We live with germs on our skin all the time. Don't get grossed
out, but there may be as many as 1 trillion germs of various
species living with every human, every day, and yes, that includes
your children. For the most part, these germs live quiet lives and
never cause us a moment of concern. In fact, some are actually
helpful by preventing dangerous germs from invading.
Without skin and its helpful germy inhabitants (such as after a
large burn injury), overwhelming infections can make us very sick,
very fast. Skin is a great defense, but occasionally, the germs
that usually live with us get a little out of control.
Impetigo (pronounced with the emphasis on the third syllable,
im-pe-TY-go) is a common skin infection in children age 2-6. It is
usually found on the face, arms and legs and starts after a break
in the skin from an insect bite, scrape or skin irritation like
dermatitis or eczema. At first it looks like a blister with
surrounding redness. Eventually an amber- or honey-colored crust
forms where the blister was. It's usually painless, but it may
itch. Impetigo is highly contagious. It can move between people
through touch, clothing or towels, or a child may spread it around
on his or her own body. It spreads quickly through day care centers
Treatment is with antibiotic creams or ointments, or antibiotics
by mouth, depending on the exact circumstances of the infection.
Current recommendations suggest that children with impetigo stay
home from school or day care for 24 hours after antibiotics are
started. Serious complications are rare.
Cellulitis is another common skin infection that is more painful
and potentially more serious than impetigo. This is a spreading
infection that causes a firm, painful, red, swollen and warm area.
Some children will develop a fever. Just like with impetigo,
bacteria enters the skin through a puncture, scrape or cut, but
very small breaks in the skin from dryness or irritation are enough
to allow infection. Sometimes it's hard to figure out the entry
Cellulitis can spread rapidly with the red area growing in size.
Sometimes there are red streaks running through the skin away from
the infection. As the body drains the area, you may notice swollen
lymph nodes in the area. These are small, firm and pea-shaped and
they can be felt through the skin.
If you think your child has cellulitis, be sure to see your
doctor. Most patients are treated with oral antibiotics and recover
completely, but cellulitis can be serious so it's best to have your
child checked out if you have any concerns.
Candida (CAN-di-duh) is a yeast fungus that lives naturally
inside of humans from the mouth to the anus. It prefers warm, moist
places. Usually Candida growth is in balance with our bodies, and
we live comfortably without knowing about its existence. But when
the body's natural balance is disturbed, for example, by
antibiotics or excessive sweating, Candida can grow, spread and
When Candida overgrowth occurs in the mouth, it is called
thrush. This is often seen in babies and looks like white, velvety
areas on the inside of the cheeks and on the tongue. Candida
overgrowth in the diaper area causes diaper rash that is beefy red
and tender. It can be very uncomfortable for a baby. Candida
infections are treated with anti-fungal medications applied
directly to the infected area. With proper treatment they heal
If your child is a nail biter, this is one infection you'll want
to know about. Acute paronychia (per-a-nee-kee-ya) is an infection
around the nail bed that is red, warm and very painful. Paronychia
can also happen after a hang nail or ingrown nail, or in children
who suck their fingers. Sometimes pus develops that separates the
skin from the nail. You may feel lymph nodes around the elbow or
armpits as the area drains.
Warm soaks three to four times a day can help the area drain,
which will relieve some of the pain. Once pus drains from the area,
the infection may go away on its own, but sometimes antibiotics by
mouth are needed. Ointments on the skin usually don't help. Rarely,
a portion of the nail may need to be removed.
Dr. Lisa Thornton, a mother of three, is director of
pediatric rehabilitation at Schwab Rehabilitation Hospital and
LaRabida Children's Hospital. She also is assistant professor of
pediatrics at the University of Chicago. E-mail her at firstname.lastname@example.org
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago.
See more of Dr. Thornton's stories here.
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