Impetigo occurs when a break in the skin, such as one caused by a bug bite or a small scratch or scrape, comes in direct contact with Streptococcal or Staphylococcal bacteria. In young children, who often play in bacteria-laden sand piles and backyard dirt, the bacteria lodges under their fingernails and then enters the body when the children touch a bite or scrape. Impetigo occurs most often on the face, arms and legs. The disease can spread over a child's body through scratching or rubbing a towel across a sore and then using the towel on other body parts. The disease spreads to others through direct body contact or through sharing of towels, bedding or clothes. Young children whose play often involves direct body contact are extremely vulnerable to impetigo.

The disease is most common in hot, humid weather when insect bites abound and make a child's body vulnerable to infection. The disease usually begins with a reddish spot or bump on the skin. Yellow pus accumulates and dries, leaving a honey colored scab that can be itched. Generally not considered a serious disease, impetigo does need prompt attention to stop the spread of the infection to other people.

In extreme cases, the infection can invade a deeper layer of skin and develop into eczema, an ulcerate form of the disease in which small, pus-filled ulcers with a crust much darker and thicker than that of ordinary impetigo. Eczema can be very itchy and can cause permanent scars and pigment changes if untreated. In about one percent of cases, mainly in children, a kidney disease, glomerulonephritis, can develop from impetigo. Symptoms include nausea, headaches, low urine output or puffiness around the face and on limbs.

"As with many infections, the best defense is a good offense," says David Kern, president of DAK Pharmaceuticals, makers of popular skin care products that offer protection against outdoor hazards and treatment for problems that do occur. "Impetigo is just one reason why you and your children should avoid bug bites by making sure you are protected with proper clothing and with insect repellents that are appropriate for children. Also, if a bite does occur, you should use a bite remedy to help relieve the itching that causes the child to scratch a bite."

"Stopping insect bites in the first place is the best way to fight impetigo," says Kern.