Impetigo During Pregnancy, Herpetiformis and How to Prevent

Impetigo is a bacterial condition of the skin that is most common in children and highly contagious. Generally, it is not considered a serious infection. Complications can, however, occur when the infection is left without treatment.

First signs of impetigo present as tiny vesicles which quickly develop into blisters and crust over to form honey-colored scabs. Once scabs have formed, impetigo becomes largely noncontagious. The blisters usually heal without leaving scars. Frequent scratching increases the risk of scarring.

Antibiotics are mainly used for treatment. These are available in form of oral and topical medications. Oral medications are reserved for more serious cases such as when impetigo has led to cellulitis or where creams and ointments are not effective.

Home treatments and remedies can also be used to improve impetigo symptoms, treat infection, or prevent spread. This article discusses the impetigo pregnancy relationship and the type referred to as impetigo herpetiformis.

Impetigo pregnancy relationship

Causes:

Impetigo is mainly caused by staphylococcus bacteria and streptococcus bacteria. Not all strains of these bacteria cause the infection however. Infection mostly occurs around an injured skin area. In people with weakened immunity or in infants, infection can start on intact skin. This is not common.

Being pregnant doesn’t increase your chances of becoming infected. The perhaps main complication is the possibility of passing bacteria to the infant after birth.

About 25% of healthy people carry staphylococcus bacteria on their skins, especially in the area between anus and genitals. Since immune system in infants is not as strong as in healthy adults, bacteria picked from the mother during birth can cause infection.

Symptoms:

There are no specific impetigo symptoms that only appear in pregnant women. The infection presents with tiny blisters which quickly burst and crust over.

Nonbullous impetigo is the more common type. Its main difference compared to bullous impetigo is that it causes smaller blisters which usually heal without scarring. Bullous impetigo occurs a bit deeper in the skin. In its final stages, it forms dark scabs which may leave scars after recovery. Bullous impetigo mostly occurs on buttocks, thighs, legs and groin.

If infection becomes serious, symptoms of systematic illness may occur. Such include swollen lymph nodes, fever and nausea. It is possible that such symptoms will associated with hormonal changes that occur during pregnancy.

Treatment:

Impetigo is treated with topical or oral antibiotics. Pregnant women should always get a prescription before buying medications. One of the reasons why a prescription is necessary is because over the counter drugs are not always strong enough to treat staph and strep infections. Continuous use of such medications can lead to more aggressive forms of impetigo that do not respond to commonly used antibiotics.

Another reason why using over the counter medications during pregnancy is not a good idea is because some medications can cause harm to unborn babies. Antibiotics such as clindamycin, amoxicillin and erythromycin which are commonly used for bacterial infections are considered safe to use during pregnancy.

Impetigo herpetiformis causes, symptoms and treatment

Impetigo herpetiformis is a rare condition that is similar to pustular psoriasis. The condition commonly affects women during pregnancy, especially in the final stages. The total number of impetigo herpetiformis reported is less than 200.

Causes:

Herpes virus is not the cause of impetigo herpetiformis. It is mostly thought to be caused by pregnancy. It also may be triggered by a type of psoriasis that is commonly caused by pregnancy. The rash that results can be taken for herpes sores. See impetigo vs herpes for comparison.

The exact reason why impetigo herpetiformis occurs mostly during pregnancy is not known. It may be one of the various skin changes that face pregnant women. It could also be associated with low levels of calcium since women diagnosed with hypoparathyroidism are thought to be more susceptible.

Since not many cases of impetigo herpetiformis get diagnosed, enough data on its causes is generally lacking. Some experts think the condition has something to do with gene mutation. However, patients usually don’t have family histories of the condition and don’t manifest symptoms outside pregnancy.

Symptoms:

Most symptoms occur after week 26 of pregnancy or what is known as third trimester. They present as areas of redness on skin that resemble pustules. There may be ulceration in the middle of the pustules the more peripheral area is gained. Burning and itching usually occur.

Patients usually develop symptoms of systematic illness such as fever, chills, diarrhea, nausea and vomiting. If impetigo herpetiformis is to recur, it comes back more aggressive than the last time.

Symptoms usually appear on skin areas that rub against each other. The condition then gradually spreads to the arms, legs and trunk.

Treatment:

Before treatment, diagnosis is required to rule out conditions such as PUPPP or PUPPS. Doctors are usually able to identify impetigo herpetiformis from during physical examination.

Treatment is done with oral steroids. It is the only type of psoriasis that can be completely treated with steroids. Some people do not tolerate steroids very well. In that case, alternatives such as home treatments and use of antibiotics will be considered. Doctors also monitor the levels of calcium and albumin in patients.

Without treatment, impetigo herpetiformis may cause stillbirths. Patients should talk with their doctors immediately after discovering the first symptoms.

