Should I avoid bathing with impetigo?

Bathing with Impetigo: Guidelines for Management

Bathing is recommended for patients with impetigo, but should be done using proper techniques to prevent spread of infection. 1

Recommended Bathing Practices with Impetigo

When you have impetigo, proper hygiene is essential for both treatment and preventing spread. Here's how to approach bathing:

Do's:

• Use sink washing rather than full immersion - Sink washing is preferable to shower or bath to limit skin exposure 1
• Use warm water instead of hot water to limit bacterial spread 1
• Maintain good personal hygiene with regular bathing 1
• Keep infected areas clean and dry after bathing 1
• Use separate towels for drying infected areas to prevent spread to other body parts 1
• Dry carefully between skin folds after bathing 1

Don'ts:

• Avoid sharing towels, linens, or personal items that have contacted infected skin 1
• Avoid hot water which may increase bacterial spread

Treatment Considerations

Proper treatment alongside appropriate bathing is crucial:

1. For limited impetigo lesions:

   • Topical mupirocin 2% ointment is recommended 1
   • Apply to affected areas after bathing when skin is clean and dry
   • Topical fusidic acid is an equally effective alternative 2, 3

2. For extensive impetigo:

   • Oral antibiotics are recommended 4
   • Options include cephalexin, TMP/SMX, or doxycycline (for patients >8 years) based on susceptibility 1
   • Treatment duration is typically 7-10 days 4

Prevention of Spread

Impetigo is highly contagious, so these measures are important:

• Keep draining wounds covered with clean, dry bandages 1
• Clean hands thoroughly with soap and water or alcohol-based sanitizer after touching infected areas 1
• Focus cleaning on high-touch surfaces in your home (doorknobs, counters, bathroom fixtures) 1
• Use separate towels for infected family members 1
• Avoid close contact sports until lesions are healed 1

When to Seek Further Medical Attention

• If impetigo lesions worsen or spread despite treatment
• If fever or systemic symptoms develop
• If lesions don't improve within 3-4 days of starting treatment 4

Special Considerations

• For children: Impetigo is most common in children 2-5 years old; supervision during bathing is important to ensure proper cleaning without spreading infection 4, 5
• For household contacts: Evaluate family members for signs of infection and treat if present 1
• For recurrent infections: Consider decolonization strategies such as dilute bleach baths (¼ cup per ¼ tub of water) twice weekly 1

Remember that good hygiene practices, including appropriate bathing, are essential components of impetigo management, both for treating current infection and preventing its spread to others.