• About
• Fact sheets
• Medicines
• Find a family doctor
• Resources
• Contact us
• Mailing list
• Contribute

Impetigo (school sores)

Impetigo is an infection of the skin. It is often called 'school sores', probably because school age children are usually the most likely to get them, and they can be spread at school. Impetigo is very easily spread, but with care spread can be reduced.

What is impetigo?

• Impetigo is an infection of the skin caused by bacteria (usually by one of two bacteria called either staphylococcus aureus or group A, b haemolytic streptococcus). These bacteria can live on the skin, in the throat or nose, or on other parts of the body without causing a problem but sometimes they start to cause an infection such as impetigo.
• Impetigo can occur on healthy skin but it often happens when the skin has already been damaged by a scratch, bite or a disease affecting the skin such as eczema or chicken pox.
• Impetigo is very easily spread.
• It is more common in hotter months.

Signs and symptoms

• The sores can be anywhere on the body, but are often on the face near the mouth and nose, or on the arms and legs.
• Impetigo may starts with a blister or a group of blisters.
• The blister bursts leaving a patch of red, wet skin which weeps.
• The spot usually becomes coated with a tan or yellowish crust, making it look like it has been covered with honey.
• There can be small spots around the first spots, spreading outwards.
• Impetigo is usually itchy.
• The sore takes about 1 to 3 days to develop after contact with fluid or crusts from a sore.
• There is often superficial peeling on the edge. 

How is it spread?

• The sore is itchy, and children can scratch it, spreading the infection to nearby skin or to other parts of their own body.
• The fluid and crusts of the sore contain the bacteria, and contact with the sore or with things that have been on the sore (clothing, dressings, towels, etc) can spread the infection to other people.
• A sore can be infectious as long as it is weeping. Usually it has stopped being infectious about 24 hours after treatment with an antibiotic has been started, and healing has begun.
• The germs can also be spread from other parts of the body that do not appear to be affected, eg from a runny nose.

Treatment

• A child with impetigo needs to be checked by a doctor to be sure that it is impetigo, because sometimes an antibiotic medicine is prescribed.
• Remove the crusts.The best way to do this is to bathe the child for 20-30 minutes, while wiping the crust away with a wet towel.
• Try to prevent your child scratching the sores as much as possible, eg cover sores with a watertight dressing and cut your child's fingernails.
• Continue medical treatment until all sores are healed.
• Your child can go back to school, kindergarten or day care after 24 hours of treatment and when the sores are completely covered with dressings.
• The sores should clear up in a few days with treatment but may need to be treated again.

Reducing the spread of impetigo

Impetigo is easily spread but it is usually not a serious infection. People can be worried about it because it is on the skin, and easy to see. Impetigo can occur even when the skin is kept clean, it is not a sign of poor parenting.

• A daily bath or shower with soap and water may reduce the risk of impetigo. Antiseptic soaps can be used, but these can irritate the skin of some people.
• Good hygiene including regular hand washing and throwing away used tissues is advised. Cut your child’s fingernails short and keep them clean.
• Make sure that grazes or cuts are thoroughly washed and if your child is scratching a sore, it may be wise to cover it with a dressing.
• People coming in contact with someone with impetigo need to wash their hands regularly. Put all dressings in a bin with a lid as soon as they are taken off.
• Wash your child’s clothes, towels and bed linen separately from the rest of the family. Wash them in hot water and dry in the sunshine or a hot tumble dryer. Toys can be washed using a mild disinfectant.

Follow up

See your doctor again if:

• The sores are spreading of getting worse even after treatment.
• Your child has become unwell - ie with a fever.
• You are worried for any reason.

Key points to remember

• Impetigo is very contagious (infectious) and can be easily spread to other children.
• Try to prevent your child scratching the sores as much as possible, eg cover sores with a watertight dressing and cut your child’s fingernails.
• Your child can go back to school, kindergarten or day care after 24 hours of treatment and when the sores are completely covered with dressings.
• Continue medical treatment until all sores are healed.
• It is extremely important to remove the crusts, even if the child is taking antibiotics.

More information

• South Australian Department of Health 'You've got what?'
• Centers for Disease Control (USA)