How to prevent impetigo during pregnancy

People get impetigo after coming into direct skin to skin contact with an infected person or with a contaminated surface. If such contact is avoided, the infection can be prevented. Adults don’t usually get impetigo since their immune systems are able to fight off invading bacteria before they can build colonies. In newborns, children and older people, this is not always the case.

Pregnancy doesn’t lower the immune system. It is therefore very unlikely that impetigo will occur due to the sole reason that a woman is pregnant. This is with exception of impetigo herpetiformis.

If you are near an infected person, care should be taken to avoid picking up impetigo causing bacteria. Below are certain factors that predispose people to impetigo:

  • Age – children between 2 and 6 years of age are most susceptible. This is especially if they attend school or day care centers. Impetigo in adults is mostly seen in older people.
  • Poor hygiene – every so often, we pick up bacteria of all types from different surfaces. These bacteria can easily be flushed out by washing hands with medicated soap and water. Additionally, sharing personal items such as towels, bed linen and clothes is a classic way to spread bacteria from one person to another.
  • Weakened immunity – our bodies are able to recognize and fight off invading harmful bacteria before they can cause infection. People diagnosed with diseases such as diabetes, HIV and cancer sometimes lack strong immunity and therefore get predisposed to infections. A good approach to avoid this is by taking medications meant to manage such diseases.
  • Congested places – the more people you get to close contact with, the larger number of bacteria and other microbes you are likely to pick up. There are chances that impetigo causing bacteria will be among the pathogens to be picked up.
  • Skin injuries – bacteria on the skin rarely cause infections. Conditions on skin are not always right for bacterial growth. Inside the skin, there are nutrients that bacteria require to proliferate. This added with the fact that it is warm and wet inside the skin makes it very susceptible to infections. Skin injuries can be managed by dressing with bandages and using medications for skin conditions like eczema, chicken pox, herpes and boils in the case of impetigo armpit
  • Certain sports – sports like football and wrestling involve direct contact. Bacteria can easily be passed from one person to another during such sports.

Generally, the following measures may help with how to prevent impetigo:

  • Frequently wash hands – this works by flushing out bacteria that may have been picked from various surfaces. Medicated soap is better suited to get the job done.
  • Good hygiene habits – if a household member has been diagnosed with impetigo, ensure to wash their clothes, bed linen and towels every day. These items should not be shared even after being washed.
  • Dress blisters and wounds – infected areas that have formed blisters or sores should be washed and covered with a light preferably waterproof dressing. This prevents direct contact as well as leaking of pus from the blisters.
  • Keep nails short – bacteria can hide in long nails after scratching infected areas. Patients should keep their nails short to avoid this.
  • Keep children from attending school – schools are a perfect place for impetigo to get passed from one kid to another. Parents are advised to keep their children at home until complete recovery.
  • Use medications – medications don’t only make recovery faster but also reduce the risk of spread. With medications, impetigo is only contagious for about 3 days after which scabs form. In final stages of impetigo, the infection is not highly contagious. See how long is impetigo contagious for more details.
  • Try natural treatmentsnatural remedies for impetigo such as tea tree oil and white vinegar may prove helpful.

Complications of impetigo

Most patients recover from impetigo without complications. Without treatment, the infection can persist for up to 10 days. This period significantly reduces with medications. Following are potential complications of impetigo:

Scarring:

Normally, impetigo blisters do not cause scarring. Scratching or leaving impetigo sores to go untreated may result in large ulcerated areas which leave scars after recovery.

Cellulitis:

Cellulitis is another bacterial infection of the skin. Unlike impetigo, it occurs much deeper in the skin and is not contagious. Cellulitis presents with red, swollen and tender skin areas. It is usually treated with antibiotics but pain and anti-inflammatory medications can be used to relieve symptoms.

Scarlet fever:

Scarlet fever is rare and usually a complication of strep throat or even impetigo on neck. Like impetigo, it is considered not serious, but contagious. It main signs are widespread pink rash, fever, pain and nausea. Antibiotics are primarily used for treatment. Patients should be kept in isolation to avoid spread.

Septicaemia:

This is a serious condition caused by blood poisoning resulting from toxins released by bacteria. Patients experience symptoms such as diarrhea, vomiting, clammy skin, confusion, low blood pressure and fever. Medical attention should be sought immediately to avoid septic shock and possible death.

Guttate psoriasis:

This is a non-infectious condition of the skin that mostly develops in children as a complication of bacterial infections. It is characterized by tiny, red and scaly patches. The condition is easily treatable with creams or ointment for impetigo.

Post-streptococcal glomerulonephritis:

This is a rare condition caused by damage to blood vessels that supply blood to kidneys. It is characterized by blood in urine and widespread swelling.

Like in humans, impetigo treatment for dogs and pets is important. This is because the same bacteria that cause impetigo in animals cause the same in humans.

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