Staph scalded skin syndrome in children: causes and treatments

Staph scalded skin syndrome in children
Medically reviewed by Dr. Devindra Bhatt

Key Takeaways

  1. Staphylococcal scalded skin syndrome (SSSS), also known as Ritter’s disease, is a skin condition with the signs and symptoms of redness, blistering, peeling, and painful surface of the skin. 
  2. It is caused due to the direct or indirect transmission of the bacteria Staphylococcus aureus in the body from hospital settings or any surface area. It will progress with stages starting from redness in localized areas to all over the surface. 
  3. In case of visible signs and symptoms, it is good to seek medical consultation for the correct diagnosis as well as treatment at the right time.


Staphylococcus skin syndrome is a serious skin condition that can affect both adult and infant populations as per the mode of transmission. This bacteria gets inside the body from the carrier and releases toxins into the body. Toxins released initiate symptoms like redness and itching on the skin, leading to severe irritability in an infant as well as in an adult. Redness will be followed by blistering and then peeling of the skin. Getting the right diagnosis at the right time will help get the right treatment to avoid the severity of the infection. 

The blog contains all the aspects of scalded skin syndrome and how it will be diagnosed and treated.

What is scalded skin syndrome?

Scalded skin syndrome, often referred to as staphylococcal scalded skin syndrome (SSSS) and Ritter’s disease, is a skin condition mostly observed in newborn infants, young children, and adults with weak immune systems, especially with kidney disease. This is a rare medical condition caused by bacteria named Staphylococcus aureus. Some of the specified strains of this bacteria lead to this disease as they release exfoliative toxins, causing extreme exfoliation effects on the skin. 
This disease is not specified to any part of the skin. Instead, it can cover the whole body. It is also termed Ritter’s syndrome and can present within 48 hours of birth in newborns.

Are you noticing any red patches on your baby’s skin? It’s serious. Get a diagnosis now.

What causes staphylococcal scalded skin syndrome in newborns?

Newborns can transmit and acquire it to cause SSSS in different ways. The following are the main causes of the bacterium getting transmitted to the baby and causing staphylococcal scalded skin.

1. Transmitted from the mother

The bacterium staphylococcus can affect the baby during or after childbirth. One of the most common causes of SSS in newly born infants is getting the bacterium from the bearing mother, where the mother was exposed to this staphylococcal strain. This type of transmission is called vertical transmission.

2. Healthcare settings

Hospitals and healthcare settings are also common routes for the transmission of the bacterium to newborn infants, especially in Neonatal Intensive care units (NICUs)  in case of the outbreak or spread of the strain in the hospital. The probability of this is rare until the SOPs are compromised.

3. Compromised hygiene

Any person taking care of the newborn and in close contact can transmit the bacteria if he or she is the carrier of this specific strain. It can be avoided altogether if hygiene is practiced strictly by the carrier and all the caregivers in close contact with the infants. 

Once the bacteria enters the body of the newborn, it starts showing its effect, leading to SSS all over the body, and can get intense with time.

What does scalded skin look like?

Skin affected with the scalded skin syndrome looks like this: 

  1. Resembling sunburn: Skin affected with the SSS-causing bacteria will appear red and resemble severe sunburn or generally a burn on the skin. 
  2. Blisters on the surface: Topical skin will be covered with small and large bulgings, bumps or blisters. they are usually fluid-filled 
  3. Peeled patches on the skin: after the disease progresses and gets severe, you will observe the peeled surface, after which the raw, new, and moist skin underneath the peeled one comes out. 
  4. Pain and sensitivity: a child’s skin would be more sensitive to topical creams or exposure, including heat, due to blisters and peeling. It will eventually make a child more irritable.
Worried about the blistering and peeling on the baby’s skin? get medical consultation now.

How is scalded skin syndrome diagnosed?

A few clinical evaluating procedures can diagnose scalded skin. 

  1. Physical examination: A physical examination will be held of the skin to learn any characteristic signs and symptoms, including blistering, peeling, or redness of the skin. 
  1. Blood tests: Your healthcare provider will perform blood tests as prescribed to get the correct diagnosis. Increased white blood cells and inflammatory markers in the test can confirm the presence of infection in the body.

Biopsy: In some cases, a biopsy can also be performed as prescribed by healthcare providers, where the piece from the affected skin is taken and tested in the laboratory for the diagnosis of a bacterial-specific strain.

How do you treat scalded skin syndrome in infants?

