Impetigo

What it is

Impetigo is a common bacterial skin infection causing sores or blisters that burst and leave golden-brown crusts, often around the nose and mouth or on the hands. It spreads easily by touch.

How it works

A bacterial skin infection causing honey-coloured crusts.

Why it matters on darker skin

It is common in hot, humid climates and in children with eczema, bites or scratches. On darker skin surrounding redness may be less obvious, and healed sores can leave dark marks.

Causes and triggers

Broken skin, eczema, insect bites, close contact.

What helps — and why it works

See a doctor or pharmacist: treatment is usually an antibiotic or antiseptic cream, or tablets if widespread. Wash hands, keep nails short, use separate towels and keep the child away from school until sores have crusted over and healed or as advised. Doctor-prescribed antiseptic or antibiotic: clears infection. Expected timeline: 1 week. Keep home until advised: prevents spread. Expected timeline: 48 h after antibiotics.

What to avoid and why

Avoid picking crusts, sharing towels and using steroid creams.

Common mistakes

• Picking crusts.
• Sharing towels.

Caring for children's skin

Children's skin is thinner, loses water faster and absorbs more of what is applied to it relative to body size, so simpler is safer. For most children a short lukewarm bath, a fragrance-free soap substitute and a plain emollient are all that is needed, plus shade, clothing and sunscreen from six months of age. Avoid adult products, essential oils, antiseptics in bath water, bleaching or 'toning' creams, and cosmetic treatments such as relaxers and gel nails. Medicines and medicated creams should be used only as a doctor, nurse or pharmacist advises, and in children Melanin & Me does not offer photo checks: a clinician should see the child. Trust your instincts as a parent: a child who is unusually sleepy, floppy, not feeding, breathing fast or has a rash that does not fade when pressed with a glass needs urgent care. Keep a simple record — photos and dates — of rashes that come and go, as this helps the doctor.

Products, medicines and when to worry

When choosing products for children, look for fragrance-free formulas with short ingredient lists, and avoid adult acne, anti-ageing or lightening products, essential oils and talc. Medicated creams — including steroid creams, antifungals and antibiotics — are safe and helpful when prescribed for the right condition and used for the right length of time, but mixed creams sold over the counter can contain strong steroids that are unsafe for children. Sunscreen is suitable from six months of age; younger babies should be kept in the shade and covered. Do not give medicines intended for adults, and ask a pharmacist about the right medicine for a child's age and weight. Seek urgent care for any rash with fever and a very unwell child, a rash that does not fade under a glass, swelling of the face or lips, or blistering of the mouth or eyes.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.