Impetigo Information - Bullous Impetigo in adult and child

Impetigo is a highly infectious skin disease most common in children. It presents as weeping, exudative areas with a typical honey-coloured crust on the surface. It is spread by direct contact. The term 'scrum pox' is impetigo spread between rugby players. Occasionally this infection can cause blistering ('bullous impetigo') due to bacterial toxins. Staphylococcus aureus is implicated in over 90% of cases but rarely group A Streptococcus can be responsible. Therefore skin swabs should always be taken. Also check out the Impetigo Symptoms

Impetigo is dealt with through the use of antimicrobials, supported by alternatives and tonics with external applications of a lotion of echinacea, marigold, myrrh and wild indigo, which can be used to combat the infection and help to rebuild ecological barriers. Scrupulous hygiene and a wholesome diet are essential.

Treatment of Impetigo
Localized disease is treated with topical fusidic acid (three times daily) and the antiseptic povidone iodine for 1 week. Extensive disease is treated with oral antibiotics for 7-10 days (flucloxacillin 500 mg four times daily for Staphylococcus; penicillin V 500 mg four times daily for Streptococcus ). Other close contacts should be examined and children should avoid school for 1 week after starting therapy. If impetigo appears resistant to treatment or recurrent, take nasal swabs and check other family members. Nasal mupirocin (three times daily for 1 week) is useful to eradicate nasal carriage. Its use in hospitals should be avoided if possible.

In adults, local measures are usually enough, except in extensive cases and ecthyma. Septran (P) or broad-spectrum antibiotics by mouth should be given in such cases.

In infants, penicillin injections or broad-spectrum antibiotics by mouth are given as a routine. This procedure has reduced the mortality rate considerably. As for local measures, blisters are aspirated aseptically, the flaccid roofs clipped away and the raw surface by soframycin (P) cream.

The treatment must be continued until all the lesions have healed up completely and have stayed so, for at least a week.