  • Initial hospitalization to avoid any further transmission of the bacteria and optimize treatment accordingly. 
  • Antibiotics (mostly IV in the case of infants ), including Vancomycin, cefazolin, Nafcillin, or Oxacillin, will be prescribed by healthcare providers as per the severity of the infections. 
  • Supportive care will be provided in the hospital setting, e.g, Dextrose intravenous preparations in case of dehydration or fluid, and wound care by providing required antiseptic solutions and bandages. 
  • Continuous monitoring and evaluation will be provided to increase the severity and avoid further transmission of the bacteria.
Medical consultation plays a critical role in diagnosing SSS and treating it at the right time. Get a virtual consultation now at home.

What are the stages of staph scalded skin syndrome?

There are no specific stages of this disease, either in young or adults, but as the disease progresses, different diagnostic and visible symptoms can indicate the stages showing the severity of the disease. 

Following are the steps of disease progress: 

  • It often starts with nonspecific symptoms like irritability and mild skin redness, making it difficult to diagnose this condition at first.
  • After the disease progresses a little more, visible patches of skin redness can be observed, e.g, in the diaper area in the infants. After showing on localized area, it starts to spread all over the body. 
  • When the redness covers the body, clear fluid-filled blisters will appear all over the surface of the skin, which will be fragile. They will cover almost every part of the body and will be easily ruptured on touching.
  • In the end, when the disease shows its peak, the skin will start to peel off the surface of the skin and cause pain. It will also lead to generalized sensitivity of the skin.

Is scalded staph contagious?

Scalded staph is contagious and can spread from one person to another. There can be different modes of transmission:

  • Direct transmission, where skin-to-skin contact with the carrier of this bacteria happens (e.g, the blister’s fluid, nasal fluid ), leads to having this disease. This type of transmission mostly occurs in healthcare and hospital settings. 
  • Indirect transmission is also the mode of transmission of this bacteria where the staphylococcus bacteria attacks you and enters your system through different objects and surfaces you touch. This bacteria has the ability to survive without a host for several hours and will cause SSS.

How serious is a staph skin infection?

Every medical condition that can not be cured on its own in 2-3 days is serious and needs proper medical consultation. SSS seriousness in the body can vary depending on its severity, the stage to which it has progressed, and how early it was diagnosed and treated. Physical examination and a keen eye on the skin surface of the infant can help you get the correct diagnosis at the right time when the disease has not yet progressed.

Are you or your baby experiencing any of the signs or symptoms stated? Get medical consultation at the ease of your home.

Consult your doctor

Consulting your healthcare provider will benefit you in getting the right diagnosis at the right time when the SSS has not yet progressed and will treat it the best possible way. It’s always good to never ignore the visible signs and symptoms, including blistering and peeling, and get yourself checked as soon as possible.

FAQs about staph scalded skin syndrome in children

What is the survival rate of staphylococcal scalded skin syndrome?

The survival rate of staphylococcal scalded skin is quite high if it gets diagnosed and treated promptly. It’s good to get a medical consultation as soon as you notice any red rashes, blistering, or peeling on the skin.

How long does staph scalded skin syndrome last?

If the scalded skin is acute and in its initial stage where just the redness appeared and got diagnosed, It will only stay for 3-4 days. If it’s severe, it can take several weeks to go away. Note that it needs medical attention and medications prescribed by a healthcare provider for the proper treatment.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Handler, M. Z., and R. A. Schwartz. “Staphylococcal scalded skin syndrome: diagnosis and management in children and adults.” Journal of the European Academy of Dermatology and Venereology 28.11 (2014): 1418-1423.
  • Ladhani, Shamez, and Robert W. Evans. “Staphylococcal scalded skin syndrome.” Archives of disease in childhood 78.1 (1998): 85-88.
  • Melish, Marian E., and Lowell A. Glasgow. “The staphylococcal scalded-skin syndrome: development of an experimental model.” New England Journal of Medicine 282.20 (1970): 1114-1119.
  • Patel, Girish K., and Andrew Y. Finlay. “Staphylococcal scalded skin syndrome: diagnosis and management.” American journal of clinical dermatology 4 (2003): 165-175.
  • Blyth, Moira, Catalina Estela, and Amber ER Young. “Severe staphylococcal scalded skin syndrome in children.” Burns 34.1 (2008): 98-103.
  • Melish, Marian E., and Lowell A. Glasgow. “Staphylococcal scalded skin syndrome: the expanded clinical syndrome.” The Journal of Pediatrics 78.6 (1971): 958-967.

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