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Children's Symptoms > Skin - Localized Symptoms > Impetigo - Infected Sores
Impetigo - Infected Sores

DEFINITION

  • Bacterial skin infection causing 1 or more coin-shaped sores

Symptoms

  • Sores smaller than 1 inch in diameter
  • Often covered by a soft, yellow-brown scab or crust
  • Scabs may intermittently drain pus
  • Begin as small red bumps which rapidly change to cloudy blisters, then pimples, and finally open sores which weep
  • Increases in size (any sore or wound that grows and doesn't heal is usually impetigo)
  • Impetigo often spreads and increases in number from scratching

Cause

  • Superficial bacterial infections of small breaks in the skin
  • The most common bacteria are Staph and Strep

Return to School

  • For mild impetigo (1 or 2 sores), child can attend school or child care if it is covered
  • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours before returning to school or contact sports

See More Appropriate Topic (instead of this one) If


WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Red or cola-colored urine
  • Red streak runs from the impetigo
  • Red tender area surrounds the impetigo
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently
  • Fever or sore throat are present
  • Large sore (larger than 1 inch across or 2.5 cm)
  • Sores and crusts are also inside the nose
  • Impetigo becomes worse after 48 hours on antibiotic ointment

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Impetigo in 2 or more children (e.g., sibs, childcare groups)
  • Child plays contact sports (Reason: to prevent spread)
  • 3 or more impetigo sores (Reason: may need an oral antibiotic because many of these children also have strep throat infection)
  • Not completely healed after 1 week on antibiotic ointment

Parent Care at Home If

  • 1 or 2 impetigo sores that started with cut, scratch or insect bite and you don't think your child needs to be seen (Reason: probably will respond to antibiotic ointment)

HOME CARE ADVICE FOR MILD IMPETIGO

  1. Reassurance:
    • Impetigo is a superficial skin infection that usually starts in a scratch or insect bite.
    • It usually responds to treatment with any antibiotic ointment.
  2. Remove Scabs: Soak off the scab using an antibacterial soap and warm water. The bacteria live underneath the scab.
  3. Antibiotic Ointment: Apply an antibiotic ointment 3 times per day (no prescription needed).
    • Examples are Bacitracin or Polysporin or one you already have.
    • Cover it with a Band-Aid to prevent scratching and spread.
    • Repeat the washing, ointment and Band-Aid 3 times per day.
  4. Avoid Picking: Discourage scratching and picking which spreads the impetigo.
  5. Contagiousness:  
    • Impetigo is contagious by skin to skin contact.
    • Wash the hands frequently and avoid touching the sore.
    • For mild impetigo (1 or 2 sores), can attend school or child care if it is covered.
    • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours before returning to school. 
    • Contact Sports: Generally, needs to receive antibiotic treatment for 3 days before returning to the sport. There can be no pus or drainage. Check with team's trainer if there is one.
  6. Expected Course: Sore stops growing in 1 to 2 days and skin is healed in 1 week.
  7. Call Your Doctor If:
    • Impetigo increases in size after 48 hours on antibiotic ointment
    • New impetigo sore occurs on antibiotic ointment
    • Not completely healed in 1 week
    • Your child becomes worse

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


Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/15/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.


Additional Resources:

 How to use the Adult Health Topics pages
 When to call the doctor
 Reviewers of Clinical Content

Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be for medical diagnosis or treatment.

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