Impetigo: Cream or Pill? What Really Works Best

Candid Conversations With Dr Lowe

Impetigo is a contagious bacterial skin infection that most often affects children—but adults can get it too. In this video, we break down what impetigo is, what causes it, and how it’s best treated. You’ll learn the difference between bullous and non-bullous impetigo, how the infection spreads, and why early recognition matters. We also explain when a simple antibiotic cream like mupirocin, ozenoxacin, or retapamulin is enough—and when oral antibiotics such as cephalexin, clindamycin, or doxycycline are needed. For mild cases, topical therapy usually works just as well as pills and helps prevent antibiotic resistance. But for more widespread or severe infections, systemic treatment is key. We’ll also share practical prevention tips—like handwashing, nasal decolonization, and keeping lesions covered—to stop impetigo from spreading. Stay informed and take control of your skin health by learning how to recognize and treat impetigo effectively. 🔹 Topics Covered: • What is impetigo? • Bullous vs. non-bullous impetigo • When to use a cream vs. a pill • Common antibiotic options • MRSA and resistant infections • Hygiene and prevention tips

Transcript

00:00Impetigo is a contagious infection of the skin that occurs most frequently in children.

00:07It tends to spread easily in close contact environments such as schools or daycare centers

00:14and is more common in living conditions where sanitation is poor or housing is crowded.

00:23The infection happens when bacteria, usually staphylococci or streptococci, invade the outer layers of the skin.

00:37It usually begins with a small fluid-filled bump or vesicle that ruptures and leaves behind a red patch of skin.

00:46This area then crusts over, forming that classic yellow to honey-colored scab, sometimes even brown or black.

00:56Impetigo can occur in two ways.

00:59It can be primary, when it appears on normal, healthy skin,

01:04or secondary, when it develops over skin already irritated by eczema, a cut, or even an insect bite.

01:14There are also two main types, the bolus and non-bolus impetigo.

01:21Bolus impetigo looks like clusters of blisters filled with clear liquid

01:26and is most often caused by staphylococcus bacteria.

01:35The good news is that impetigo can sometimes heal without treatment.

01:41However, if it is caused by streptococcus bacteria and left untreated,

01:48it can occasionally lead to complications such as kidney inflammation, known as glomerulonephritis.

01:57More serious cases can also lead to deeper infections like cellulitis.

02:04Studies show that for uncomplicated impetigo, where only a few areas of skin are affected,

02:17antibiotic creams are the treatment of choice.

02:21In these mild cases, there is no difference in how well creams work compared to antibiotic tablets.

02:29The one exception is penicillin, which has been found to be less effective than topical creams.

02:39In some countries, antiseptic lotions like benzoyl peroxide are used for mild infections,

02:46but antibiotic creams generally work faster and better.

02:51If someone has many lesions, or if the infection causes fever or other systemic symptoms,

03:03or if it is bolus or goes deep into the tissues,

03:08then antibiotic tablets are the preferred treatment.

03:12Common and effective creams include mupiracin, oxenoxicin, and ratapneelin.

03:21For all antibiotics, doctors may prescribe cefalexin, doxycycline, clindamycin, or amoxicillin clavulonic acid.

03:32If the infection is due to MRSA, the antibiotics of choice are doxycycline, clindamycin, or tramitroprim sulfametoxazole.

03:48Treating impetigo doesn't stop at the medication.

03:52It is also important to address areas of the body that harbor the bacteria,

03:57such as the nasal passages, and to maintain good personal hygiene.

04:03Regular hand washing, keeping fingernails short, and avoiding sharing of towels and clothing

04:10all help to prevent the spreading of the infection.

04:16The takeaway message is simple.

04:19There isn't one single best treatment for impetigo.

04:23The choice between a pill or a cream depends on the severity of the infection

04:30and on the type of bacteria involved.

04:35For small, mild infections, a topical cream is usually all that's needed.

04:41For more widespread or serious cases, oil antibiotics work best.

04:47And regardless of the treatment, good hygiene is key to preventing the infection

04:54from coming back and spreading to others.

04:58I hope you enjoyed the video.

05:00If you did, like and share the video with your friends and family.

05:04You can support the channel by subscribing.

05:07Until the next video, stay healthy and stay safe.

05:11Thank you, guys.

05:30Stay healthy and stay healthy and leave me at the confirme.

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