Skin Infections

Common Skin Infections on Kids in Singapore

1. Impetigo

Impetigo is a very common bacterial infection of the skin in young children. It commonly presents with honey coloured crusts in the face, arms and body. It can be red, itchy and sore or asymptomatic. It is common in children with eczema.

Common Causes

It is caused by a bacteria called staphylococcus aureus. These germs like to reside (commensals) in our nostrils, armpits and groin where they do not cause any problems. However, when there is damage to our skin (for example, cuts, grazes, insect bites and eczema) these germs invade the affected skin and cause problems. It can also spread within the patient and from person to person by direct skin to skin contact.

Treatment Method

Swabs from the skin can be sent to confirm the diagnosis. The affected area will require topical medications and oral antibiotics in severe cases. Most of the patients recover from the infection. However, a small minority of patients can progress to a more severe disease. Thus, impetigo should be quickly diagnosed and managed.

What can I do?

  • Avoid sharing of personal items among family members.
  • Advise the older children not to touch the lesions and prevent others from touching it too.
  • Hand hygiene is important. Always wash hands with soap and water before and after touching the area.
  • Treat any underlying eczema quickly.
  • Watch for similar lesions in the other children.

2. Molluscum Contagiosum

Molluscum is a common viral infection of the skin that affects children and young adults. It appears as small dome-shaped spots and can be mildly itchy. It is common in children with eczema.

Common Causes

It is caused by a pox virus. It can spread to other parts of the skin or to others when there is direct contact with the spots or if they share clothing and towels.

Treatment Method

The condition can self resolve but it can take up to 6 – 18 months. However, during this time there maybe development of new ones whilst old spots are clearing and it can spread to other children in the family as well. Thus, treatments are recommended to speed up the recovery. Treatments aim to induce inflammation and include topical medications, scraping and freezing the lesions.

What can I do?

  • Avoid sharing of personal items among family members.
  • Treat any underlying eczema quickly.
  • Watch for similar lesions in the other children.

3. Viral Warts

Viral warts are small thick rough lumps on the skin, hands and feet and nails. They are common in children and adults. They are non cancerous but can be unsightly and cause pain or discomfort when pressed on.

Common Causes

It is caused by human papillomavirus. It spreads directly by close skin-to-skin contact with the affected lesions. The risk is increased in damaged, macerated and wet skin.

Types of Warts

Common warts most commonly occur on the hands and around the nails. They may occur as single or multiple lesions, and appear as flesh coloured papules with a rough surface. They may bleed if the surface is scratched or pared. Flat warts occur commonly on the face, neck, arms and legs. They are usually smooth and flesh coloured papules. Plantar warts occur on the soles of the feet and toes and maybe painful on applying pressure over the areas.
Ano-genital warts occur around the genitals. In view of the location, it is important to consider STI, although it can be transmitted through non sexual contact as well.

Treatment Methods

Although some studies have shown that some warts can spontaneously resolve, this can take months to years and often there can be new lesions before the old ones disappear. Hence, the warts can be treated to hasten the recovery process. Treatments for young children include topical medications and cryotherapy treatment. However, these require multiple visits and take a long time to clear. For adults and older children, electrocautery or laser treatments can be used to clear the lesions quickly.


This is a highly effective therapy for warts. This maybe painful and not suitable for younger patients. Liquid nitrogen, at a temperature of -196oC to the wart with a cotton tipped applicator or via a spray gun, for 10 to 20 seconds. The number of applications per treatment session depends on the size of the wart and its location. Treatment is best repeated 1-3 weeks interval until the wart resolves. A blister may form at the site of the cryotherapy. If the blister is small, it maybe left alone. If the blister is large and painful, come back to the clinic for treatment of the blister.

What can I do?

  • Avoid touching or picking at the warts.
  • If there is warts on the foot – avoid sharing footwear, change socks daily.
  • Treat warts early as they can spread to other parts of the family or among family members too.

4. Tinea

Tinea or ringworm is a type of skin infection caused by a fungus. It looks like a red skin rash that forms a ring around normal-looking skin.

Causes of Tinea Infections

A ringworm infection is not caused by an actual worm. It is caused by fungi on the skin, hair and nail beds called dermatophytes. Different types of dermatophytes affect different parts of the body. Children are at risk of Tinea infections if they share the clothes, personal items with infected people. A weak immune system either due to illness/ medications can also increase the risk of Tinea infections.

