How do I recognise impetigo?

Impetigo starts with red spots or bumps on the face, particularly around the mouth and nostrils. It can also develop in areas where there is already a small wound, such as from chickenpox, eczema or a small cut. The bumps turn into blisters filled with yellowish fluid. When these blisters burst, they form moist areas with yellow-brown crusts. These areas can be painful or itch. In some cases, (larger) patches can appear on the arms and legs.

How do I get impetigo?

Impetigo is usually caused by the bacterium Staphylococcus aureus, and sometimes by group A streptococci. Many people carry these bacteria without showing any symptoms. The bacteria are primarily spread through the fluid from the blisters. Scratching the blisters can transfer the fluid to other areas, such as the skin, toys or door handles, allowing others to pick up the bacteria. It can also spread through skin-to-skin contact with the blisters or by touching the blister fluid.

The bacteria are also present in the nose and throat of an infected person. Coughing, sneezing or talking can release small droplets containing the bacteria into the air. In some cases, people can become infected through these droplets.  

Impetigo remains contagious until 24 hours after starting antibiotic treatment and/or until the blisters have dried out. People can get impetigo more than once.

How can I prevent impetigo? 

Regularly washing your hands and good personal hygiene reduce the risk of impetigo. Try to avoid touching the blisters or fluid from the blisters of an infected person. If contact occurs, wash your hands thoroughly. Thoroughly clean frequently touched objects, such as door handles and shared toys.

Measures to prevent spreading include:

• Cough and sneeze into a tissue or your elbow.   
• Wash your hands regularly with soap and water, especially after coughing or sneezing. 
• Keep your nails short. 
• Do not cover the sores with plasters, as this can make the infection worse. Where possible, cover the sores with clothing to make them less noticeable and reduce scratching.

Can impetigo be treated?

Impetigo can be treated with an antibiotic ointment. A course of antibiotics may be necessary if the ointment does not work, or if the patient feels unwell and has a fever. You can find more information about when to contact a GP for impetigo on Thuisarts.nl.

Is impetigo dangerous during pregnancy?

Impetigo is not dangerous for the unborn child. The risk of complications for pregnant women is usually no greater than for others. However, in 10 to 20% of cases, impetigo is caused by group A streptococci. Women who have recently given birth are at a higher risk of postpartum infection when exposed to this bacterium. Postpartum infection is serious and should always be treated.

If you are in your third trimester or have recently given birth, avoid contact with people who have impetigo. If someone in your household has impetigo or another group A streptococcal infection, such as scarlet fever or tonsillitis, avoid kissing them, touching the blisters or saliva, and sharing glasses or cutlery. Practice good hygiene: wash your hands frequently, clean frequently touched surfaces like door handles and banisters more often, and do not share towels. If someone close to you has impetigo, contact your GP for antibiotic treatment. If you have had close contact and develop symptoms of impetigo, call your GP.

How common is impetigo in the Netherlands?

Impetigo is quite common, especially among children under three years old, often following a bout of chickenpox. It tends to be more frequent among children during the summer months. The exact prevalence of impetigo is not known because people with mild symptoms often do not seek medical help, and GPs are not required to report it. However, GPs do keep track of how often they see patients with impetigo. Weekly statistics on common illnesses, including impetigo, are shared on the Nivel website.

Can someone with impetigo go to childcare, school or work?

If your child has impetigo but feels well, they may attend childcare or school as usual. Please do inform the childcare worker or teacher about your child's impetigo, so they can consult with the Municipal Public Health Services and possibly notify other parents. This will allow parents to monitor their own children for symptoms of impetigo. In some cases, a child may only return to school or childcare 24 hours after starting antibiotic treatment.

Adults with impetigo who feel well may also go to work as usual. However, if you work in: 

• healthcare; 
• a profession that involves contact with young children;

it is advisable to consult your occupational health physician, employer or the Municipal Public Health Service before going to work.