Infant Illnesses | Spotlight on impetigo

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It typically starts as a blister inside the nose and spreads quickly to other areas. (Original image: Getty Images)
It typically starts as a blister inside the nose and spreads quickly to other areas. (Original image: Getty Images)

Having a newborn baby is overwhelming enough, and if they show signs of illness, it can be really scary.

At Parent24, we've put together a series on common infant illnesses to help guide you when baby is sick.

And we'll help you to decide when you should actually panic (it's probably not as serious as you think, but let's be sure!).

Catch more instalments of our #infantillness series here

A typical concern:

"The small blister inside my two-year-old's nose is spreading across his face in the form of red bumps. What's going on?" 


It seems like your baby has impetigo, a common skin infection in children aged two to six. It typically starts as a blister inside the nose and quickly spreads to other areas. 

While the infection is not very serious and, in most cases, does not cause long term health issues in the young, impetigo is highly contagious, says Netcare Femina Hospital paediatrician Dr Elelwani Mathivha. 

"It is spread by skin-to-skin contact like hugs, kisses and handshakes," she says.


Dr Mathivha advises that the skin infection is typically due to one of two bacterium: Staphylococcus aureus or Group A beta-haemolytic streptococcus. 

Also see: Infant Illnesses: Spotlight on Colic

Symptoms to look out for:

"It can affect any part of the body but most often starts in the nostrils then often spreads to the face. It usually starts as a superficial blister which later erodes the skin, becoming deeper round moist blisters that rupture, leaving yellowish crusts around the edges. The blisters may result from tiny vesicles or form large pocket-like fluid-filled lesions called bullae. It is usually not painful, and it is not associated with fever. It may, however, be itchy," Mathivha explains. 

How long will it last? 

With medication, the skin infection takes about one week or up to ten days to resolve, says Mathivha. 

Similar conditions:

According to Dr Mathivha, impetigo is often mistaken for a few conditions, including: 

  • Ringworm (Tinea corporis)
  • Burns
  • Viral infections like chickenpox or shingles (varicella-zoster) and Herpes simplex
  • Scabies

"While not an illness, signs of child abuse, or non-accidental trauma, could present similarly," Mathivha notes. 


Home treatment, which includes oral antibiotics, usually follows diagnosis. 

"Only complicated cases may require intravenous antibiotics," however, these are rare, says Dr Mathivha. 

Also see: Everything you need to know about your baby's hearing, explained

When to call the doctor

Dr Mathivha says that if the condition does not improve after the initial visit to the doctor, and your child isn't responding to the prescribed antibiotics, then a follow-up visit is necessary. 

She advises parents to note the following as complications of impetigo, which call for urgent medical care: 

  • Fever
  • Swollen lymph nodes
  • Swelling of surrounding tissue (cellulitis)
  • Cough and fast breathing (usually a sign of pneumonia)

You can also ask a doctor or paediatrician directly via Health24 here: Ask an Expert

Tips for parents

Except for the complications noted above, Dr Mathivha says that the condition tends to run its course without incident. "Lesions usually resolve completely with no scar formation, and full resolution of the infection is usually attained".

What are you most concerned about when it comes to your baby's health?


Share your stories and questions with us via email at Anonymous contributions are welcome.

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