Impetigo: a recurring problem?

When there was an outbreak of impetigo at their school two months ago, both of our children, aged seven and nine, got it. The younger girl was treated with antibiotic cream and got better quickly. The older boy had a worse attack, with spots on hands and face, and had to take antibiotics for a week. Since then, he has had two further attacks on his face, which have both cleared up with cream. Will he continue to get impetigo?

Dr Fred Kavalier answers your health question:

Impetigo is a skin infection caused by the bacteria Staphylococcus aureus. It used to be rampant in schools and other institutions, because it spreads easily from person to person, but in recent times it has become less of a problem. The "staph" bacteria infects the skin and causes a crusty rash sometimes described as "golden". If not treated, the rash can spread extensively and even cause scarring. It is easily treated with antibiotics, but is usually resistant to penicillin and amoxicillin. The best antibiotic is flucloxacillin (or erythromycin if allergic to penicillin). If the infection is small and localised, it can usually be eradicated with an antibiotic cream such as fusidic acid. Some people find it hard to get rid of the staph bacteria, and can be symptomless carriers. The bacteria sometimes takes hold in the nose, where it doesn't cause any problems until it breaks out again as a skin infection. If your son continues to have recurrent impetigo, he should have a nasal swab taken to see if he is carrying the staph bacteria inside his nose. If he is, there are nasal antiseptic creams that can be used to eradicate it.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.