symptoms include vomiting, cold and clammy skin, breathlessness, and an abnormally low urine output. The treatment of septic shock involves oxygen therapy, intravenous fluid therapy, drugs for increasing blood flow, and antibiotics.

Sepsis is a severely life-threatening condition and whether or not the patient survives depends greatly on how early it was detected and treated. If the sepsis has been arrested at its early stage and there is minimal involvement of the vital organs, then it can be managed with antibiotics at the hospital or even at home. Those who experience septic shock may have to be admitted to the intensive care unit.

Scarlet Fever

The scarlet fever is commonly due to the streptococcal causative agent in impetigo. The strep bacteria creates a toxin which causes the scarlet-hued rashes. Not all patients are susceptible to this toxin but those who are end up developing scarlet fever. The latter starts off as a rash that closely resembles a sunburn. It starts on the face and the neck while avoiding the perioral area. The scarlet rash then extends to the torso and to the back and finally, to the extremities. It can break out in skinfolds such as the axilla and the elbows, creating deep red streaks. When you press on a rash, it turns white. After six days, the rash fades away and then the skin starts to peel off.

A couple of days prior to the appearance of the rash, the following signs and symptoms may be observed: a sore throat, headache, flushed cheeks, a swollen tongue, and a fever of 101 F or higher.

Treatment of this complication includes antibiotic therapy with penicillin or amoxicillin. If one neglects to comply with the antibiotic treatment, the patient may remain infectious for up to a couple of weeks. With antibiotic therapy, patients are usually non-infectious after 24 hours or so.

Guttate Psoriasis

Dry, scaly, and severely itchy skin are the hallmarks of psoriasis. This complication of infantigo is usually mistaken for measles due to the similarity in appearance. It is also referred to as eruptive psoriasis. It manifests itself as small lesions all over the trunk and the extremities. The lesions range from half a centimeter to one and a half cm in size. It occurs commonly in young adults. They first come about as tiny, dry red spots which tend to be a bit itchy. When you scratch them, the thin layer of skin falls off and reveals the reddish dry skin underneath. The skin consists of white areas. These areas are where the dry bits of skin form. After a few weeks, the lesions may have grown up to one inch in width. Large lesions may consist of a yellowish part in the center. The lesions may travel to the buttocks, the bikini line, and even the eyelids.

The initial treatment for guttate psoriasis often comes in the form of mild steroid therapy such as hydrocortisone. However, this does not always work. Some dermatologists would recommend exposure of the affected skin to sunlight with the aid of sunscreen. Sometimes, the psoriasis goes away on its own. Nevertheless, that's not always the case. The best thing that the affected individual can do is to keep the skin clean and moisturized to prevent wounds and bleeding due to excessive exfoliation.

The deal with psoriasis is that it does not only ruin you physically but it also destroys your self-confidence. Thus, patients with recurring psoriasis require constant emotional support.

Post-streptococcal Glomerulonephritis

Glomerulonephritis is the infection of the glomeruli of the kidneys. Post-streptococcal glomerulonephritis is a type of glomerulonephritis that comes three to four weeks after the start of an impetigo caused by a strep infection. Hence, rather than occurring on the kidneys, infection begins on the skin. The bacterial causative agent inflames the small blood vessels in the kidneys' filtering units. As a result, the kidneys are unable to filter urine efficiently.

The treatment of post-streptococcal glomerulonephritis is done through antibiotic therapy. Addressing the cause (the impetigo) is also essential. Diuretics may be given to manage the swelling and drugs to lower the blood pressure may be ordered as well. You may also be asked to limit the salt in your diet.

This complication is more frequently experienced by kids aged six to ten. If you or your child has impetigo and is manifesting other symptoms like a rust-tinged urine, abnormally low urine output, hematuria, and swollen extremities or face or eyes, seek medical help right away. Other symptoms to watch out for include pain, swelling, or stiffness in the joints.

Toxic Shock Syndrome

This is yet another severely life-threatening condition related to pyoderma. This is brought about by the exotoxins excreted by both the streptococcal and the staphylococcal bacterial causative agents. These toxins trigger the T cells of the body's immune system to create cytokines. The latter ends up causing shock and damage to the tissues.

If you have impetigo, obtain emergency care right away once you notice symptoms such as an extremely high temperature and abnormally low blood pressure. Other warning signs include rashes on the palms of your hands and the soles of your feet, alteration in your state of consciousness, loose watery stools, muscle pain, stomach pain, and nausea and vomiting.

The prognosis depends greatly on the promptness of detection and treatment. Treatment of toxic shock syndrome includes intravenous antibiotics and fluids. Some individuals might need respiratory support and may be admitted to the intensive care unit.

Septic Arthritis

This complication is due to either the streptococcal bacteria or the staphylococcal bacteria. The pathogen enters the blood stream via the infected open wound. It usually targets the joints such as the knees, the ankles, the elbows, the waist, or the hips. It can also affect your spine. If you have impetigo and you experience symptoms such as swelling of the joints, pain in the joints, immobility of the joints, and high temperature, contact your doctor immediately. Other symptoms include chills and generalized malaise.

