Skin Infection

Shortly after birth normal infants are exposed to a whole range of different bacteria, viruses, and fungi. As we grow, infants and children establish colonies of many different organisms that do not harm the body.

Even though we might take exceptional good care of our children’s skin, permanent colonies of microorganisms develop. Only when the normal checks and balances of the body are affected, will you notice the presence of an infection.

The skin might not be the only location for the spread of viruses, bacteria, or fungi. Some infections invade deeply into the blood system, spreading throughout the body or adjacent organs.

The skin is naturally dry. The first locations for infectious overgrowth will be in areas where moisture is increased. The groin, underarms, around the neck, and feet are frequent sites for infections to grow or spread.

There are many common types of bacterial infections found. Here is a brief list of the those I see: impetigo, folliculitis, furuncles, carbuncles (boils), paronychia, and cellulitis.

Infections are first noted on the outermost areas of the skin. Impetigo is one of the most common skin infections in children. It can start as a simple small red bump or flat area. It progresses to form a small white head or larger collection of pus. Drainage can occur on its own with crusting. This crusting is generally honey colored. Bacteria grow in the collection of crusts and continue to reinfect the skin.

As the parent you can help to control the infection by removing the crusts with medicated ointments, crèmes, or lotions. This will reduce the reinfection of the skin. Over-the-counter Neosporin, bacitracin, or Betadine are just a few examples of possible medications.

Other forms of impetigo appear such as large pus-filled blisters. This is more common in the diaper area and between the thighs. This is called bullous impetigo and needs antibiotic treatment with oral medications.

Deeper infections can produce pain and fever. In most cases this infection called cellulitis starts as a simple pimple but grows involving deeper zones of the skin, muscle, and bone. The skin might be red, tender, and swollen.

These are more serious and require my care. Close doctor follow-up is necessary to avoid progression of the infection into the body organs or the blood system.

Some infections start at the hair follicle and cause redness, irritation, pain, and sometimes a discharge of watery, yellow, or bloody fluids. Soaking these with water might be your first option. It will help if you keep the area clean with soap and water and then dry well.

On occasion small areas of infection group form an abscess which will require minor surgical drainage. I recall a recent patient account where a well-meaning parent tried to clean and drain an infection around a nail by lancing it with a needle. After repeated attempts at draining the area, the infection grew. It invaded the bone in the finger. The destruction of the bone infection eroded the end of the finger bone, leaving his fingertip shortened by about an inch. Don’t try to drain an abscess at home with a needle. Very serious complications can result.

A form of skin infection called Methicillin Resistant Staph Aureus (MRSA) is resistant to common antibiotics. There are two forms. One is a community acquired form which is less serious and can be treated in the office. It can reoccur. The other form is acquired in the hospital with patients that often have chronic illnesses and their form requires care from an infectious disease specialist.

Reviewed 5/2/2024