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Skin Health Skin Health Basics

Impetigo

When impetigo occurs, bacteria enter the skin’s outer layer (epidermis) and form skin lesions that may ooze and form crusts. These lesions are extremely contagious. Touching, rubbing or scratching them often leads to their spread to other parts of the body.

Typically, impetigo is acquired by direct skin-to-skin contact with an infected person. People can also become infected through contact with infected objects (e.g., utensils, clothes, toys, doorknobs). Children pass it during contact at school or while playing. Impetigo is more common in warmer weather and tropical climates. It occurs more readily in crowded conditions and in areas where there is inadequate hygiene.

Most cases of impetigo occur among children between 2 and 6 years old, although a less common form occurs among infants.

Impetigo is seldom serious, especially if treated early. The lesions clear up within a few weeks, although scarring can sometimes occur. In a few rare cases, impetigo can spread to other parts of the body and lead to complications. These may include:

• Cellulitis. An infection affecting the tissues underneath the skin that spreads to the lymph nodes and bloodstream.
• Post-streptococcal glomerulonephritis. A rare complication of impetigo resulting in inflammation of the kidneys, which may lead to kidney failure.

• Nonbullous impetigo. This form of impetigo – also called impetigo contagiosa – is the most common form. It is usually caused by either the Staphylococcus aureus (staph) or Streptococcus pyogenes (strep) bacteria, or a mix of the two. Infection typically occurs at sites of trauma to the skin, such as a chickenpox sore, insect bite, cut or other laceration that results in a break in the skin. Specifically, these bacteria attack a protein that helps bind skin cells together. When this protein is damaged, the bacteria invade and establish infection in the skin. This form of impetigo usually occurs among children between 2 and 6 years of age, often during warmer months.

  Ecthyma is a rare form of nonbullous impetigo that penetrates deep into the skin’s second layer (dermis). The streptococcal bacterium is the most common infectious organism associated with ecthyma. The infection may begin at the site of an injury, such as a scratch or insect bite, and often affects the legs.

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