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Impetigo: Worthy of all the Fuss?

Since I was a wee little one, I've been very alert to anything health related. Biology fascinated me. First aide was my jam in middle school. I was in the Health track in High School, training to be a nursing aide. So while impetigo isn't super common, it's been on my radar as long as I can remember. I am sure it probably came up in some of my training to be a rock star babysitter.

What I remember is #impetigo being an incredibly contagious infection, common in children, and that any hint of golden discharge, on any area of skin on a child, should initiate the critical steps of distancing myself, sounding the alarms, and getting that kid to the doctor for antibiotics. I remember even in nursing school learning about impetigo and not having yet seen this phenomenon in real life, one of my classmates shared that she had been diagnosed with impetigo in elementary school and she was really shamed for it. She was separated from her peers, her father had to come pick her up, and she was told not to return until there was no trace - registering for her on the embarrassment meter like head lice.

As a young mom though, my little ones played on our little farm. We had garden veggies, wagons and 4-wheelers, chickens and goats, all the fun. My daughter had been playing and scraped the front of her shin on the wagon. It was nice size, fairly superficial wound but like "all good moms" who nurture this inner voice of the healer, I didn't even consider having it evaluated by a clinician. It will help her grow chest hair, right? I slapped some bacon fat on it, or whatever else we had available (please read some sarcasm in here) and bandaged it up.

That week was busy though, because we had VBS on top of working full-time and caring for our little farm, so before I even realized it, my daughter was sharing that she had goop dripping from her wound. And I mean some serious drippage was happening because there was golden crusties from her knee to her sock, and we had our VBS show to attend that evening. I dropped in a local urgent care, they diagnosed impetigo, offered #antibiotics, and it quickly resolved but before we even finished the prescription, my daughter had broken out with a red patchy rash that progressed even after stopping the medication. Years later and after multiple misdiagnosis, we would discover that she suffered guttate psoriasis, a common secondary infection to strep.

Superficial Skin Infection Caused by Strep and Staph

The simple explanation is that impetigo is an infection from which the normal bacteria on your skin fell into a superficial skin wound and just got a bit rowdy. Maybe you had a cat bite? Maybe a mosquito bite? Maybe your child was picking their nose, or maybe you were itching a fungal infection, broke down the barrier of your skin with your nails and then a few less friendly germs moseyed beyond the safety wall of that skin barrier?

Group A Streptococcus and Staphylococcus aureus are the culprits here. These germs spread easily from person to person so they are quite #contagious, particularly when your wound are weepy. Often it is the more itchy spots that become infected with impetigo, because as we itch, we can break down the skin and in doing so, we've contaminated the barrier of the skin with the germs under our nails from itching. These spots then spread as they proliferate off the nourishment they find in your wound. Yeah, it's all kind of gross, and super fascinating.

Impetigo does have a classic golden ooze, although not always as significant as what is seen above. Most of the time admittedly, it isn't super obvious but an experienced clinician can diagnose it at first glance. These can show up anywhere on the body, and often cluster together in groups. In most cases, this is fairly benign and may even go away on its own in two or three weeks. However, antibiotics are the mainstay of treatment and typically resolves the infection in about 10 days.

The real concern is #cellulitis, or a significant infection within the skin itself. This is really quite rare though, and much more likely with those who are immunocompromised, such as those with any autoimmune disease, #diabetes, and such. People with impetigo generally feel well and don't have fever or other symptoms. These lesions though are a real nuisance as they can be itchy, painful, and messy.

Natural Approach to Treating Impetigo

My clients are fairly well known to me. I've been in practice for nearly two decades. I've been to the homes of most of my clients and they can reach me on my personal cell, so while many practices will immediately offer antibiotics for impetigo, this really isn't my preference for my clientele. If I worked in an urgent care clinic and didn't understand the mindset towards health of the client I was caring for or even their available resources, then certainly, for liability reasons and to mitigate catastrophe, I'd offer antibiotics in these circumstances; it's the community's expectations. Alas, I am blessed to be a primary care provider in private practice with clients who prioritize natural healing modalities and who don't hesitate to reach out to me if signs and symptoms are worsening. They honestly prefer to manage these circumstances at home, with natural remedies, where appropriate.

For this reason, my go to is typically #botanical. A drawing salve works wonders. Lavender oil is magic. Honey is divine. Maybe a black drawing salve, but of course, this is all with the guidance and assurance that we have properly diagnosed the lesion and that we aren't suffering cellulitis.

Our practice has challenged our clients to create a botanical remedy for their home first aid kit, each month, for the 2023 calendar. For the month of January we are creating a healing salve for our home first aid kits. We've provided a recipe in our Pediatric Educational Forum and then plan to share our efforts in our private facebook group. There is little more satisfying than creating your own healing medicines for your family (except maybe growing the herbs within your own garden).

It may be that you'll want to wash bedsheets, pajamas, even stick your shoes in the dishwasher to sterilize them depending on the location of your infection. Remember, this is super contagious. And maybe you want to stay home; certainly the little ones should not attend school outside the home. But with early and consistent treatment, natural remedies can be super effective.

What may be found in a natural healing salve or ointment is a carrier base, one with antibacterial, antiviral, and antifungal properties and then adding in the healing botanicals whether, essential oils or herbs. Burdock root is common, garlic, yarrow, calendula, lavender, plantain, and even echinacea. Manuka honey, witch hazel, and colloidal silver are other great options. If you'd like to dive into botanical medicine a bit more, and how you can apply this at home, join our Earth Medicine program.

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