Staphylococcal Scalded Skin Syndrome (SSSS) in Children

What is staphylococcal scalded skin syndrome?

Staphylococcal scalded skin syndrome (SSSS) is a response to a Staphylococcus “staph” infection. It causes a reddening and blistering of the skin that gives it a scalded or burned look.

SSSS is most common in infants and children, but can also affect adults with a depressed immune system or problems with kidney function. The condition can range from mild to life-threatening, though it is usually not life-threatening in children.

What are the symptoms of SSSS?

The condition often begins with a low-grade fever and general redness of the skin. The skin may feel like sandpaper and look wrinkled.

The rash usually spreads quickly and may especially affect the area around the mouth as well as areas of skin that are creased, such as the arms, groin, legs and neck. This is followed by the formation of fluid-filled blisters that rupture easily. The top layer of skin may start to peel away off in sheets, revealing reddish, moist skin below.

Other symptoms may include:

  • weakness
  • joint and muscle pain
  • chills
  • not feeling well

What are the causes of SSSS?

Staphylococcal scalded skin syndrome is caused by a toxin produced by a staph infection.

How is SSSS diagnosed?

Staphylococcal scalded skin syndrome is usually diagnosed based on medical history and complete physical exam. In some cases, the doctor may order a skin biopsy to confirm the diagnosis. This test involves taking a small piece of skin to check under a microscope.

What are the treatment options for SSSS?

The treatment options will depend on the severity of your child’s condition. Common treatments include:

  • antibiotics to fight the infection
  • creams and ointments to help soothe affected skin
  • fluid replacement
  • over-the-counter pain medication

With treatment, most children start feeling better within one to two days. The skin is often completely healed a few days later. Some children may have some dry peeling of the skin, which is harmless, a week to ten days later.

Children with more severe cases may need to stay in the hospital for treatment. In rare cases, children may need to be treated in a specialized burn unit.

How we care for staphylococcal scalded skin syndrome

The Division of Infectious Diseases at Boston Children's Hospital cares for children and adolescents with a variety of infections. We also are dedicated to researching better ways to diagnose, treat and prevent infectious diseases.