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What is Impetigo? Characteristics, Symptoms and Causes

Impetigo (also known as school sores) is an infectious disease that mainly affects children. It is estimated that about 1% of European children have suffered from this disease. In Latin America the percentage is as high as 15%. It isn’t a serious problem, but it can lead to significant consequences.

Impetigo is rare in adults. However, this disease can occur at any age. It usually occurs in childhood, in children between the ages of 2 and 6. At this stage, there are no fully established hygiene habits and there’s a lot of physical contact between children.

When faced with a case of impetigo, it’s important to treat it in the shortest possible time. Although in principle it isn’t serious, it’s very contagious and spreads rapidly. In some children, it can also trigger post-infectious glomerulonephritis, which is a serious problem.

What is Impetigo?

Impetigo is a skin infection caused by bacteria. It usually appears as red sores on the face. These are located mostly near the mouth or nose. They can also be found on the hands and feet. These sores burst and leave honey-colored scabs.

The infection occurs in the epidermis, which is the most superficial area of the skin. In this area, there’s a protective layer called keratin, which acts as a barrier from contact with the outside world. If this layer is weakened or damaged, it allows the bacteria which causes impetigo to pass through.

There are basically three types of impetigo:

  • Blistering. Caused by staphylococci and leads to the formation of blisters on the skin.
  • Non-blistering. Caused by streptococcus bacteria and instead of forming blisters, it erodes the skin. It’s the most common form.
  • Ecthyma type. Generates ulcers, instead of blisters or erosions.


The first symptom of this disease is a reddening of the skin, as if something has irritated it. It also becomes itchy.  A little later, small blisters or vesicles appear. These have a very thin coating, which breaks easily.

When they burst, the blisters or vesicles release pus. This substance is highly contagious and any contact with it should be avoided. The skin is raw and bloody. Some blisters are particularly resistant, and have a yellowish crust around them.

It’s very common for the lymph nodes near the affected area to become swollen. These can move when they’re displaced and often cause pain. However, this is a symptom that often goes unnoticed. There’s no fever or discomfort because it’s a localized and superfluous infection.

Causes of Impetigo

Impetigo is usually caused by Staphylococcus aureus bacteria or Streptococcus pyogenes. The latter is also known as “Group A Streptococcus” and is the cause of strep throat. The disease is acquired through direct contact with an infected person.

If a child scratches themselves and then touches some other part of their body, the infection can be transferred to that new area. The disease is also spread by touching objects that have been in direct contact with the skin, such as clothing, towels, etc.

The main risk factors for impetigo are as follows:

  • Age. It mainly affects children between 2 and 6 years of age.
  • Overcrowding. The contagion spreads in places with a high concentration of children.
  • Climate. Impetigo occurs more often in hot, humid climates and in summer in countries with seasons.
  • Skin lesions. Impetigo bacteria usually enter the skin through small wounds, such as insect bites or similar lesions.

Other interesting information

Although rare, the disease can also occur in adults. Those most at risk are those whose immune systems are weakened, either by the use of medication or by another disease. Diabetics are also a population at risk.

Usually, the sores heal after a while and don’t leave any scars. Only in rare cases do complications arise. The most common are marks or scars, kidney problems, or panniculitis.

The disease is usually treated with antibiotics. It’s recommended that the child stays off school until at least 24 hours after treatment has begun. In some cases, it’s recommended to cover the affected area with a dressing or gauze.

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