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DEAR DR. GOTT:
I am a 24-year-old woman who has suffered from recurring impetigo all my life. As far as my medical history is concerned, I am 5’ 9” tall and weigh 138 pounds. Twice a year without fail I get this horrible sore on my lower lip that spreads to part of my chin. I can always get it to go away in about two weeks; however, in the mean time it is very unsightly and painful. I cannot disguise it with makeup because it spreads if touched.

I am very careful to not use washcloths or towels more than once during an outbreak. I wash everything in hot water. Do you know of anything else I can take to prevent getting this?

DEAR READER:
Impetigo is a skin infection that most often affects infants and children but can affect adults as well. It begins as red sores that rupture, ooze and form a yellowish/brown crust. The lesions form when bacteria enter the skin, most commonly through insect bites or cuts, but unfortunately can also develop in healthy skin. This highly contagious condition can spread easily to other individuals or to other parts of the body simply by scratching or touching the sores. While seldom serious, it can be painful, inconvenient and unattractive.

Two types of bacteria, staph and strep, cause the condition. Both can live on healthy skin and remain harmless until the skin is compromised through an open sore, cut or rash. Staph bacteria produce a toxin that attacks proteins that help bind skin together. If such protein is damaged, bacteria are free to spread rather quickly.

A deep form of impetigo is known as ecthyma. It is marked by large boils and sore, crusting lesions that commonly appear on the skin of the legs. Ecthyma can develop in individuals with diabetes or in those with a compromised immune system.

Complications of advanced impetigo are kidney inflammation, cellulitis, methicillin-resistant staphylococcus aureus (MRSA), and a strain of staph resistant to most antibiotics.

Treatment of impetigo is primarily centered on hygienic measures. Keep skin clean and avoid skin-to-skin contact with infected individuals. Avoid using towels and clothing of infected individuals and do not sleep in their bedding.

When there is any doubt about the possibility of the condition, visit your primary care physician who can likely make a diagnosis simply by visual examination. Should questions remain, a culture can be sent to a laboratory for analysis.

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