Recurring Impetigo

My son turned 2 years old last December, and currently has a circular red rash on his chin.  It is really red, raised and has little blisters in it.  It is also forming the honey crusty scabs and was diagnosed as Impetigo by his pediatrician.  My question concerns recurring impetigo.  My son first broke out with this in mid-December and has since broke out in the same spot about 4 other times.  Each time we use the Bactroban he was prescribed and it usually goes away within a few days.  This last break out a few days ago happened practically over night and was a lot worse than the times before.  We took him in and his doctor again said that it was Impetigo and prescribed Trimox and more Bactroban.

I'm starting to worry about why this keeps breaking out and why we can't seem to get rid of it completely.  Could it be that I'm not cleaning the house well enough? (it's not dirty, but not spotless either) Or, could the humidifier be causing extra germs in the air?  Also, eczema and psoriasis run in the family, but I have psoriasis and this doesn't look dry and scaly  to me at all, so I'm in agreement with the pediatrician that this is impetigo.  I'm also starting to worry about complications arising, scarring, etc.  

Can you suggest something that will help get rid of this for good?

Thanks,
Dena

[Alan Rockoff, MD]

Dena:

Getting impetigo in the same place over and over is not the norm.  Although I am by no means sure about this, another condition worth looking into is a herpes cold sore (kids get 'em too.)  This also produces honey-colored crusts, and recurs in the same place.  I suggest that if he or she has not already done so, your pediatrician performs a bacterial and viral culture the next time either kid gets an outbreak.

Scarring is unlikely in either of these very superficial conditions, and cleanliness has nothing to do with it.  Treatment differs, of course.

Best.

Dr. Rockoff

[rosess]

A related discussion, impetigo was started.