Impetigo is one of the most common skin infections. It leads to blisters and sores and can be extremely contagious. The main infection agent is the bacteria Staphylococcus aureus, which also causes eczema and a number of other infectious diseases. The impetigo isn't normally a severe disease and can disappear in a few weeks even without any treatment, while treating it takes about one week. It is a bad idea to scratch the sores, since the bacteria can penetrate into the skin.

Bacteria penetrates the skin through a break, which can be extremely small, visible only with a microscope. Normally, the wounds are clearly visible and can be cuts, skinned areas (on the knees for example) or sometimes insect bites.

Regardless of how they enter the skin, the bacteria will start reproducing inside, which results in a blister. Typically, the blister will then fill with pus and break, creating a crust. The crust is very typical and is one of the trademarks of this disease, along with the blisters.

Types of impetigo

Impetigo is classified into several types. These have different causes and can also present different symptoms, which makes them unique.

Non-bullous impetigo (Impetigo contagiosa)

Characteristic for this type is that it starts with red sores around the mouth and the nose, although sometimes the outbreak starts elsewhere. These are full of ooze or pus and burst pretty fast, forming a thick crust with a yellow or brown color. The crusts eventually dry and fall off, while a red area remains in their place. It usually disappears in time, without a scar.

While the sores don't hurt, they can be extremely itchy and annoying. Scratching or even touching them should be avoided, to reduce the risk of contagion both to other people and to different areas of the body. Severe infections are quite rare and can lead to swollen lymph glands, fever or other more serious consequences.

Bullous impetigo

This variation is usually encountered on newborn children or very young ones, no older than two years. In this case, the blisters are large or medium in size and develop on the arms, legs or the body. Blisters are surrounded by areas of itchy skin that is red without being sore. The blisters expand quickly and result in a yellow crust after eventually bursting, which normally doesn't leave a scar.

The blisters are very itchy and should not be touched or scratched. This is not easy to accomplish, given the young age of the patients. The cause of bullous impetigo is a specific type of Staphylococcus aureus. These bacteria produce a toxin that irritates skin tissues. Inflamed lymph glands and fever are common symptoms of the disease.


When the infection reaches the second skin layer and not just the superficial one, the most severe type of impetigo starts. In this case, the blisters hurt and can evolve into more serious conditions like skin ulcers or even large open sores. These usually leave permanent scars.

What causes impetigo?

There are two different bacteria that can cause impetigo: the streptococcus or the staphylococcus. The infection can start at any time, even if the skin is very healthy.

Impetigo can also be a side effect of other diseases, mainly skin conditions like eczema. There are many other types of wounds or conditions that irritate the skin, allowing the bacteria to penetrate it and cause impetigo. Kids are especially vulnerable to the disease. They can become infected if the skin around their nose is hurt during a cold or as an effect of some allergies.

There are many other possible ways to become infected. The disease is extremely contagious and it's enough to come in contact with objects that have been touched by a sick person. Direct skin contact is even more dangerous. The bacteria can also get inside the skin through wounds, dermatitis, cuts, animal bites or even insect stings.

Staphylococcus aureus can produce some toxins that destroy the proteins that form the structure of the cells inside tissues. After these are destroyed, the bacteria are free to penetrate nearby areas and the infection spreads fast.

Impetigo can be classified in two types. When the bacteria uses a breach of the skin to get inside it, the disease is considered a primary impetigo. When the skin is damaged by other diseases, allowing the bacteria to bypass it, it is named a secondary impetigo.

What are signs and symptoms?

The effects of this disease are very hard to tolerate for children. In case of adults, the symptoms are uncomfortable and shameful, the worst situation is when the blisters appear on the face. Sores can remain for a few days and it's very easy to spread out the infection to other areas of the body. Even without touching the blisters, bacteria can be transported on clothes. We have already discussed the different types of impetigo, these are quite similar but don't have the exact same symptoms.

The most obvious sign of infection is the presence of sores of various sizes, which can increase in number. Sometimes, impetigo can start with a few small red spots that are very itchy, these later turn into blisters that burst. Blisters that leak pus or ooze are another common symptom. Other signs are skin lesions or swollen lymph nodes in more severe cases.

What is impetigo treatment?

Since impetigo is highly contagious, it is a very good idea to keep infected kids at home until they are healed or at least until the treatment is in an advanced stage. This way, the disease will not spread to other children but also the damaged skin is less exposed to pathogens.

People who come in contact with an infected person also have to be careful. The most important precaution is to separate the clothes, towels and bed sheets from other members of the family, since these items can easily spread the infection.

The bacteria quickly attack any breach in the skin. Everyone must be extremely careful around an infected person and monitor the health of their own skin. Any wound, no matter how small, must be cleansed and bandaged in order to stop the bacteria. This includes skin rashes, small cuts or even insect bites.

Personal hygiene is also crucial to stop the transmission of the disease. Although some special products exist, plain soap and water are effective enough when bathing on a regular basis.

Elma 01 Skin Ointment can be a great treatment for mild infections on limited areas. However, if the disease is severe, a cure based on oral antibiotics is sometimes required. The disease usually responds very well to treatment but there is a risk of a new infestation after a while, sometimes as late as 9 months.