ERBIL POLYTHECNIC UNIVERSITY

SORAN TECHNICAL INSITITUTE

MIDWIFERY DIPARTMENT

FIRST STAGE(M)
 (IMPETIGO)

Prepared by :Narmin Salh Muhammad

Supervisor :Azad Husen Amin

2019-2020

CONTENT

Definition and introduction……………………………….3

Sing and symptoms……………………………………...…3

Cause ……………………………………………………….4
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Diagnoses …………………………………………………...5

Prevention …………………………………………………..5

Treatment ……………………………………………….…..6

How to get rid of impetigo with home remedies ………….7

Prognosis …………………………………………………....12

Reference …………………………………………………….13

Definition and Introduction

Impetigo is a bacterial infection that affects the skin

above the surface. The most common occurrence is
yellowish crusts on the face, arms, or legs. Large
blisters can occur which involve the groin or armpits
less often. Might be sore or itchy lesions. Fiever is out
of the ordinary. This is typically attributed to either the
Staphylococcus aureus or Streptococcus pyogenes.
Day care, crowding, poor diet, diabetes mellitus,
contact sports, and skin breaks such as from mosquito
bites, eczema, scabies, or herpes are all risk factors. It can spread around or among touched
people. Typically, diagnosis is based upon the symptoms and appearance. Prevention is by
hand washing, removing sick people and cleaning up injuries. Treatment normally requires

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antibiotic creams such as mupirocin, or fusidic acid. If wide areas are infected, mouth-borne
antibiotics such as cephalexin can be used. Forms which are immune to antibiotics have been
discovered. In 2010, Impetigo infected approximately 140 million people (2 per cent of the
world 's population). It can happen at any age, but is most common in young kids. The
disorder is also known in some countries as "school sores" Individuals usually get better
within three weeks without medication. Recurring infections may occur because the bacteria
colonize the nose. Complications can involve cellulite or glomerulonephritis poststreptococci.
The name comes from Latin impetere which means "strike"

Signs and symptoms

 Contagious impetigo

This most common type of impetigo, also called nonbullous impetigo, most often begins as
a red sore near the nose or mouth which soon breaks, leaking pus or fluid, and forms a honey-
colored scab, followed by a red mark which heals without leaving a scar. Sores are not sore,
but they can be itchy. In the infected area, lymph nodes can get swollen, but fever is rare.
They can quickly spread the infection to other parts of the body by rubbing or scratching the
sores. Redness and scarring of skin ulcers can also result from scratching or abrading of the
skin.

 Bull
ous

impetigo

Bullous impetigo, seen mostly in children under 2

years of age, includes painless, fluid-filled
blisters, often on the arms , legs, and trunk,

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 surrounded by red skin and itchy (but not sore). Blisters may be tiny or huge. They form
yellow scabs after break.

Figure(1):Bullous impetigo after the bulla have

broken

 Ecthyma

Ecthyma, the nonbullous type of impetigo, produces painful fluid- or pus-filled sores with
skin redness, typically on the arms and legs, becoming ulcers which penetrate deeper into the
dermis. They develop hard, dense, gray-yellow scabs after breaking open which sometimes
leave scars. In the affected area ecthyma may be followed by swollen lymph nodes.

Causes

Impetigo is an inflammation caused by staph or strep bacterial strains. These bacteria can get
into your body from a cut, scrape, bite of insects or rash through a break in the skin. They are
then able to conquer and colonize. Might be a infectious disease. These bacteria may be
detected by touching a person's sores with impetigo or by touching objects such as towels,
clothing or sheets that the person used. These bacteria are natural in our atmosphere as well,
however, and most people who come into contact with them would not necessarily develop
impetigo. Typically some people bear staph bacteria inside their nose. If the bacteria spread
to their skin they can become infected.

Adults and children are at higher risk for impetigo if they:

• Live in a wet, humid atmosphere

• That has diabetes

• Is under dialysis

• Have a compromised immune system, for example HIV

• Have skin disorders like eczema, psoriasis or dermatitis

• Get a sunburn or burns

• Have itchy lesions like lice, scabies, herpes simplex or varicose veins

• Have bites from insects or poison ivy

• Play Sports Touch

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Diagnosis

Impetigo is usually diagnosed based on its appearance. It generally appears as honey-colored

scabs formed from dried serum, and is often found on the arms, legs, or face. If a visual
diagnosis is unclear a culture may be done to test for resistant bacteria.

Differential diagnosis

Other conditions that can contribute to symptoms similar to the normal type include contact
dermatitis, herpes simplex virus, discoid lupus, and scabies Other conditions that can result in
blistering-like symptoms include other bullous skin diseases, burns, and fasciitis necrotizing.

Prevention

Children with impetigo may remain at home until they no longer become infectious if the
lesions cannot be covered consistently. Adults working in jobs requiring close touch should
ask their physician when returning to work is appropriate for them.

Good hygiene is the number one way of avoiding impétigo. Follow the following Tips:

• Bathe and wash your hands regularly to remove bacteria on your skin.

