Impetigo in children: What you need to know as a parent

As a dermatologist, you sometimes encounter skin problems that can appear quite worrying, especially when they occur in young children. This can be quite shocking for parents. This blog about impetigo, also known as school sores, was written at the request and with the permission of a mother and grandmother, to make other parents aware of this condition.

Recently, a healthy 4-year-old girl developed a rapidly growing blister under her foot. She had difficulty walking and appeared a bit listless, but did not show any fever or other signs of illness. Initially, her parents went to the emergency room, where it was suspected to be a blister caused by a splinter or insect sting. There, the blister was punctured (incision) and drained. Two days later another blister formed, for which Fucidin cream was prescribed, this had a moderate effect. When the area continued to worsen, an antibiotic treatment was started, which was successful and the girl recovered well. The pink spot under her foot will disappear in the coming weeks and eventually, nothing will be visible.

In retrospect, it turned out that her aunt had an infection blister and may have infected her.

Impetigo highest in years!

The NIVEL – Netherlands Institute for Health Services Research, reports weekly on the health problems registered in general practices. They reported that the number of young children who went to the doctor with impetigo this summer is the highest in years.

Impetigo occurs when bacteria invade the skin, often through a small wound, a cut, an insect bite, or another skin damage. It can also occur on an existing skin condition such as eczema or chickenpox, a situation called impetiginization. This means that the bacteria infect an existing condition, making the problem worse. Some types of the Staphylococcus aureus bacteria produce special toxins, which we call ET-A and ET-B.

These toxins break down a certain protein in your skin called desmoglein. Desmoglein acts like a kind of glue that holds skin cells together. If this protein is broken down, the skin cells detach from each other, which can lead to blistering and skin damage, as you see with impetigo. Sometimes a large, clear fluid-filled blister forms on a non-red skin.

Imagine you have a small cut on your knee from a fall while playing sports. This cut could be an entry point for bacteria such as Staphylococcus aureus. Within a few days, a red, moist spot with yellow crusts could appear, suggesting that you may possibly have impetigo. If this spot is further irritated, for example by scratching, the bacteria could spread and cause more spots. If this bacteria also produces toxins that break down desmoglein, you may even see blisters form around the infected spot.

How do you recognize impetigo?

Impetigo often occurs in children between the ages of 2 and 12 and usually appears on the face, especially around the nose and mouth. Damage or irritation of the skin caused by a cold, such as a runny nose or drooling, can exacerbate the infection by making it easier for bacteria to access the skin. The classic symptoms are honey-yellow crusts, peeling, and blisters that vary from small to large with a clear or yellowish content. These blisters can quickly grow and expand, which can further spread the infection. Although impetigo usually occurs in children, adults can also get it, though less frequently, often after contact with infected children, if they have a weakened immune system or disrupted skin barrier.

Distribution and Prevention

Impetigo spreads easily through direct contact, such as through hands, shared toys, clothing, or towels. Adherence to good hygiene is essential to prevent further spread. Regular hand washing, especially after touching the infected skin, plays an important role in limiting the infection. As long as the blisters are secreting fluid, the condition remains contagious.

Should your child stay home from school?

From an epidemiological perspective, it is usually not necessary to keep children with impetigo at home, as they are already contagious before the symptoms manifest. In practice, however, parents and teachers often prefer a short stay at home (usually 48 hours after the start of treatment) to limit further spread and inform other parents in time about a possible outbreak.

So what parents need to know about impetigo

When blisters of various sizes suddenly appear on the body, which are bright or yellowish in color and sometimes have honey-yellow crusts around the edges, it’s important to be vigilant. Children may be a bit listless, have mild fever, experience pain or walk differently, without clear causes such as tight shoes, skin burns, or contact with garden plants such as nettles, giant hogweed, spurge, or rue. In such cases, it’s wise to consider impetigo and possibly consult a doctor for a correct diagnosis and treatment.

Do you want to read more about skin reaction after gardening

How to treat impetigo

Although impetigo often heals by itself within 2-3 weeks in healthy children, treatment is strongly recommended. Prompt treatment helps prevent complications and reduces the risk of spreading to others.

Important tips:

• Consult the family doctor: A doctor can make the proper diagnosis and prescribe the most appropriate treatment.
• Leave scabs alone: Try not to remove scabs, as this can damage the skin and worsen the infection. Let them come off naturally.
• Keep the skin clean: Regularly cleanse the affected skin with mild soap and water.
• Use prescribed medication: The family doctor will usually prescribe an antibiotic ointment, and in more severe cases, oral antibiotics may be needed.

Prevention of Spread:

• Trim nails short and keep hands clean.
• Wash bedding, towels, and clothes regularly at a high temperature – above 50 degrees Celsius
• Wash infected clothing and towels separately.
• Cover open wounds with a bandage.
• Do not let children with impetigo play with others until the infection has healed.

Now that you’re here

Athlete’s Foot: Causes, Prevention and Effective Treatment

Athlete’s foot, also known as tinea pedis, is a common fungal infection that primarily affects the skin between the toes. It often leads to symptoms such as itching, redness, and flaky skin, which can sometimes also be painful. Although the condition is usually harmless, the discomfort can be considerable and the fungus often returns.

Want to know more, click here