Key points to remember about school sores

• school sores (impetigo) are common in children
• school sores are skin infections caused by bacteria
• school sores spread between children very easily
• try to prevent your child scratching the sores as much as possible - cover sores with a watertight dressing and cut your child's fingernails
• wash hands with soap and dry thoroughly before and after touching the skin or sores 
• your child can go back to school, kindergarten or daycare one day after the start of treatment and when the sores are completely covered with dressings
• continue medical treatment until all sores are healed

What are school sores?

School sores (impetigo) are skin infections. They are often called 'school sores' because they are common in school children and spread easily.

What causes school sores?

Schools sores are caused by bacteria. The most common bacteria are Staphylococcus aureus and 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 school sores.

School sores can happen even when you keep your child's skin clean. It is not a sign of poor parenting. School sores can happen on healthy skin but they often happen when the skin has already been damaged by a scratch, bite or condition such as eczema or chickenpox. 

What are the signs and symptoms?

• the sores can be anywhere on the body, but most often appear on exposed areas such as the face (near the mouth and nose), or on the hands, arms or legs
• school sores may start as 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
• school sores can be itchy

How are school sores spread?

School sores spread easily while they are weeping or oozing.

When should I seek help for school sores?

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

With early treatment, school sores are not usually a serious infection but untreated school sores can lead to serious illness.

You need to go back to your family doctor if:

• the sores do not begin to heal within 2 days
• more sores develop
• redness spreads around a sore
• sores have pus in them
• your child is unwell with a fever or you are worried about their symptoms

Occasionally, school sores can lead to other skin infections such as boils or cellulitis. See Boils in detail [1] and Cellulitis [2]. 

What is the treatment for school sores?

• treatment depends on how far the school sores have spread and how severe the infection is
• your child may get an antiseptic cream or antibiotic medicine from your doctor - your child may need both 
• it is important to take the antibiotics every day until they are finished, even if the school sores seem to have cleared up earlier
• gently wash the sores with warm water and a soft cloth - wash the sores until the crust comes off and wash away the pus and blood
• 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
• make sure your child washes their hands with soap often, and dries them thoroughly

School sores should clear up in a few days with treatment but your child may need treatment if the sores happen again.

How can I reduce the spread of school sores?

Keep your child home from school, kindergarten or daycare until one day after the start of treatment. Make sure the dressings completely cover their sores.

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. You can wash toys in a mild disinfectant.

The following may also reduce the risk of school sores:

• taking a daily bath or shower with soap and water
• practising good hand hygiene - wash hands with soap regularly 
• putting all used tissues and dressings in a rubbish bin with a lid 
• cutting your child's fingernails short and keeping them clean
• thoroughly washing grazes or cuts - if your child is scratching a sore, cover it with a dressing