COMMON SKIN CONDITIONS

Impetigo

Unlike eczema or other allergic skin conditions, impetigo is a contagious skin infection caused by bacteria (streptococcus and/or staphylococcus). These bacteria enter the skin through a scratch, a small cut or an insect bite. They cause local irritation and red bumps that develop into small, pus-filled blisters. With time, these blisters tend to rupture, turn-ing into soft yellowish-brown scabs or crusts.

For children in the middle years, impetigo is usually not a serious condition, even though it may be unsightly and uncomfortable. On rare occasions, however, it can lead to complications, including a serious kidney disorder called glomerulonephritis. When treated appropriately, the infection usually heals in about a week.

To get rid of the bacteria that live beneath the scabs, your pediatrician may suggest that you remove these crusts after first softening them. Soak the sores in warm water - or use a clean, wet, warm washcloth - for ten to 15 minutes, four times a day, followed by washing with a mild soap. Don't scrub, since rubbing away the scabs can be painful. Once the scabs are gone, antibiotic ointment should be applied to the area several times a day. In particularly troublesome or widespread infections, your doctor may prescribe an oral antibiotic as well.

Because impetigo is contagious, epidemics of this skin disorder sometimes occur in schools and within families. Keep your infected child home until she has been on treatment for a day.

Warts

Viruses in the skin are responsible for the abnormal growth of skin cells that we call warts. While warts may not be visually appealing, they are quite harmless. However, depending on where they develop, they can sometimes be uncomfortable, particularly on the soles of the feet.

Warts usually disappear on their own without any treatment, although this may take as long as a couple of years. If the warts are uncomfortable, if they become infected or bleed, or if your child is self-conscious about them, talk to your doctor about treating and removing them. The pediatrician might recommend daily applications of a nonprescription salicylic-and-lactic acid solution on the wart; after a few months the wart might fall off. However, this kind of treatment is time-consuming and unpredictable. Warts can also be removed by surgery, freezing or electrical cauterization.

Cold Sores

Cold sores are oozing blisters that can erupt on any part of the body, although they tend to occur most often on or near the lips or inside the mouth. The herpes simplex virus, which can be transmitted from child to child or parent to child, often through saliva, is responsible for these sores.

The first time your child has a herpes simplex infection, the lesions will typically spread throughout his mouth. Thereafter, the virus itself changes character and lies dormant within the nerve, occasionally reactivating in response to any of a number of triggers, including sunlight, cold, heat, fever and stress. Just before these new blisters emerge, your child may feel an itching or tingling sensation in the region.

There are antiviral drugs that are effective against herpes simplex virus; these drugs are used for severe infections and for infections in children whose immune systems are not normal. Although these drugs can relieve symptoms and shorten the duration of the illness, they are not cures and do not prevent recurrences. Most children do not need antiviral therapy; topical therapy is not very helpful, and oral therapy must be started very early to be effective. The only therapy needed in most cases of cold sores is symptomatic relief: Many doctors recommend that children keep cold sores moist with lip balm in order to help relieve discomfort. These sores will eventually form scabs and heal, disappearing after seven to fourteen days. Until they are gone, discourage your child from scratching or picking at them. In general, however, there is no need to keep him home from school.