Ask the CPCMG Pediatrician: Impetigo

My child has red bumps on her nose and mouth that look like pimples. Could this be an infection or allergic reaction?

It sounds like your child has impetigo (“im-puh-TY-go”), a common childhood bacterial contagious skin infection which causes red sores that can break open, ooze fluid, and develop a yellow-brown crust. Children typically have this infection on their face, usually around the nostrils or mouth. Infants can also get this infection in the diaper area. These skin areas can be sensitive and therefore more likely to become infected with the bacteria that causes impetigo.

Impetigo has a very distinct appearance. At first, the skin will look like it has small red bumps on it. As the impetigo spreads, some of the bumps may get bigger and look like small pimples. Some of these may pop easily and leave a yellow crust over the affected area. The rash will often itch but usually is not painful.

Children with impetigo are not usually sick. They do not have fever, headaches, or sore throat. However, they may have been sick with runny nose symptoms prior to developing the impetigo or skin infection. When kids have drippy noses, it makes the skin more susceptible to the bacteria that cause impetigo: staphylococcal (staph) or streptococcal (strep). The bacteria can live on top of our skin and provide us with a very thin layer of protection from other bacteria. However, if our skin is broken, like when we have a scrape, a small cut, or the skin is moist for an extended period of time, the bacteria can enter our skin and cause the impetigo skin infection.

Because impetigo is caused by a bacterial infection, the treatment includes antibiotics. If the infected area is somewhat small, your CPCMG pediatrician may start with a course of topical ointment to treat the bacteria and prevent it from spreading. If your pediatrician feels the impetigo is too large to treat with topical antibiotics, oral antibiotics will be prescribed. If your child is allergic to penicillin type antibiotics, your doctor might have to choose a different oral antibiotic.

Impetigo is a contagious infection – it is spread by touching or rubbing the infected skin. You will want to make sure your child has started treatment before returning to school or daycare. Occasionally, the impetigo will recur and if it does, you will want to discuss this further with your CPCMG pediatrician.