• To protect the area cover any skin wounds or insect bites.

• Keep the nails tucked away and tidy.

• Do not touch open sores, or scratch them. That spreads the infection.

• Wash all in hot water and laundry bleach which comes into contact with the impetigo sores.

• Adjust bed sheets, towels and garments that sometimes come into contact with sores, until
the sores are no longer infectious.

• Clean and disinfect surfaces, appliances, and toys that could have come into contact with
impetigo.

• Don't share any personal things with an impetigo user.

Treatment

Antibiotics are typically administered either as a cream, or by mouth. Mild cases may be
treated with ointments made with mupirocin. In 95 percent of cases, a single course of 7 days
of antibiotics results in child resolution. It has been argued that topical antiseptics are inferior

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to current antibiotics, and should thus not be used as a supplement. However, as of February
2020, the National Institute for Health and Care Excellence (NICE) recommends a 1%
hydrogen peroxide cream antiseptic as opposed to topical antibiotics for localized non-
bullous impetigo in individuals otherwise well. This recommendation is part of an attempt to
minimize antimicrobial overuse that may lead to resistant species such as MRSA. More
serious cases require oral antibiotics, including dicloxacillin, flucloxacillin, or erythromycin.
Alternatively, amoxicillin can also be used as an antibiotic remedy, along with clavulanate
potassium, cephalosporins (first-generation), and many others. Alternatives for people with
extreme penicillin allergy or methicillin-resistant Staphococcus aureus include doxycycline,
clindamycin, and trimethoprim-sulphamethoxazole; while doxycycline should not be used in
children under the age of eight due to the risk of drug-induced decoloration of the tooth.
Penicillin is the medication of choice when streptococci alone are the cause. Valacyclovir, an
antiviral, can be given when the condition develops ulcers in case the ulcer is caused by a
viral infection.

Figure(2): Impetigo is treated with antibiotics and/or an antibiotic cream.

 Alternative medicine

There is not enough evidence to suggest herbal medicine such as tea tree oil or honey.

How to Get Rid Of Impetigo with Home Remedies?

Below are the easiest 19 ways to safely handle impetigo at home. You can choose one of the
approaches, and try to get relief from the impetigo daily.

1. Hot Compress

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Heat is one of the most common ways to treat impetigo. It is going to kill the bacteria which
cause the infection. It also relieves the inflammation, and dries the lesions out.

• Submerge a wash cloth in enough hot water.

• Remove the excess and position it over the infected areas.

• Take it off after a few minutes.

• Repeat the multiple times a day.

2. White Vinegar

White vinegar has antibacterial characteristics. It also promotes healing process and
maintains the affected area clean. By following the below procedure you can make an
antibiotic solution for treating impetigo.

• Drop 1 spoonful of white vinegar into two cups of lukewarm water.

• Wash the infected areas with the paste, using a cotton pad.

• Add some antibiotic ointment and pat dry.

• Safe bandage area or gauze area.

• Repeat 2-3 times a day until the infection is healed.

3. Tea Tree Oil

Tea tree oil prevents the spread of infection, as it has good antibacterial and anti-
inflammatory properties.

• Apply a few drops of tea-tree oil to 1 spoonful of olive oil.

• Add the blend to the affected regions.

• Let it sit for 20 – 30 minutes and rinse with tippy water.

• Repeat the treatment 2-3 times a day.

• Note: Jojoba oil can also be used in place of olive oil.

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• Alternative: Add few drops of tea tree oil to enough amounts of lukewarm water. Wash the
infection area using the solution and pat dry.

4. Grapefruit Seed Extract

Grapefruit extract is one of the most effective forms of treating impetigo because it contains
antioxidant and antibacterial properties. It acts likewise as a non-toxic disinfectant.

• Apply only a few drops of grapefruit seed extract to 2 table spoons of water.

• Spread the mixture on contaminated areas using a cotton pad.

• Remove to dry full.

• Repeat the treatment 2-3 times a day.

5. Garlic

Garlic is one of the best ways of treating impetigo. It contains antibiotic properties that
destroy the infective bacteria. It soothes discomfort and itchiness too.

• Put 2 table spoons of sesame oil and 2 – 3 minced cloves of garlic in a pan.

• Fry the garlic cloves for a few minutes, then remove from the flame.

• Let it cool and relax.

• Add oil to areas affected.

• Repeat request 2 times a day.

6. Manuka Honey

It has antibacterial, antiseptic, anti-inflammatory and soothing properties that are beneficial
for the treatment of impetigo.

• Spread Manuka honey layer over affected areas.

• Put on for a few hours and rinse off with torrential water.

• The procedure should be repeated regularly for successful performance.

7. Goldenseal

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Goldenseal is among the herbal treatments for the treatment of impetigo. It contains antiseptic
and antibacterial properties that cure the sores and blisters. Besides that, it is improving the
immune system.

• In a cup of hot water add 1 teaspoon goldenseal powder.

• Let it pause for ten minutes.

• Strain and allow to cool.

