From the Guidelines
Impetigo and ringworm are two distinct skin infections that require different treatment approaches, with impetigo being a bacterial infection and ringworm being a fungal infection. Impetigo is caused by Staphylococcus or Streptococcus bacteria, presenting as red sores that quickly rupture, ooze fluid, and form honey-colored crusts, typically around the nose and mouth. According to the Infectious Diseases Society of America guidelines 1, treatment involves topical antibiotics like mupirocin or retapamulin applied twice daily for 5 days, or oral antibiotics such as cephalexin or dicloxacillin for more widespread cases.
Key Differences in Treatment
- Impetigo treatment:
- Topical antibiotics like mupirocin or retapamulin for limited infections
- Oral antibiotics like cephalexin or dicloxacillin for more widespread cases
- Ringworm treatment:
- Topical antifungals like clotrimazole, miconazole, or terbinafine for mild cases
- Oral antifungals like griseofulvin or terbinafine for more severe cases, with dosing regimens guided by the British Association of Dermatologists' guidelines 1
Prevention and Hygiene
Both conditions are contagious through direct contact, so good hygiene practices including handwashing and avoiding sharing personal items are essential for prevention and during treatment. The British Association of Dermatologists' guidelines also recommend screening and treatment of family members and close contacts in cases of ringworm caused by certain dermatophytes 1.
Treatment Duration and Follow-up
The duration of treatment for impetigo is typically 5-7 days for topical antibiotics and 7 days for oral antibiotics, as recommended by the Infectious Diseases Society of America guidelines 1. For ringworm, the treatment duration is usually 2-4 weeks for topical antifungals and 6-8 weeks for oral antifungals, with follow-up mycology sampling recommended to confirm mycological clearance 1.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) • cures most jock itch (tinea cruris) and ringworm (tinea corporis) • relieves itching, burning, cracking and scaling which accompany these conditions INDICATIONS AND USAGE Mupirocin ointment, 2% is indicated for the topical treatment of impetigo due to: Staphylococcus aureus and Streptococcus pyogenes. The main difference between impetigo and ringworm is the:
- Cause: Impetigo is caused by bacteria (Staphylococcus aureus and Streptococcus pyogenes) 2, while ringworm is a fungal infection (tinea corporis) 3.
- Treatment: Impetigo is treated with antibiotics such as mupirocin ointment 2 2, while ringworm is treated with antifungals such as terbinafine 3.
From the Research
Impetigo vs Ringworm: Key Differences
- Impetigo is a highly contagious, superficial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes, characterized by honey-colored crusts on the face and extremities 4, 5, 6.
- Ringworm, on the other hand, is a fungal infection caused by dermatophytes, characterized by a ring-shaped lesion with a clear center.
- Impetigo primarily affects the skin, while ringworm can affect the skin, hair, and nails.
Treatment Options
- Impetigo can be treated with topical antibiotics such as mupirocin, retapamulin, and fusidic acid, or oral antibiotics such as amoxicillin/clavulanate, dicloxacillin, and cephalexin 4, 5, 7.
- Ringworm is typically treated with antifungal medications such as terbinafine, itraconazole, and fluconazole.
- It's worth noting that there is no standard treatment for impetigo, and many options are available, including natural therapies such as tea tree oil and Manuka honey, although their effectiveness is not well established 4, 5.
Complications and Prevention
- Impetigo can lead to complications such as poststreptococcal glomerulonephritis, although this is rare 4, 6.
- Ringworm can lead to complications such as kerion, a severe inflammatory reaction.
- Prevention of both impetigo and ringworm involves practicing good hygiene, such as washing hands regularly and avoiding close contact with infected individuals.
Current Research and Concerns
- The increasing prevalence of antibiotic-resistant bacteria is a concern in the treatment of impetigo, and new topical antimicrobials and antiseptics are being developed as alternative treatment strategies 8, 7.
- There is a need for further research on the effectiveness of alternative agents, including new topical antimicrobials and antiseptics, to ensure that therapy does not contribute to bacterial resistance 8.