Dr Phil Kieran: My three-year-old has an angry scab on his chin he won't stop picking

Unfortunately, stopping kids from picking at something that is pickable is very difficult.

Dr. Phil Kieran

GENERAL PRACTITIONER

My three-year-old son has an angry-looking impetigo on his chin. The doctor prescribed an antibiotic cream which has helped. But he keeps picking the scab, which is slowing the healing. What would you suggest?

Unfortunately, stopping kids from picking at something that is pickable is very difficult.

Impetigo is a skin infection caused by a bacteria called Staphylococcus (Staph) aureus. This bug can frequently live on our skin causing no problems for years and years. Then something changes, and the skin’s defence weakens, and all of a sudden, there is a big, angry-looking red rash with a yellow crusty surface spreading across the face.

An ointment can be very successful but if your son can’t leave it alone and it is spreading even with this treatment, he may need to go on some oral antibiotics to clear it up.

To prevent the picking, you could try covering the wound with a plaster or other adhesive dressing, but beyond that, it’s just a matter of encouraging him not to pick and reapplying the ointment whenever he wipes or picks it off.

Try and figure out why the infection happened. 

The most likely reason for impetigo on the chin area in a child this age is that something is harming the skin. The most common cause is that the skin is wet a lot of the time. This is usually caused either by pacifiers still being used (which trap saliva between the pacifier itself and the face), kids chewing on the top of the zip of their coat or clothes or sucking their thumb. 

Breaking any of these habits can be difficult but it is critical to start trying to prevent this infection from re-occurring in the future. In teenagers, it is more likely to occur through injuries due to shaving or picking at spots.

When there is a case of impetigo in the house, it is important to bear in mind that it can be contagious, so make sure that there isn’t any sharing of towels and that all clothes or towels are washed at a high temperature after being exposed to the lesion to kill bacteria that have hitched a ride.

Impetigo looks worse than it is and often once it starts to heal, it resolves quickly and completely — even with a child who can’t leave it alone.

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