Types of Tinea infection

  1. Scalp ringworm (Tinea Capitis) - Scalp ringworm is highly contagious, especially among children. It occurs mainly in children between the ages of 2 and 10. It rarely occurs in adults.
  2. Body ringworm (Tinea Corporis) - This skin infection is characterised by a ring-like rash anywhere on the body or the face. It occurs in all ages, but is seen more frequently in children. It is more common in warmer climates.
  3. Athlete's foot (Tinea Pedis) - This common condition mostly affects teen and adult males. It less frequently affects children before puberty. Contributing causes include sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather conditions.
  4. Nail infection (Tinea Unguium) - An infection of the fingernail or toenail, this type is characterised by a thickened, deformed nail. This condition affects the toenails more often than the fingernails. It occurs more often in adolescents and adults rather than young children.

Symptoms of Tinea infection

  • Body - Red ring like patches with itch and scaling
  • Scalp - Scaly rash with hair loss, boggy swellings with discharge
  • Feet - itchy rash with scaling and blisters, whitish discolouration of skin in between toes
  • Nails - thickening and yellowish discolouration of the affected nails

How are Tinea infections diagnosed in Singapore?

Ringworm is usually diagnosed based on a medical history and physical examination of your child. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical examination. In addition, a culture or skin scraping of the lesion to confirm the diagnosis.

Treatment Methods

Because the fungi can live indefinitely on the skin, recurrences of ringworm are likely and treatments are often repeated. Specific treatment will be determined based on:

  • Child's age, overall health, and medical history
  • Extent of the condition
  • Location of the ringworm

Topical treatment are used most commonly in children - anti fungal shampoo, powders and creams.

Oral anti-fungals are used for persistent cases that do not respond to topical treatments.

5. Scabies

Scabies is a common skin infection on kids caused by the mite, Sarcoptes Scabiei. This mite only lives on human skin, where it lays its eggs. The eggs take a week to hatch and the mite lives for 30 to 60 days.

Causes of Scabies

Scabies is transmitted by direct contact with an infected person. It can spread through shared bedding and clothing. Re-infection can occur if other infected family members are not treated at the same time. It spreads very fast in nursing homes and crowded facilities

Symptoms of Scabies

  • Severe itch usually worsens at night
  • Skin rash including red, scratched bumps over the webspaces between fingers, toes, wrists, ankles, armpits, waist and genitals.
  • When there is excessive scratching, bacterial infections can occur on the skin too.
  • Even after treatment, itch can last for months.

Can we confirm Scabies diagnosis?

Sometimes, the mites may be seen from scrapings of the skin rash. However, a negative result does not exclude presence of scabies and if there is a clinical suspicion then it should be treated first.

Treatment Methods

  • Topical treatment is usually used in scabies. It needs to be applied in appropriate amounts to the required body surfaces and treatment needs to be repeated as per the doctor’s advice.
  • Topical permethrin
  • Topical malathion
  • Oral ivermectin is used for severe and persistent cases.
  • All close contacts need to be treated to minimise re-infection. Bed sheets, clothing require thorough cleaning, preferably in a washing machine.

What can I do ?

  • If you suspect scabies, immediately see a doctor to confirm the diagnosis and start treatment.
  • Ensure all infected family members and close contacts are treated quickly and thoroughly to minimise re-infection
  • Ensure all beddings, towels, clothes are washed to prevent reinfection


Are skin pigmentation disorders serious?
Hyperpigmentation is generally harmless and isn't a sign of a serious medical condition. Hypopigmentation conditions such as vitiligo may require further treatment.
How can I increase my skin pigment?
Eating certain vitamin C–rich foods like citrus, berries, and leafy green vegetables may increase melanin production.
Should I treat skin pigmentation?
If you suspect your skin pigmentation is getting bigger or causing you concern, consult a dermatologist.
Can skin pigmentation go away completely?
For some types of skin pigmentation disorders, it can take several rounds of laser treatment to remove patches completely, while some can fade with skin lightening creams.



Dr Uma Alagappan is a MOH accredited consultant dermatologist in private with more than 15 years experience as a medical doctor. She sub-specialises in paediatric dermatology, women’s dermatology and general dermatology. Dr Uma’s interests include chronic eczema, food allergy and immunodermatology. She is also well versed with the use of lasers for treating paediatric and adult patients.
Dr Uma completed her dermatology training in Changi General Hospital and National Skin Centre in 2015. She joined KKH Dermatology Service to subspecialize in paediatric dermatology in 2017. She was awarded the Ministry of Health Manpower Development Plan Award in 2019 to pursue paediatric immunodermatology and allergo-dermatology in the renowned Boston Children’s Hospital, Massachusetts, USA. Upon her return, she spearheaded a number of clinics at KKH including the food allergy eczema clinic for the paediatric eczema patients, immunodermatology clinics and the psychology eczema multi-disciplinary clinics.
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Fax: +65 6592 1411

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321 Joo Chiat Pl, #05-01A Parkway East Specialist Hospital, Singapore 427990

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Tel: +65 6320 0310

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290 Orchard Road 09-01/02 Paragon Medical Centre, Singapore 238859

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