Bullous Impetigo

Bullous Impetigo

bullous impetigo
bullous impetigo

What is Bullous Impetigo?

Bullous Impetigo is one class of impetigo that primarily affects newborn and children who are younger than 2 years old. The characteristic lesions that are painless, fluid-filled blisters usually appear on the trunk, arms, and legs.

In general, impetigo is a highly contagious skin disorder. The infection usually follows a bacterial invasion through openings in the skin such as wounds, cuts, or insect bites. But in some cases, impetigo can also affect children who have perfectly healthy skin.

Although impetigo is seldom serious and usually resolves on its own within two to three weeks, the complications it may lead to are something doctors cannot ignore, considering that mostly affected are infants and children who might have weak immune systems.


Aside from Bullous Impetigo, there are other types of Impetigo:

Impetigo Contagiosa

This type of impetigo is also known as nonbullous impetigo, and this is the most common form of impetigo. The lesions begin to develop on the face, especially around the nose and the mouth. The skin lesions rupture easily, draining either fluid or pus, and leave honey-colored crust, which will eventually heal.


This is another form of impetigo and is considered to be the most serious one since it penetrates deep into the dermal layers of the skin. Resulting symptoms include painful pus-filled sores that may lead to deep ulcers. These are usually found in the legs and feet. The lesions may break open and scab over with hard and thick crust. The scar will remain after the sores heal.

Bullous Impetigo Symptoms

The following are symptoms of bullous impetigo:

  • Bullous Impetigo is characterized by the formation of large vesicles on the skin. They may appear anywhere in the body, but the most common areas are the arms, legs, and trunk.
  • The sores are usually filled with pus.
  • The sores that develop in bullous impetigo are not painful and rupture easily.
  • When the lesions become ruptured, the pus and fluid that are inside will be released. The skin surrounding the ruptured vesicles usually are not painful, but they are said to be very itchy and become red.
  • It is common for blisters to be covered with yellow crust initially, but eventually, the crust will become darkened.

Bullous Impetigo Causes

There are two types of bacteria that cause impetigo. They are the Staphylococcus aureus and Streptococcus pyogene, with the former being the most common causative agent. Note that these bacteria live freely and harmlessly on the skin surface; however, when they find any portal of entry, then they would surely ease their way into the skin. In adults, the most common instance wherein these bacteria can enter is due to an injury to the skin or other dermatologic conditions. Good example of it is dermatitis. In children, though, the most common routes bacteria follow are through wounds or cuts in the skin.

Transmission of this disease can happen if you come in contact with a person who is affected by impetigo. It may be touching the sores itself or the things that affected people have touched and used such as toys, clothing, towel, linens, etc. Once a person is infected with the disease, then it would be easier to transfer the disease to others.

In addition, Staphylococcus bacteria secretes a toxin that can spread the impetigo to surrounding skin areas. The toxin will attack a protein that functions to adhere the skin cells together, but once this protein is being attacked and damaged, then bacteria can easily contaminate the nearby skin cells.

Another thing considered to be one of the factors in the development of impetigo is the application of deep pressure on the skin though wearing tight clothing.

Risk factors

The following are risk factors in the development of impetigo:

  • Age is between two to six years old
  • School age or child care
  • Direct contact with an individual with impetigo or sharing things with infected individuals such as clothing, bed linens, toys, etc.
  • Crowded areas would put someone at risk in contracting the disease by touching someone who has impetigo.
  • Warm, humid weather
  • Sports activities that involve skin-to-skin contact such as wrestling or football.
  • The presence of chronic dermatitis or other skin conditions.

Bullous Impetigo Treatment

The goal of treatment of impetigo is to hasten the healing process, improve the skin condition and appearance, and limit the spread of the infection. The specific treatment method given to patients depends largely on the type of impetigo and the severity of the condition. The following are the common treatment methods used in the management of this condition.

Maintaining a good body hygiene

Minor cases of impetigo can be managed by simple hygienic measures and keeping the skin clean all the time.

Topical antibiotics

This includes the use of ointments such as mupirocin (Bactroban) or retapamulin (Altabax). Before application of the ointment, it is necessary to remove the scabs in order for the medication to be absorbed by the deeper layers of the skin.


Oral antibiotics are prescribed to manage widespread impetigo and for severe cases.

Home remedies

Home remedies can be given, which includes vinegar solution, soap wash, and avoidance in scratching the affected area. Vinegar solution is done by mixing 1 tablespoon of vinegar with 1 pint of water. The affected area is soaked into the solution for 20 minutes. This home remedy is effective in gently removing scabs.

Bullous Impetigo Pictures

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