Both kids and adults can be afflicted with septic arthritis. The diagnosis of septic arthritis is done through arhtrocentesis. A surgical puncture will be performed to gather sample fluid from the joint. Synovial fluid is normally sterile. A positive indicator of septic arthritis includes high levels of white blood cells upon lab examination as well as the presence of pathogens. X-rays may be performed in order to assess for joint damage. Blood tests are ordered to continuously observe for inflammatory activity. Meanwhile, MRI's may be useful in determining destruction of the joints in the late stages of septic arthritis.

Septic arthritis is treated with potent antibiotics via the intravenous route. The synovial fluid from the joints will also have to be drained at the hospital with a needle and a syringe. The fluid may have to be drained daily or it can be done through a series of surgical procedures. With the aid of arthroscopy, the surgeon can perform irrigation of the affected joint as well as removal of any infected tissues. If both procedures prove to be unhelpful, an open joint surgery can be performed. For excessive fluid buildup, a drain will be left in place.

How to Prevent Impetigo from Coming Back

It's nasty-looking. It's itchy. It's embarrassing. Of course you wouldn't want to risk the chance of your infantigo making a comeback. To reduce the likelihood of recurrence, make sure that you wash any wounds, scratches, and insect bites that you sustain in the future. Use running water and a gentle soap. Keep the area clean and dry.

The moment you observe the development of any skin infection that can cause skin breakage (such as eczema), treat it right away.

For recurring impetigo, it would be best to consult with your physician and ask if a nasal swab is necessary.

One cannot stress enough the importance of proper hand washing. Wash the hands briskly for a minimum of 15 seconds to a maximum of 30 seconds. Brisk washing is necessary as it is the friction in hand washing that actually removes the dirt and bacteria and not the soap. Pay attention to the areas that are commonly neglected such as the spaces between the fingers, the wrists, and underneath the fingernails. Dry your hands with a disposable towel. To turn off the faucet. Place another disposable towel on top of it then turn it off. Throw the towels immediately into the garbage.

Carry a sanitizer with you in case hand washing is not possible. It must be made up of at least 62% alcohol. Rub the sanitizer vigorously until it dries up and don't forget to include the spaces between your fingers.

If you acquire a wound or a burn keep it clean and covered. Make use of sterile and dry bandages until they have completely healed.

Tampons are a great breeding ground for nasty microorganisms. Women can avoid this toxic shock syndrome as a complication of impetigo by changing their tampons frequently. That means sticking in a new tampon every eight hours at the very least. Alternating tampons with sanitary pads also help.

Personal items are meant to be kept personal. To avoid acquiring staph skin infections like impetigo, refrain from lending or borrowing personal stuff like razors, clothing, makeup, jewelry, hairbrushes, and even sports equipment to and from other people.

After engaging in sports or any vigorous physical activity, make it a habit to shower using soap and a fresh towel afterwards. Athletes with weeping skin infections or wounds must refrain from going out into the field. If you work out at the gym and have to share workout equipment with others, then wipe the equipment up with antiseptic wipes before using it. Pay special attention to the hand grips.

When sneezing or coughing, cover your nose and mouth using disposable tissue. Then, dispose of the tissue immediately. Since both actions are involuntary, this may not always be possible. In such cases, you may sneeze or cough on the sleeve of your clothes right on the crook of your arm (inner elbow) rather than covering your mouth and your nose with your hands.

Disinfect areas of the home such as doorknobs, countertops, computer keyboards, etc. with an antibacterial spray.

Refrain from picking your nose with your bare fingers. Use a facial tissue instead and throw it away immediately.

Some health experts recommend a full-body cleanse for curing and preventing the recurrence of impetigo. Adults who are prone to developing infantigo can start off with a bowel cleanse to eliminate harmful toxins caused by bacteria. Afterwards, one may proceed to a dental cleanup. A kidney cleanse and a liver cleanse might also help in increasing your chances of having zero remissions.

Initially, impetigo may just be a minor skin condition but when ignored, its terrible effects are definitely more than skin deep. Thankfully, there are many things you can do to treat and combat impetigo and prevent its spread. As you may have noticed, it all comes down to the most basic and most important things which are maintaining a healthy lifestyle, observing proper hygiene, and receiving prompt treatment for skin infections.

Resources

  1. "Bullous impetigo", Wikipedia. Retrieved Jan. 4, 2017.
  2. "Cellulitis", NHS Choices. Retrieved Jan. 4, 2017.
  3. "Septic Arthritis", WebMD. Retrieved Jan. 4, 2017.
  4. "impetigo", HealthLine. Retrieved Jan. 4, 2017.
  5. Vanessa Ngan, "Ecthyma". January 2016. DermNet New Zealand. Retrieved Jan. 4, 2017.
  6. "Impetigo", Oxford Journals. Retrieved Jan. 4, 2017.
  7. "15 Natural Ways To Stop Impetigo". Natural ON, Natural health news & discoveries. Retrieved Jan. 4, 2017.

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