Impetigo - Infected Sores

Is this your child's symptom?

• Coin-shaped sores on the skin covered by scabs
• The infected crusts are the color of honey
• Skin infection caused by a bacteria

Symptoms of Impetigo

• Sores smaller than 1 inch (2.5 cm)
• Often covered by a soft, yellow-brown scab or crust
• Scabs may drain pus or yellow fluid off and on
• Starts as small red bumps. These change quickly to cloudy blisters or pimples. Then, they become open sores which drain fluid or pus.
• Sores increase in size
• Any sore or wound that grows and doesn't heal is usually impetigo.

Cause of Impetigo

• A skin infection caused by a bacteria. It starts in a small break in the skin. Examples are a scratch or insect bite.
• The most common bacteria are Staph and Strep. If the child has a sore throat, they may also have Strep throat. A rapid Strep test will give the answer.
• Impetigo often spreads and increases in number from scratching.

When to Call for Impetigo - Infected Sores

Call Doctor or Seek Care Now

• Pink or tea-colored urine
• Fever and spreading redness around the impetigo
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Spreading redness around the impetigo and no fever
• Fever or sore throat are present
• Sore is larger than 1 inch (2.5 cm) across
• Sores and crusts inside the nose
• Impetigo gets worse after 48 hours on antibiotic ointment
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Impetigo in 2 or more children (such as siblings or play groups)
• Child plays contact sports. Reason: to prevent spread.
• 3 or more impetigo sores. Reason: may need an oral antibiotic. Many of these children also have a Strep throat.
• Not healed up after 1 week on antibiotic ointment
• You have other questions or concerns

Self Care at Home

• Mild impetigo (1 or 2 sores that started with a scratch or insect bite)

Care Advice for Impetigo

1. What You Should Know About Impetigo:
   • Impetigo is a skin infection. Most often, it starts in a scratch or insect bite.
   • It usually responds to treatment with any antibiotic ointment.
   • Here is some care advice that should help.
2. Remove Scabs:
   • Soak off the scab using soap and warm water. The bacteria live underneath the scab.
3. Antibiotic Ointment:
   • Put an antibiotic ointment (such as Polysporin) on the sores. No prescription is needed. You can also use one you already have.
   • Do this 3 times per day.
   • Cover it with a bandage (such as Band-Aid) to prevent scratching and spread.
   • Repeat the washing, ointment and dressing 3 times per day.
4. Do Not Pick at the Sores:
   • Help your child not to scratch and pick at the sores. This spreads the impetigo.
5. Return to School:
   • Impetigo is spread to others by contact with skin lesions.
   • Wash the hands often. Try not to touch the sores.
   • For mild impetigo (1 or 2 sores), can go to school if it is covered.
   • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours. Then your child can go back to school.
   • Contact Sports. In general, needs to be on antibiotics for 3 days before returning to sports. There must be no pus or drainage. Check with the team's trainer if there is one.
6. What to Expect:
   • Sore stops growing in 1 to 2 days.
   • The skin is healed in 1 week.
7. Call Your Doctor If:
   • Impetigo sore gets bigger after 48 hours on antibiotic ointment
   • Gets new impetigo sore on antibiotic ointment
   • Not healed up in 1 week
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.