Impetigo
Also known as School sores
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is impetigo?
Impetigo is a superficial bacterial skin infection that produces blisters and characteristic honey coloured crusts, most often around the nose and mouth. It is very contagious, spreading by direct contact and shared items, and is common in children. It responds quickly to antibiotic treatment.
Causes
- Staphylococcus aureus bacteria, the most common cause
- Group A Streptococcus
- Entry through broken skin from eczema, bites or cuts
- Direct contact with an infected person or their towels
Symptoms
- Red sores that burst quickly
- Golden or honey coloured crusts
- Blisters that may be fluid filled
- Itching but usually little pain
- Most often around the nose and mouth
- Spread to other areas by scratching
- Swollen glands in some cases
Risk factors
- Age 2 to 5 years
- Existing eczema or skin damage
- Warm humid weather
- Close contact settings such as nurseries
- Scabies or head lice causing scratching
- Weakened immune system
Diagnosis
- Clinical diagnosis from the characteristic crusting
- Skin swab for culture in recurrent or resistant cases
- Assessment for underlying eczema or scabies
- Checking household contacts
Treatment
- Hydrogen peroxide cream for very localised infection
- Topical antibiotic such as fusidic acid
- Oral antibiotics for widespread or bullous impetigo
- Treating underlying eczema or scabies
- Staying off school until crusts have healed or 48 hours of antibiotics
Self care
- Wash the affected area gently with soap and water
- Keep sores covered with a loose dressing where practical
- Wash hands after touching the area
- Do not share towels, flannels, bedding or clothing
- Discourage scratching and keep nails short
- Wash towels and bedding on a hot cycle
- Complete the full antibiotic course
When to see a doctor
Book an appointment if:
- Suspected impetigo, since antibiotics are usually needed
- No improvement after 48 hours of treatment
- The rash spreading rapidly
- Recurrent episodes
- Impetigo in a newborn
- Underlying eczema flaring at the same time
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Treat eczema and skin breaks promptly
- Wash hands regularly
- Do not share towels or personal items
- Keep nails short to reduce scratching damage
- Cover sores and stay off school until no longer contagious
Outlook
Impetigo heals within seven to ten days of starting antibiotics and usually leaves no scarring, since the infection is superficial. Rarely, streptococcal impetigo is followed weeks later by kidney inflammation, which is why dark urine or facial puffiness afterwards should be reported.
Common questions
How long is it contagious?
Until the sores have dried and crusted over, or 48 hours after starting antibiotics. Children can return to school at that point rather than waiting for the skin to look completely normal.
Why does my child keep getting it?
Recurrence usually points to an underlying cause such as eczema, scabies or nasal carriage of staphylococcus. Treating that, rather than repeating antibiotics alone, is what breaks the cycle.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.