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Impetigo - Infected Sores

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Definition

  • 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.
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When To Call

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
  • Fluid-filled blisters on the face
  • 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)
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Care Advice

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.

Remove Scabs:

  • Soak off the scab using soap and warm water. The bacteria live underneath the scab.

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 to prevent scratching and spread.
  • Repeat the washing, ointment and dressing 3 times per day.

Do Not Pick at the Sores:

  • Help your child not to scratch and pick at the sores. This spreads the impetigo.

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.

What to Expect:

  • Sore stops growing in 1 to 2 days.
  • The skin is healed in 1 week.

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

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

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Photos

Impetigo of Elbow

This shows impetigo on the elbow. Impetigo is a skin infection caused by bacteria. The infection causes a red sore which leaks fluid. This area will then dry and become crusty as it heals.

Source: Wikimedia Commons
Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License. This is a public domain image file from Wikimedia Commons. Wikimedia is a freely licensed media repository.

Impetigo of Left Cheek

This shows impetigo on the face. Impetigo is a skin infection caused by bacteria. The infection causes a red sores which leak fluid. This area will then dry and become crusty as it heals.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
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