Impetigo is a highly contagious bacterial skin infection that most commonly affects infants and young children. Adolescents and adults with a weakened immune system are also susceptible. The hallmark of the most common impetigo diagnosis is blisters with a honey-colored crust that typically starts around the mouth and nose. It eventually spreads to hands, feet and the trunk. (1) Treatments for impetigo are available to relieve the itching and discomfort associated with this acute skin infection.
Impetigo is classified by the CDC in the “non-invasive group A strep illness” category, like strep throat. It’s a common skin condition identified with blisters filled with fluid. In Europe, 2 out of every 100 children are treated each year. (2) The World Health Organization estimates that 111 million children living in developing countries have impetigo; (3) the CDC does not currently track the number of cases in the United States.
What Is Impetigo?
There are three main types of impetigo: Non-Bullous Impetigo, Bullous Impetigo, and the most serious condition, Ecthyma.
Non-Bullous Impetigo is the most common. It’s casually referred to as the “crusted impetigo.” It typically starts on the face in clusters of tiny red blisters. As they begin to burst, the skin weeps a fluid that develops into a gold-colored crust.
Bullous Impetigo is less common. The first skin lesions typically appear on the neck, trunk or in the diaper region. Unlike the small non-bullous impetigo blisters, bullous impetigo blisters are much larger. Bullous impetigo blisters are filled with a clear liquid that turns cloudy before erupting.
Ecthyma is a significantly more serious condition. The blisters become painful and pus-filled leading to the development of deep ulcers. Like the non-bullous type, a crust does form over the blister and the ulcer, presenting a risk for scarring.
Signs & Symptoms
The first sign of non-bullous impetigo in children is often tiny red blister clusters that appear around the nose and mouth. At the onset, the blisters start out about the size of a small pimple. As impetigo continues to spread, the blisters can grow more to than the size of a nickel. While typically not painful, a common impetigo symptom is itching. Itching is the primary reason for its rapid spread. In non-bullous impetigo and ecthyma, individuals may experience swollen lymph nodes as the infection progresses.
Ecthyma begins as non-bullous impetigo. It evolves into necrotic ulcers that are slow to heal. This is most common in individuals with a compromised immune system. These individuals include those with Type 1 or Type 2 diabetes, certain types of cancer, HIV and others whose bodies have a difficult time fighting bacteria.
Bullous impetigo’s larger blisters are often the first sign of this skin infection. The weeping does not typically occur and the blisters can heal without scarring. (4) In Bullous impetigo, an outbreak is severe when multiple areas of the body have lesions, and additional symptoms of weakness, fever and diarrhea are present.
While rare, individuals with any of the three types of impetigo can experience a low-grade fever, nausea and general malaise as the body fights the bacteria.
Causes & Risk Factors
Either streptococcus or staphylococcus aureus causes impetigo. These bacteria enter into the body through an open wound, burn, insect bite or even just raw, irritated skin. (5) This is why impetigo is so often seen around the nose and mouth of young children after a cold, or during allergy season.
As mentioned above, individuals with a weakened or compromised immune system are at a greater risk of developing impetigo than those with strong immune systems. In order to effectively guard against an impetigo outbreak, it is vital to keep wounds clean and covered. It’s also important to wash hands frequently to prevent unhealthy bacteria from entering the body.
Impetigo most often occurs in children from 2 to 5 years old. Because impetigo is highly contagious, it spreads rapidly through day care centers and schools. A risk factor for older children and teens is participating in contact sports like wrestling, football and cheerleading. Regardless of age, if an outbreak is suspected, the child should remain home until the blisters are no longer weeping.
Adults with diabetes or poor immune system function are more likely to develop the more serious infection, ecthyma. Ecthyma can lead to potentially dangerous complications like cellulitis, meningitis and kidney inflammation.(6) It is imperative that all open wounds and irritated patches of skin be kept clean and protected.
In addition, both children and adults with cold sores, chickenpox or eczema are at a higher risk for developing impetigo. (7) Use good hygiene practices to keep the bacteria that causes impetigo at bay.
After a physician diagnoses impetigo, they may prescribe a topical antibiotic ointment or cream. Over-the-counter antibiotic creams are typically not advised. Depending on severity, an oral antibiotic may also be prescribed, particularly in cases of ecthyma or large scale outbreaks. (8)
9 Natural Impetigo Treatments
- Grapefruit Seed Extract
Grapefruit seed extract is known for fighting candida and fungal infections. An additional grapefruit seed extract benefit is its ability to fight staphylococcus aureus, or MRSA, one of the bacteria that causes impetigo. A 2004 study from the Department of Biological Sciences at the Manchester Metropolitan University in Manchester, UK, found a combination of grapefruit seed extract and geranium oil showed the “greatest anti-bacterial effects against MRSA.” (9)
Long used in Ayurvedic practice to fight bacteria, boost immune system function and reduce inflammation, ginger can help to speed healing during an impetigo infection. Incorporate ginger into your diet by adding to smoothies and salad dressings or drinking a kid-friendly orange carrot ginger juice.
- Apple Cider Vinegar
Well-known for its ability to detoxify the body, balance blood sugar, and as a treatment for acid reflux, skin care is another effective apple cider vinegar use. During an impetigo outbreak, dab pure apple cider vinegar on blisters and lesions to fight the bacteria and ease the inflammation.
