Impetigo and Other Childhood Skin Infections in Brampton

It might start as a small red spot under your child’s nose that you assume is from a runny nose or a scratch. A day or two later, the spot has become a blister, burst, and formed a golden, honey-coloured crust. Then another appears on the chin. This pattern is typical of impetigo, one of the most common skin infections in young children.

Impetigo is caused by bacteria and spreads easily, especially among children who play closely together, share toys and touch their faces often. It is usually mild and responds well to treatment, but it can spread quickly around a child’s body and to others in the household if not managed.

In Ontario, pharmacists can assess impetigo as part of their minor ailment services. At Pharmasave BramNorth in north Brampton, you can learn more on our skin infections and impetigo page. This article will help you recognise impetigo, care for your child and know when to get help.

What causes impetigo

Impetigo is caused by bacteria, most often Staphylococcus aureus or Streptococcus pyogenes (the same type of bacteria that causes strep throat). These bacteria commonly live on the skin or in the nose without causing problems. When they get into a small break in the skin, such as a scratch, insect bite, eczema patch or cold sore, they can cause infection.

Children aged about two to five are most commonly affected, but anyone can get impetigo. It is more likely in warm, humid weather, in crowded settings and when skin is already irritated. Children who have eczema are more prone because their skin barrier is often broken.

What impetigo looks like

There are two main forms:

Non-bullous impetigo is the most common. It begins as small red sores or blisters that quickly break open, ooze, and form yellowish or honey-coloured crusts. It most often appears around the nose and mouth but can occur anywhere, including the arms, legs and diaper area. The sores may be itchy but are usually not very painful.

Bullous impetigo causes larger, fluid-filled blisters that may stay intact longer before bursting and leaving a thin crust. It is more common in babies and young children and can appear on the trunk, arms, legs or diaper area.

Children with impetigo usually feel well otherwise. If your child has a fever, swollen glands, or seems unwell, that may suggest a more widespread infection and should be checked by a doctor.

How it spreads

Impetigo spreads through direct contact with the sores or the fluid from them, as well as through items such as towels, clothing, bedding and toys. Children often spread it to other parts of their own body by scratching and then touching another area.

That is why preventing scratching and keeping sores covered are so important. It also explains why impetigo can move through a family or classroom quickly if precautions are not taken.

How pharmacists and doctors treat impetigo

Treatment depends on how many sores there are and how widespread they are. For a small, localised area, a topical antibiotic cream or ointment is often used. For more widespread impetigo, or when topical treatment is not suitable, a doctor may prescribe an oral antibiotic.

Under Ontario’s minor ailment program, pharmacists can assess impetigo and, when appropriate, prescribe a topical treatment. During the assessment, the pharmacist will ask about your child’s age, how many sores there are, where they are, how long they have been present, whether your child has a fever, and any allergies or other health conditions. If the infection is too widespread or there are other concerns, the pharmacist will refer you to a doctor.

When using a cream or ointment:

1. Wash your hands.
2. Gently clean the area with mild soap and water, and pat dry. Softening crusts with a warm, damp cloth can help, but do not force them off.
3. Apply a thin layer of the treatment as directed.
4. Cover with a light, non-stick dressing if possible.
5. Wash your hands again.

Use the treatment for the full time recommended, even if the sores start to look better. Do not share the tube with other family members.

Keeping it from spreading at home

In a busy household, a few precautions can stop impetigo from moving from one child to another:

• Wash hands often, especially after touching the sores or applying treatment.
• Keep your child’s fingernails short and clean.
• Cover sores with a loose dressing or clothing.
• Give your child their own towel, face cloth and pillowcase, and wash these frequently in hot water.
• Wash toys that have been in contact with the sores.
• Avoid sharing razors, sports equipment or clothing among older children and teens.

Helping a child who cannot stop scratching

Telling a four-year-old not to touch an itchy sore rarely works for long. A more practical approach is to make scratching harder and less tempting. Covering sores with a light dressing or soft clothing removes easy access. Trimming nails short and filing rough edges limits the damage when scratching does happen. At night, some parents find that cotton gloves or socks over the hands help younger children.

Distraction is useful during the day. Keeping hands busy with crafts, building toys or play dough can reduce face-touching, though shared play materials should be washed or set aside for your child while the infection is active. Praise your child when they remember to leave the sores alone, and gently redirect rather than scold when they forget.

If itch is severe and keeping your child awake, ask a pharmacist for advice. Some anti-itch products are not suitable for broken or infected skin, so it is important to choose carefully.

School, child care and sports

Children with impetigo can spread it to others. Many health authorities recommend that children stay home from school or child care until they have been on effective treatment for a period of time, often 24 hours, and sores are covered or drying. Policies vary, so check with your school or child care provider. Peel Public Health’s website has general information on infections in school settings.

For older children involved in contact sports such as wrestling or martial arts, coaches may ask that the athlete sit out until cleared. Ask your child’s healthcare provider when it is safe to return.

Conditions that can look similar

Several other skin conditions can be confused with impetigo, and some of them need very different treatment:

• Cold sores, caused by the herpes simplex virus, usually appear as clusters of small blisters on the lip that may tingle or burn first. They need different management.
• Eczema flares cause dry, itchy, red patches, which can become infected with impetigo on top.
• Ringworm is a fungal infection that typically forms a ring-shaped red patch with a clearer centre.
• Insect bites can be itchy and red but do not usually produce honey-coloured crusts unless they become infected.
• Hand, foot and mouth disease is a viral illness with small blisters on the hands, feet and in the mouth, often with fever.

If you are unsure what you are looking at, a pharmacist or doctor can help. Our pharmacists can also assess ringworm and cold sores in appropriate cases.

When impetigo needs a doctor

Contact your doctor or seek medical care if:

• Sores are widespread or keep spreading despite treatment.
• Your child has a fever, swollen lymph nodes or seems unwell.
• The skin around the sores becomes red, warm, swollen or painful, which may suggest a deeper infection such as cellulitis.
• Sores do not improve after a few days of treatment.
• Your child is a newborn or very young infant.
• Impetigo keeps coming back.
• Your child has a weakened immune system or another significant health condition.

Rarely, impetigo caused by streptococcal bacteria can be followed by a kidney problem. Signs include dark, cola-coloured urine or swelling around the eyes. Seek medical attention promptly if you notice these.

Protecting skin to prevent future infections

Healthy skin is a strong barrier against bacteria. To reduce the risk of impetigo:

• Treat eczema consistently so the skin barrier stays intact.
• Clean cuts, scrapes and insect bites with soap and water, and cover them if needed.
• Discourage nose picking and scratching, which can introduce bacteria.
• Teach children good handwashing habits, particularly after playing outside and before meals.

During warm summer months, when children are outdoors at parks and splash pads, keep an eye on bites and scrapes and clean them promptly.

Let us help with skin concerns

If you have noticed crusty sores on your child’s face or body, the pharmacists at Pharmasave BramNorth can take a look and talk you through your options. Ask about the assessment, any eligibility details and whether it applies to your child’s situation.

Visit us at 25 & 26 - 2 Dewside Drive, Brampton, ON L6R 3Y5, or call (905) 792-7333. Our contact page has directions and store details, and the booking page lets you request a time with a pharmacist.

This article is general information about impetigo and similar skin conditions. It should not be used to diagnose or treat your child without input from a pharmacist or doctor.