Impetigo

Impetigo is a common bacterial infection of the skin that can appear on many parts of the body. It can happen to anyone, of any age, but is more common in children. For this reason, it used to be called "school sores."

Causes

It’s normal to get scrapes on your body from activity or from scratching your skin. The skin normally has bacteria on it. Sometimes an impetigo infection can start on healthy skin. But it usually starts when there is an injury to the skin, or break in the skin. Although nothing usually happens, the bacteria normally on the skin can cause infection. This is the most common way people get impetigo.

Impetigo is very contagious. So once there is an infection, it needs to be treated so it doesn't get worse, spread to other areas, or to other people. Impetigo can easily be passed to other family members, friends, schoolmates, or co-workers, through scratching, rubbing, or touching an infected area. Common causes include:

  • After a cold

  • Bites

  • From another infected person

  • Injury to skin

  • Insect bites

  • Other skin problems that are infected, such as eczema

  • Scratches

Symptoms

There is often a skin injury like a scratch, scrape, or insect bite that may have gone unnoticed or been ignored before the infection began. Symptoms of impetigo include:

  • Red, inflamed area or rash

  • One or many red bumps

  • Bumps that turn into blisters filled with yellow fluid or pus

  • Blisters break or leak causing honey-colored crusting or scabbing over the area

  • Skin sores that spread to other surrounding areas

Home care

The following guidelines will help you care for your infection at home.

Wound care

  • Trim fingernails and cover sores with an adhesive bandage, if needed, to prevent scratching. Picking at the sores may leave a scar.

  • If the infection is on or around your lips, don't lick or chew on the sores. This will make the infection worse.

  • If a bandage or dressing is used, you can put a nonstick dressing over it.

  • Wash your hands and your child’s hands often. This will avoid spreading the infection to other parts of the body and to other people. Do not share the infected person’s washcloths, towels, pillows, sheets, or clothes with others. Wash these items in hot water before using again.

  • Clean the area several times a day. You don’t want to scrub the area. The best way to do this is to soak the sores in warm, soapy water until they get soft enough to be wiped away. This will help remove the crust that forms from the dried liquid. In areas that you can’t soak, like the mouth or face, you can put a clean, warm washcloth over the infected are for 5 to 10 minutes at a time, until the scabs soften enough to remove.

Medicines

  • You can use over-the-counter medicine as directed based on age and weight for pain, fever, fussiness, or discomfort, unless another medicine was prescribed. In infants ages 6 months and older, you may use ibuprofen as well as acetaminophen. You can alternate them, or use both together. They work differently and are a different class of medicines, so taking them together is not an overdose. If you or your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines. Also talk with your healthcare provider if your child is taking blood-thinner medicines.

  • Do not give aspirin to your child. Aspirin should never be used in children ages 18 and younger who is ill with a fever. It may cause severe disease or death. 

  • Impetigo can often be cured with topical creams. Apply these as directed by your healthcare provider.

  • If you were given oral antibiotics, take them until they are used up. It is important to finish the antibiotics even if the wound looks better to make sure the infection has cleared.

Follow-up care

Follow up with your healthcare provider if the sores continue to spread after 3 days of treatment. It will take about 7 to 10 days to heal completely.

Your child should stay out of school until completing 2 full days of antibiotic treatment.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

  • Fever of 100.4°F (38°C) or higher, or as directed

  • Increased amounts of fluid or pus coming from the sores

  • Increasing number of sores or spreading areas of redness after 2 days of treatment with antibiotics

  • Increasing swelling or pain

  • Loss of appetite or vomiting

  • Unusual drowsiness, weakness, or change in behavior