Q. After a recent cross-country drive, staying in many roadside motels, I ended up with a skin infection called impetigo. Could I have gotten this infection in a motel? And how can I prevent it in the future?
A. It would be difficult for me to say for certain where you picked it up. Impetigo is a highly contagious bacterial skin infection. The shorthand names for the two types of bacteria that cause impetigo are "staph" and "strep."
The same type of strep that causes strep throat can also cause impetigo. These bacteria can live on people's skin without causing impetigo or any other visible signs. They also can live for short periods on upholstery, bed sheets, clothes and other objects a person may come into contact with. So it's possible you were exposed to it during your travels, but it would be hard to pinpoint where or when.
Impetigo is most common in children, but as you've discovered, it can also occur in adults. This is especially true of adults who have itchy skin conditions such as eczema.
Other conditions that can increase your risk of developing impetigo include chickenpox, reactions to insect bites, burns of the skin and diabetes.
Impetigo often appears around the nose and mouth, but it can develop wherever there's an opening in the skin from cuts and scrapes or cold sores -- anyplace bacteria can enter.
Impetigo causes small bumps or blisters that burst. The skin is moist, tender and red, and oozes a clear liquid that eventually forms a crust. If the disease is more severe, you also may have a fever and swollen glands in your face or neck. When impetigo is caused by strep, a person can develop serious heart and kidney problems if it is not promptly treated.
To prevent impetigo, start by keeping your skin clean by bathing or showering daily. If you have cuts or scrapes in your skin, or a poison ivy rash, make sure to keep the area clean and avoid scratching.
Impetigo can spread from one area of skin to another. If you touch it, your fingers can pick up the infection. If you then touch another area of skin, you can spread the infection there. Another way to prevent spreading is to wash your pillowcases and sheets every day.
To prevent the spread of impetigo to others, personal items such as soap and towels should be kept separate from other family members. Children who have impetigo should try to avoid contact with others until it clears up.
Impetigo usually is treated with antibiotics. Sometimes a topical skin cream such as mupirocin (Bactroban) is prescribed. Covering the area with gauze and tape or a loose plastic bandage can help reduce the risk of spreading the infection to other parts of the body. For impetigo that affects a large area of skin, or for impetigo that causes little blisters, antibiotic pills are often used. Regardless of how you picked it up, what's important is that you get the right treatment.
• Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: AskDoctorK.com.