Impetigo is one of the many skin infections common among children ages 2 to 5, but babies (and their parents) can get it, too — it's itchy and very contagious!
If you think your child's rash resembles impetigo, call your pediatrician to find out for sure. Unlike some other baby skin conditions, impetigo does need antibiotics to heal. Here's what you'll need to know about symptoms, treatment and prevention strategies.
What is impetigo?
Impetigo is a contagious skin infection that occurs when bacteria — most commonly Staphylococcus aureus or Streptococcus pyogenes — enter the body through a break in the skin (e.g., bug bites, little scrapes, fingernail scratches).
There are two forms of impetigo that can cover thighs, buttocks, lower abdomen and spread to other parts of the body:
- Non-bullous: Tiny blisters that burst and leave red, weeping patches. Eventually, these areas crust over with a yellowish-brown or honey-colored crust.
- Bullous: Larger fluid-filled blisters that stay on the skin longer without bursting.
Impetigo symptoms start four to 10 days after the initial exposure to the bacteria — making it very easy to spread to others unintentionally. Outbreaks can occur in preschool and day care settings, especially during the summer months.
With the right treatment, impetigo typically goes away in two to three weeks. If left untreated, impetigo can cause more serious skin infections and scarring.
What causes impetigo in babies?
Blame it on bacteria. In addition to cuts and scrapes mentioned above, that nasty bacteria can invade your baby's skin through eczema or other areas where the skin is sensitive.[1] Simply touching an infected child or caregiver (or toys or blankets that the infected child touched) can cause the bacteria to spread.
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Other factors that can increase the risk of impetigo in babies include:
- Being in a day care setting
- Living in crowded conditions
- Having siblings between ages 2 and 5 and sharing bath towels
- Living in a warm and humid climate
- Having a weak immune system
What are the symptoms of impetigo in babies?
It can take up to 10 days for sores to appear on your baby or toddler after exposure to the Streptococcus pyogenes and/or Staphylococcus aureus bacteria that cause impetigo.
Symptoms of impetigo include:
- Red, itchy sores. They often appear around your baby's nose and mouth, her diaper area, arms and legs, although impetigo can occur anywhere on the body. This is often the first symptom parents notice. The sores eventually break open and leak clear fluid or pus for a few days. A crusty, yellow scab then forms over the sore.
- Fever
- Swollen lymph nodes
How to treat impetigo in babies
Since impetigo is a bacterial infection, your pediatrician will likely give you a prescription for an antibiotic ointment. Usually, it takes 24 hours after starting the antibiotic to start seeing the infection clearing. Here's what you'll need to do:
- Apply the ointment to sores. Your doctor may suggest covering any larger infected areas with a bandage.
- Keep your baby out of day care. Have her stay home the first 24 hours after starting treatment to prevent others from getting sick. Without an antibiotic, impetigo is contagious for several weeks.
- Trim your child's nails, and consider having her wear mittens during naptime and at night.
- Keep your baby's tush as clean and dry as possible. Impetigo thrives in the moist diaper area.
- Wash baby's clothes, sheets, towels and clothing daily until the infection clears. Impetigo can be passed on through items that have come in contact with infected skin.
- Once sores have scabbed over, gently wash them with soap and warm water and pat dry.[2] Make sure to use a clean towel each time or a paper towel you can toss to prevent germs from spreading.
- Finish the entire tube of the antibiotic ointment to keep the infection from returning.
If the infection spreads, it might be time for oral antibiotics. Talk with your baby's pediatrician.
Can you prevent impetigo?
While there is no vaccine to prevent impetigo, there are steps you can take to protect your baby from viruses and infections:
- Wash hands regularly with soap and water for 20 seconds or use alcohol-based hand sanitizer.
- Clean and disinfect toys.
- Don't share soap or towels — even within the family.
- Always clean and cover any open cuts or scrapes on the skin.[3]
Unfortunately, having impetigo once does not protect your baby from getting it again in the future. If your child gets recurrent infections, it can help to do a bleach bath once a month or every few months. Use 1/4 cup bleach in a full tub of water, and put her in the bath for 10 to 15 minutes.
When to talk to your doctor about impetigo
If the rash spreads or the prescribed treatment doesn't seem to make your child's impetigo better after three days, it's time to call the pediatrician. The doctor may need you to come back in and take a tissue sample (a simple skin swab of the infected area) to determine if the specific antibiotic prescribed needs adjusting.
Other reasons to call:
- Your baby gets a fever.
- You notice the infection getting redder.
- Your baby seems increasingly irritable or in pain.
- Your baby keeps getting re-infected with impetigo.
Remember that while it may look frightening when your baby has impetigo, the infection is common and typically mild, and it resolves with treatment.
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