A recent study published in the Journal of Tropical Medicine states that curcumin demonstrates powerful antibacterial activity against staphylococcus aureus. Researchers agree that further investigation is necessary to fully understand the action of curcumin, and how best to harness it. (10)
While researchers continue to look at the scope of turmeric’s benefits and antibacterial powers, it can be used to reduce the inflammation of the lesions and associated itching and general discomfort. Mix 1 teaspoon ground turmeric with 1 tablespoon of coconut oil and dab onto affected areas. Cover with a non-stick bandage as turmeric will stain clothing. Rinse daily and reapply until healed.
- Coconut Oil
When applied topically, the lauric acid in coconut oil makes the skin inhospitable to certain pathogens, including bacteria. In essence, when used as a lotion, it creates an invisible barrier that can ward off bacteria, viruses and fungi. Coconut oil aids in the detoxification of the body. Coconut oil lotion creates a protective barrier on the skin to protect against antibacterial compounds and antiviral compounds. Combine with tea tree oil for effective topical treatment.
Internally, coconut oil boosts immune system response, fights inflammation, balances hormones and so much more. During an infection like contagious impetigo, find more ways to incorporate coconut oil into your diet. Add it to smoothies, use it instead of butter on toast and popcorn, or make up a batch of granola that the kids will love.
- Manuka Honey
Long prized as a potent antifungal, antiviral, antibacterial, Manuka honey also has high antimicrobial activity. The many health benefits of Manuka honey can be helpful during an outbreak of impetigo to speed healing in children or adults.
Researchers at The University of Wales Institute, Cardiff, found that when cells with MRSA were exposed to Manuka honey, cell division was interrupted. This led researchers to believe that overall growth of MRSA was slowed down. (11) This supports the use of Manuka honey on cuts and infections to fight a wide range of viruses, fungi and bacteria.
Researchers from The University of North Carolina’s Department of Chemistry/Biochemistry found that the use of Goldenseal (H. canadensis leaf extract) to treat skin infections is warranted. (12) Of particular note in this study, it appears that H. canadensis acts against MRSA, one of the bacteria that causes impetigo.
While fighting an infection such as impetigo, goldenseal’s health benefits can provide a powerful one-two punch. Internally, it helps to boost immune system response. Externally, it can fight bacteria that causes infections. For external use, make a strong tea solution and, when cool, dab over the lesions as you would a facial toner to help remove the crust caused by the weeping of the blisters.
- Green Tea
Long heralded for its healing and health benefits, researchers have found green tea can inhibit and kill a wide range of bacteria. In theory, using green tea topically could help prevent the spread across the body, as well as to other non-infected individuals. In addition to using it externally, boosting the immune system with my comforting Green Tea Chicken Soup Recipe is a great way to get the most out of this healing tea throughout a bacterial infection.
- Tea Tree Oil
Used for hundreds of years in traditional medicine, tea tree oil benefits and uses are widely accepted. It has been proven effective for treating acne, eczema, psoriasis, ringworm and for skin infections.
In a small study published in the Journal of Hospital Infection, researchers found that 5% tea tree oil extract was as effective as prescription antibiotic treatments in treating MRSA and streptococcus. (13) Study participants treated affected areas 3-4 times per day throughout the trial.
3 Tips to Prevent Impetigo
While impetigo is incredibly contagious and common, there are a few things you can do to prevent infection.
Practice good hygiene.
Teaching young children how to properly wash their hands can help prevent a wide variety of illnesses, from the common cold to impetigo. Use a natural antibacterial hand soap, several times a day. Combine ½ cup Castile soap, ½ cup distilled water, 1 teaspoon vitamin E oil, 1 tablespoon coconut oil, 10 drops peppermint oil and 30 drops of tea tree oil in a dispenser. Shake well, and use as normal soap.
Keep fingernails short.
Bacteria, dirt, viruses and even fungi thrive underneath fingernails. While washing hands often helps, it is important for small children to keep nails short to prevent spreading during an outbreak of impetigo or other contagious skin conditions.
Eat to boost immune system response.
Follow a balanced eating plan that features plenty of fresh fruits and vegetables and lean proteins. Designed to decrease inflammation, eliminate toxins, and optimize nutrients, it is a great way to fight disease and infection before onset.
After impetigo treatment has begun, it is still imperative that the infected individual limit contact until the lesions and blisters are no longer spreading, and weeping fluids. The bacteria that cause impetigo spread easily through incidental contact, including on bedding, towels and clothing.
Monitor impetigo in adults and children closely. Many find that taking daily photos of the affected areas can help you track the spread and healing rate. If the infected individual has Type 1 or Type 2 diabetes or otherwise has a compromised immune system, examine all of the affected areas daily for any changes that indicate the treatment is not working.
- Impetigo is a highly contagious bacterial skin infection caused by either streptococcus or staphylococcus aureus bacteria. It most commonly affects infants and young children. Adults and adolescents can also get it.
- There are three main types of impetigo: Non-Bullous, Bullous and, the most serious condition, Ecthyma.
- Impetigo causes clusters of red, itchy blisters that may weep and that spread quickly. Depending on the type, the blisters may be larger, lymph nodes may swell and other symptoms may occur, including fever and diarrhea. Ecthyma may lead to severe complications, including cellulitis, meningitis and kidney infection.
- A conventional doctor will prescribe a topical antibiotic ointment or cream for impetigo. Depending on severity, an oral antibiotic may also be prescribed
- There are several natural treatments, including: grapefruit seed extract, ginger, apple cider vinegar, turmeric, tea tree oil, green tea, coconut oil, Manuka honey and Goldenseal.
- Take steps to prevent impetigo by practicing good hygiene, keeping finger nails short, and eating a diet that boosts the immune system.