Key points to remember about impetigo

• impetigo is a common skin infection in children caused by bacteria
• impetigo is very contagious (catching) and can be easily spread to other children
• try to prevent your child scratching the sores as much as possible; cover sores with a watertight dressing and cut your child’s fingernails
• your child can go back to school, kindergarten or day care after 24 hours of treatment and when the sores are completely covered with dressings
• continue medical treatment until all sores are healed

What is impetigo?

Impetigo is a skin infection. It is often called “school sores” because it is common in school children and it spreads amongst them quite easily.

What causes impetigo?

Impetigo is caused by bacteria (usually by one of two bacteria called either Staphylococcus aureus or Streptococcus pyogenes). These bacteria can live on the skin, in the throat or nose, or on other parts of the body without causing a problem but sometimes they start to cause an infection such as impetigo.

Impetigo can occur even when the skin is kept clean; it is not a sign of poor parenting. It can occur on healthy skin but it often happens when the skin has already been damaged by a scratch, bite or condition such as eczema or chickenpox. See the following fact sheets on this website:

What are the signs and symptoms of impetigo?

• the sores can be anywhere on the body, but most often occur on exposed areas such as the face (near the mouth and nose), or on the hands, arms or legs
• impetigo usually starts with a blister or a group of blisters
• the blister bursts leaving a patch of red, wet skin which weeps or oozes
• the spot usually becomes coated with a tan or yellowish crust, making it look like it has been covered with honey; it grows larger day by day
• there can be small spots around the first spots, spreading outwards
• impetigo is usually itchy

See Acknowledgements for these images.

How is impetigo spread?

When should I seek help for impetigo?

You should see your doctor as soon as you suspect your child has impetigo.

If treated promptly, impetigo is not usually a serious infection but untreated impetigo can lead to serious illness.

Go back to your GP if you have started treatment and:

• the sores do not begin to heal within two days
• more sores develop
• redness spreads around a sore
• your child is unwell with a fever or you are worried about their symptoms

What is the treatment for impetigo?

• treatment depends on how far the impetigo has spread and how severe it is
• your doctor may prescribe either an antibiotic or antiseptic ointment applied to the affected area or antibiotics taken by mouth (or both)
• if antibiotic medicine is prescribed, give it to your child as recommended by your doctor; it is important to finish the full course of medical treatment, even if the sores have healed
• gently clean the crusts or oozing sores by soaking a clean cloth in a solution and applying to your child’s sores several times a day; you can make up one of the following solutions:
  - half a cup of white vinegar in a litre of warm water
  - soap and warm water
  - half a teaspoon of salt in a cup of warm water
  Alternatively, you can use an antiseptic solution such as Savlon or Dettol (follow the directions for making the solution on the bottle)
• try to prevent your child scratching the sores as much as possible; cutting your child’s fingernails can help prevent damage and infection from scratching
• cover sores with a watertight dressing to prevent the infected fluid and crusts from spreading
• using an antiseptic soap may prevent the infection spreading to other parts of the body

Impetigo should clear up in a few days with treatment but may need to be treated again if the sores recur.

How to reduce the spread of impetigo

Keep your child home from school, kindergarten or day care until they have had 24 hours of treatment. Make sure their sores are completely covered by dressings.

Your child should avoid swimming until all the sores have healed.

Wash your child’s clothes, towels and bed linen separately from the rest of the family. Wash them in hot water and dry in the sunshine or a hot tumble dryer. Toys can be washed using a mild disinfectant.

The following measures may also reduce the risk of impetigo:

• taking a daily bath or shower with soap and water
• using antiseptic soaps (although these can irritate the skin of some people)
• practising good hygiene - wash hands regularly (especially important if you are in contact with someone with impetigo), throw away used tissues
• putting all dressings in a bin with a lid as soon as they are taken off
• cutting your child’s fingernails short and keep them clean
• thoroughly washing grazes or cuts; if your child is scratching a sore, cover it with a dressing

Where to go for more information about impetigo

On this website
Serious skin infections

Impetigo pamphlet (Auckland Regional Public Health Service)
The pamphlet is also available in Samoan and Tongan.

Acknowledgements

This fact sheet has been adapted from:

• The Royal Children’s Hospital (Melbourne) Kids Health Info for parents: Impetigo (school sores) 

• Community and Public Health. Canterbury District Health Board. 2004. Impetigo (School sores)

Images of impetigo on this page have been reproduced, with permission, from the website of the New Zealand Dermatological Society Incorporated. Published online at: www.dermnetnz.org