Cellulitis, impetigo, scabies and lice: nursing care, isolation and teaching
- Safe practice
The nurse watches cellulitis for spread, stops impetigo, scabies and lice passing to others, and teaches hygiene and laundry.
What it is
Skin infections and infestations are common on the ward and in the community. Cellulitis is a bacterial infection of the deeper skin that can spread fast; the nurse watches its edge, elevates the limb and looks for signs that it is getting worse. Impetigo, scabies and lice spread to other people: impetigo through the fluid from its sores, scabies through prolonged skin-to-skin contact, lice mainly through head-to-head contact. The nursing job is to break that chain with gloves and gowns where needed, personal items that are not shared, correct laundry and treatment of contacts, and to teach the patient and family. Burns and sepsis have their own pages.
What it requires
- Cellulitis: red, warm, swollen, tender skin that spreads, sometimes with fever, chills and body aches.
- Impetigo: blisters that break easily and honey-coloured crusts; it spreads by scratching and by contact with the fluid.
- Scabies spreads by prolonged, direct skin-to-skin contact.
- Head lice spread mainly by head-to-head contact, less often by shared hats, combs, brushes, towels or bedding.
Components
- Watching cellulitis for spread and for signs of severe infection.
- Contact precautions for scabies during hands-on care.
- Hygiene of the skin and personal items.
- Laundry and handling of bedding and clothing.
- Finding and referring contacts, and teaching the family.
How it is applied (and why)
- Mark the edge of cellulitis redness as the protocol allows and compare it at each check: spread beyond the line shows the infection is advancing.
- Elevate the affected limb above heart level and encourage rest: this reduces swelling.
- Check temperature, pain, blistering and red streaks on the skin: they show whether the infection is getting worse.
- Look for skin breaks, such as cracks between the toes or ulcers, and keep the skin moisturised: breaks let bacteria in.
- For impetigo, wash the skin gently to lift crusts, without scrubbing, with a clean cloth and towel each time: the fluid spreads it.
- For scabies, wear gloves and a gown for hands-on care and wash your hands afterwards: mites pass by skin contact.
- Wash bedding and clothes on hot water and hot dryer cycles; seal items that cannot be washed in a closed plastic bag.
- Help identify people with prolonged skin contact before treatment so they can be treated too: untreated contacts reinfect the patient.
- For lice, teach not to share combs, brushes, hats or towels and to soak combs and brushes in hot water.
In nursing practice
- Cellulitis needs hospital care with high fever, low blood pressure, infection around the eye, failure of oral treatment or a weak immune system.
- Fever with low blood pressure in a patient with a skin infection needs urgent review: see the sepsis page.
- Items that cannot be laundered for scabies are kept in a closed bag for several days to a week; for lice, two weeks.
- Discarding mattresses or disinfesting the whole room is generally not necessary for scabies; for lice, vacuuming is enough.
- Lice: a live louse on the scalp confirms the infestation; nits close to the scalp suggest an active one.
Common mistakes
- Scrubbing impetigo crusts hard instead of washing them gently.
- Treating the patient with scabies but not the people in close contact.
- Using fumigant sprays or fogs for lice.
- Not reporting cellulitis that keeps spreading despite treatment.
Test yourself
Think of the answer, then tap the question to see it.
Why is the edge of cellulitis redness marked?
Comparing at each check shows whether the redness spreads beyond the line, which means the infection is advancing despite treatment.
How does impetigo spread, and what does the nurse teach?
Through contact with fluid from the sores. Wash gently without scrubbing, use a clean cloth and towel each time, and do not share towels, clothes or razors.
Which laundry measures are used for scabies?
Bedding and clothes go on hot water and hot dryer cycles; items that cannot be washed are sealed in a plastic bag for several days to a week.
Are fumigant sprays needed for head lice?
No. They are unnecessary and can be toxic; washing used items on hot cycles, soaking combs and vacuuming are enough.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Cellulitis (MedlinePlus, U.S. National Library of Medicine, 2025); Impetigo (MedlinePlus, U.S. National Library of Medicine, 2025); Public health strategies for scabies outbreaks in institutional settings (Centers for Disease Control and Prevention (CDC), 2025); About head lice (Centers for Disease Control and Prevention (CDC), 2025).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.