Impetigo in children

Overview

Impetigo (say: im-peh-TIE-go) is a common, highly contagious bacterial skin infection that mainly affects children. It causes sores, often around the nose and mouth, that can break open, ooze, and form a honey-colored crust.

Yes, impetigo is very common in children, especially those aged 2 to 5 years. It is one of the most common skin infections in young children.

Impetigo mostly affects children, but adults can get it too. It is more common in warm, humid weather and in settings where children are in close contact, such as schools and daycare centers.

Symptoms

Common symptoms

• Red sores that quickly burst, ooze fluid, and form a thick, golden-brown crust.
• Itching and mild pain around the sores.
• Swollen lymph nodes near the infection.

Symptoms in children

• Sores often appear around the nose and mouth, but can spread to other areas.
• Children may scratch the sores, spreading the infection to other parts of the body.
• Sometimes children feel generally unwell, with a mild fever.

Symptoms in older adults

• In older adults, impetigo is less common but can occur, especially if they have weakened immune systems or skin conditions.
• Sores may be more widespread and take longer to heal.

Causes

Main causes

• Bacteria called Staphylococcus aureus or Streptococcus pyogenes enter the skin through a cut, scrape, or insect bite.
• Direct contact with the sores or fluids from the sores of an infected person.

Risk factors

• Being a child, especially in daycare or school.
• Living in warm, humid climates.
• Poor hygiene, such as infrequent handwashing.
• Having a weakened immune system.
• Having other skin conditions like eczema or poison ivy.

When to see a doctor

See a doctor urgently if:

• If the child has a fever or seems very unwell.
• If the sores are spreading quickly or appear infected (hot, red, swollen).

Book a routine appointment if:

• If you notice honey-colored crusted sores on your child's skin.
• If the sores are itchy or uncomfortable and do not improve with simple cleaning.

Diagnosis

A doctor can usually diagnose impetigo just by looking at the sores. The distinctive honey-colored crust is a key sign.

Tests that may be done

• In some cases, a swab of the fluid from a sore may be sent to a lab to identify the bacteria.
• This is not always needed but can help if treatment is not working.

What to expect at your appointment

The doctor will examine the sores and ask about symptoms. The visit is quick and usually does not involve any painful tests.

Treatment

Impetigo is treated with antibiotics to kill the bacteria. Treatment can be a cream applied directly to the sores or, in more widespread cases, an antibiotic medicine taken by mouth. It is important to finish the full course even if sores look better.

Self-care at home

• Keep the sores clean and dry.
• Wash hands thoroughly with soap and water after touching the sores.
• Cover sores with a light dressing to prevent spreading.
• Do not let your child scratch or pick at the sores.

Medical treatments

Doctors may prescribe an antibiotic cream to apply to the sores. For more severe or widespread infections, they may recommend an oral antibiotic (taken by mouth). Always follow the doctor’s instructions for how long to use the medicine.

When is surgery considered?

Surgery is not needed for impetigo.

Living with this condition

Your child can usually return to school or daycare 24 to 48 hours after starting treatment, as long as the sores are covered and the child is feeling well. Keep the child home until the sores are no longer contagious.

Lifestyle tips

• Encourage regular handwashing, especially after touching sores.
• Wash bedding, towels, and clothing in hot water.
• Keep fingernails short to reduce scratching and spreading.

Diet and exercise

No special diet is needed. Ensure the child drinks plenty of fluids and eats healthy food to support recovery. Gentle activity is fine if the child feels well.

Mental health and emotional wellbeing

Impetigo can be embarrassing for a child because of the visible sores. Reassure your child that it’s a common infection and will go away with treatment. Encourage them not to feel isolated or ashamed.

Prevention

While it is not always possible to prevent impetigo, good hygiene greatly reduces the risk. Wash hands frequently, avoid sharing towels or personal items, and clean cuts and scrapes promptly.

Complications

If left untreated

• Infection may spread to deeper layers of skin (cellulitis).
• Rarely, the bacteria can cause a kidney problem called post-streptococcal glomerulonephritis (kidney inflammation).
• The infection may spread to other people.

Long-term outlook

With proper treatment, impetigo usually clears up completely within a week or two, with no scarring. Serious complications are rare. Most children recover fully and return to normal activities quickly.

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