Today, in most areas of the country, individuals are required to wear face masks to minimize exposure and the spread of COVID-19. The practitioner may not be aware that their client has either of these two skin infections until the face mask is removed.
Both herpes simplex and impetigo fall under the skin infection category. Both can look similar with blister-like appearances; however, herpes is viral in nature as opposed to impetigo, which is caused by bacteria. The practitioner should refer any client with these presentations to their medical provider and reschedule any skin care services until the lesions heal.
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COLD SORES
Herpes simplex virus or cold sores are a contagious, viral infection affecting an estimated 50 to 80% of Americans. The clinical name for cold sores is human alphaherpesvirus 1. There is no cure for herpes, making suppression from outbreaks the first course of treatment. Herpes simplex lies dormant between outbreaks. Each outbreak is typically short-term, resolving within a few days or weeks, but the condition itself can last several years or be lifelong.
CAUSES, SYMPTOMS, & TRANSMISSION
Once an infected individual has contracted this virus, additional outbreaks are typically related to stress or a compromised immune system. Before an outbreak, clients may feel tingling or burning. Next, blister-like clusters form, typically around the mouth or nose areas. Herpes simplex is usually transmitted through direct contact with an infected individual’s lesions.
DIAGNOSIS & TREATMENT
Herpes requires a medical diagnosis often using laboratory testing, either by a culture from the lesion or a blood test for antibodies. A viral infection should always be diagnosed and treated by a medical professional, typically with topical or oral medications. A cold sore can disappear on its own without treatment. However, many cold sore sufferers opt for over-the-counter or prescription medication for cosmetic reasons. Again, never proceed with any skin care treatment while lesions are present.
Prescription oral medications include valacyclovir (FDA approved since 1995), acyclovir (used since the 1970s), and penciclovir. Antiviral drugs inhibit the proliferation of viruses in the body. Regular use of an antiviral drug can make living with herpes much easier by accelerating the healing process post-outbreak and reducing the risk of transmission to others. The client can take these medications after an outbreak occurs, or daily, to suppress frequent outbreaks, reduce their severity, and minimize the risk of transmission.
OVER-THE-COUNTER DEVICES
Technology now allows the client to treat cold sores with infra-red light. The invisible infra-red light demonstrated enhancement of the local immune response to the cold sore infection. There are devices that are approved to treat cold sore with infra-red light technology. If used during the tingling phase, it can prevent an outbreak. When used after the blisters erupt, it speeds up the healing process.
IMPETIGO: SCHOOL SORES
Impetigo is a highly contagious, superficial pyoderma (bacterial skin infection). Impetigo is known to affect infants and children, especially school-aged children, thus, getting the name school sores. It accounts for approximately 10% of skin problems observed in pediatric clinics. It is the most common bacterial skin infection and the third most common skin disease amongst children.
There are two primary forms of impetigo. The first form is nonbullous, and it is responsible for 70% of cases, caused by the staphylococcus aureus bacteria (staph infection) or Streptococcus pyogenes (strep throat). The second type of impetigo is bullous. This type is responsible for 30% of cases and is due to staphylococcus aureus bacteria.
Impetigo is very common, with more than three million cases annually in America. It occurs more frequently in warm, humid environments making it more prevalent in the southeastern United States than in the northern states that have cooler climates. School sores tend to be more of a seasonal disorder, with peak breakouts during the summer and fall. In regions that remain warm and humid throughout the year, impetigo can cause breakouts year-round. Although this skin infection is commonly found in school-age children, it is very contagious and can be transmitted to adults.
CAUSES, SYMPTOMS, & TREATMENT
Staphylococcus aureus, a bacterium is the most common cause of impetigo. Another bacterial source is Group A Streptococcus. Red pustules and honey-colored, crusted erosions characterize impetigo. Red sores form in the perioral area, rupture, ooze for a few days, and then develop a yellow-brown crust. Impetigo also requires a medical diagnosis often with laboratory testing. Impetigo requires treatment by a medical professional using topical or oral medication. All lesions must heal before having a skin care treatment.
PRESCRIPTION ANTIBIOTIC MEDICATIONS
Antibiotics kill bacteria, shorten the bacterial outbreak, speed the healing process, and prevent spread to surrounding cells. Common topical and oral antibiotics used to treat impetigo include mupirocin, fusidic acid, amoxicillin or clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, and trimethoprim or sulfamethoxazole.
HOMECARE
Tea tree, olive, garlic, coconut oils, and manuka honey have claimed success in the improvement and treatment of impetigo; however, clinical studies are needed to prove that they are effective scientifically.
As a professional skin health provider, recognize that the client with cold sores or school sores must be referred to a medical provider. Always follow universal precautions with every client to prevent the spread of infection. When you see a client with lesions, glove up. Be sure that the workstation is completely disinfected before and after each client. Both cold sores and school sores can be contracted by merely encountering any instrument used during a service that has not been adequately disinfected. Empathize with the client while explaining that medical intervention is necessary to solve their skin infection. Be sure to reschedule the appointment as soon as the lesions heal.
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Brenda Linday is a licensed aesthetician, licensed aesthetic instructor, and certified aesthetic consultant with over 16 years’ experience in the medical aesthetic industry. Linday serves as a consultant for medical and aesthetic companies desiring to build strong sales and education teams. She develops clinical and sales education content, and trains sales and educational units, clinicians, physicians, and distributors around the world. Linday is also a featured author in many industry publications. Her passion is sharing her wealth of knowledge with other like-minded professionals who believe that education is the key to building lasting relationships with our clients, making each clinician more successful by increasing client satisfaction. Reach her at brenda@lindayconsulting.co or @LindayConsult.