• Clean the contaminated areas and pat dry with the solution.

• Repeat the treatment 2-3 times a day.

8. Aloe Vera

Aloe vera contains antibacterial, antiseptic, anti-inflammatory and skin-repairing properties

that are of great benefit in the treatment of impétigo.

• Freshly squeezed aloe vera gel should be applied to affected areas.

• Leave on for 30 minutes, then let it dry.

• Repeat the weekly procedure 2 – 3 times a day.

9. Cleavers

One of the herbal treatments for treating impetigo is cleaver. It deals with the infection
causing the staph bacteria. This decreases the lymph inflammation caused by impetigo when
ingested.

• Put a bottle of water to boil.

• Add in a spoonful of cleaver leaves.

• Detach from the flame and simmer for 5 minutes.

• Let it steep for 10 minutes, strain and drink it.

• Repeat the procedure regularly.

10. Apple Cider Vinegar

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Apple cider vinegar dries out the sores and lesions that were created from the infection. It
also has antiseptic and antibacterial properties.

• In a cup of water, dilute apple cider vinegar;

• Dip the ball of cotton in the solution and wring out the excess.

• Rub it softly over the sores of the impétigo.

• Allow to dry completely.

• Repeat the step many times a day.

11. Coconut Oil

Coconut oil is one of the unconventional therapies for impetigo. The natural acids found in
coconut oil destroy the infection causing the bacterial strains.

• Apply the coconut oil to the affected areas using a cotton pad.

• Allow to dry completely.

• Repeat the healing process daily to promote healing.

12. Mirror

Myrrh oil contains anti-inflammatory properties that are effective in battling the infective
bacteria.

• Mix enough myrrh oil and honey together.

• Add the mixture to areas contaminated.

• Leave on for 15 minutes , then rinse with water.

• Repeat the procedure periodically until the effects are visible.

13. Petroleum

Olive oil contains two strong chemicals – oleuropein and rutin, which are effective in fighting
off the bacteria that cause infection with the impétigo.

• Apply olive oil directly to areas contaminated.

• Leave on to let the skin absorb it for some time.

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• Rub away the excess using a tissue paper.

• Occasionally repeat the procedure for fast results.

14. Epsom Salt

This process provides relief from the itching and irritation caused by the impetigo. The
antibacterial properties of Epsom salt also deals with the bacteria causing impetigo.

 Add a cup of Epsom salt into your bathwater.

 Soak the infected areas in it for 20 minutes.

 Bath normally and pat dry.

 Repeat the process regularly.

15. Lavender Oil

Lavender oil is one of the best essential oils to cure impetigo. It contains antibacterial
properties which deal with the infection causing bacteria.

 Add 1 drops of lavender oil on a cotton pad.

 Apply it on the blisters and leave it on as long as possible.

 Discard the cotton pad and let the area dry.

 Repeat the process 4 times in a day.

16. Impetigo Healing Gel

By following the below procedure, you can make a healing gel which contains skin healing,
antibacterial, antiseptic properties that are helpful in treating impetigo.

• Combine 50gms of freshly squeezed aloe vera gel, 12 drops of lemon grass oil and 12 drops
of patchouli essential oil.

• Apply appropriate quantities of the mixture to affected areas.

• Remove to dry full.

• Repeat request at least three times a day.

17. Vaseline and Cornstarch

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Even if it sounds odd, this combination is known to reduce the impetigo symptoms within 48
hours. Cornstarch keeps the area infected dry, and Vaseline accelerates the healing process.

• Mix ample quantities of Vaseline and corn starch.

 Leave it on for as long as possible.

 Rinse with water and pat dry.

 Repeat the process daily.

18. Rosemary and Thyme

This is one of the best herbal treatments available for treating impetigo. This combination
eliminates discomfort, and effectively removes the impetigo.

• In a cup of water add only a few rosemary and thyme leaves.

• Cook for 45-50 minutes.

• Strain the mixture and allow to cool.

• Wash the areas affected with a solution and pat gently dry.

• Repeat at regular intervals.

Prognosis.

Those with impetigo usually get better within three weeks without medication. Complications
can involve cellulite or glomerulonephritis poststreptococci. There does not seem to be any
connection between rheumatic fever.

Reference

1.  "ISDH: Impetigo".  state.in.us. Archived from the original on 11 December 2014.

Retrieved 11 December 2014.
2. ^ "Impetigo: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from
the original on 2016-11-07.

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3. ^ "Self-management - Impetigo - Mayo Clinic". www.mayoclinic.org. Archived from
the original on 16 October 2016. Retrieved 7 October 2016
4.  The Barnhart Concise Dictionary of Etymology. Harper Collins. 1995.  ISBN  978-0-
06-270084-1.
5. ^ MacDonald RS (October 2004). "Treatment of impetigo: Paint it
blue". BMJ.  329 (7472):
979.  doi:10.1136/bmj.329.7472.979. PMC 524121. PMID 15499130.
6.  "Impetigo symptoms and treatments". www.nhsinform.scot. Retrieved  2020-05-26.

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