Impetigo in infants

Overview

Impetigo (im-puh-TYE-go) is a common, highly contagious skin infection caused by bacteria. It usually appears as red sores or blisters that burst, ooze, and form a golden or honey-colored crust. In infants it is usually mild but spreads easily.

Yes, impetigo is very common, especially in children aged 2 to 5 years. It is also common in infants, particularly in warm, humid weather or in settings like daycare.

Impetigo mainly affects infants and young children. It can also occur in older children and adults, especially if they have close contact with an infected person or have poor hygiene or minor skin injuries.

Symptoms

Common symptoms

• Red sores that quickly burst and ooze fluid or pus.
• A golden or honey-colored crust forming over the sores.
• Sores often appear around the nose, mouth, chin, and on the hands.
• Mild itching or discomfort around the sores.
• Swollen lymph nodes near the infected area (less common).

Symptoms in children

• In infants, sores may appear as small blisters that break open easily.
• The crust may look like stuck-on, dried honey.
• Impetigo can spread to other parts of the body (like the diaper area) when touched.
• Infants may be irritable or have mild fever if the infection is widespread.

Symptoms in older adults

• In older adults, impetigo is less common but may occur if the skin is damaged or immune system weak.
• Sores may take longer to heal and can be more painful.
• Older adults may also develop deeper skin infections (cellulitis) more easily.

Causes

Main causes

• Bacteria called Staphylococcus aureus (staph) or Streptococcus pyogenes (strep) enter the skin through a cut, scratch, insect bite, or other minor injury.
• Direct contact with the sores or fluids from an infected person.
• Touching contaminated objects like towels, bedding, toys, or clothing.
• Scratching the sores and then touching other parts of the body.

Risk factors

• Living in warm, humid climates or crowded conditions.
• Poor hygiene, such as infrequent handwashing or bathing.
• Attending daycare or school where children are in close contact.
• Having skin conditions like eczema, chickenpox, or a recent insect bite.
• Weak immune system, such as from a medical condition or treatment.

When to see a doctor

See a doctor urgently if:

• If your infant has a fever or seems unwell.
• If the sores are spreading quickly or not healing after a few days.
• If the area around the sores becomes red, swollen, or very painful.
• If you notice red streaks or warmth spreading from the sores.

Book a routine appointment if:

• If you suspect impetigo for the first time to confirm the diagnosis and get treatment.
• If sores are not improving after a few days of self-care (like gentle cleaning).
• If your infant has recurrent bouts of impetigo.

Diagnosis

A doctor or nurse can usually diagnose impetigo by looking at the sores and asking about symptoms and history. They may also ask about recent scrapes or contact with others who have sores.

Tests that may be done

• Usually no tests are needed.
• If the infection is severe, keeps coming back, or does not respond to treatment, the doctor may take a swab of the fluid from a sore to send to a lab. This helps identify the bacteria and guide treatment.

What to expect at your appointment

The doctor will examine the sores and may gently press on them to see if they ooze. They might also check for fever and look at the lymph nodes near the sores. The visit is usually quick and painless.

Treatment

Impetigo is treated with antibiotics to kill the bacteria. Mild cases may be treated with antibiotic cream or ointment applied directly to the sores. For more widespread or stubborn infections, a course of oral antibiotics (taken by mouth) may be needed. Keeping the sores clean and covered also helps healing and prevents spread.

Self-care at home

• Gently wash the affected skin with warm soapy water and pat dry. Do not scrub.
• Cover the sores with a loose bandage or gauze to prevent scratching and spreading.
• Do not share towels, washcloths, bedding, or clothing with others.
• Wash your hands thoroughly after touching the infected area.
• Keep your infant’s nails short to reduce scratching.
• Change your infant’s clothes and bedding daily until the sores heal.

Medical treatments

A healthcare provider may prescribe an antibiotic cream or ointment to apply directly to the sores several times a day for about 5 to 7 days. If the infection is widespread or does not respond to topical treatment, they may prescribe an oral (by mouth) antibiotic. It is important to finish the full course even if sores look better. Follow your provider’s instructions exactly.

When is surgery considered?

Surgery is not needed for impetigo.

Living with this condition

During the contagious period (usually until sores are crusted over or 24-48 hours after starting antibiotics), keep your infant home and away from other children. Clean and bandage sores, wash hands often, and avoid direct contact with others. Most children can return to daycare or school once treatment has started and sores are dry and crusted.

Lifestyle tips

• Maintain good hand hygiene for the whole family.
• Wash all towels, clothing, and bedding in hot water and detergent.
• Disinfect toys and surfaces that may have touched the sores.
• Avoid touching or scratching the sores.
• Keep your infant’s skin cool and dry to help prevent moisture.

Diet and exercise

No special diet is needed. Offer plenty of fluids to keep your infant hydrated if they have a fever. Gentle, normal activity is fine as long as the child feels well. Avoid activities that may rub or irritate sores. Rest if fever or discomfort occurs.

Mental health and emotional wellbeing

Impetigo can be worrying for parents because it looks unpleasant and spreads quickly. It is important to remember it is very treatable and usually clears up without problems. For older children, visible sores may cause embarrassment. Reassure them that the sores are not their fault and will heal. Keep communication open.

Prevention

Yes, impetigo can often be prevented by good hygiene. Wash your infant’s hands frequently, especially after touching others. Keep cuts, scratches, and insect bites clean and covered. Avoid sharing personal items. If someone in the family has impetigo, wash all linens in hot water and clean surfaces regularly.

Complications

If left untreated

• Cellulitis: a deeper skin infection that can cause redness, swelling, pain, and fever.
• Spread to other parts of the body or to other family members.
• Scarring, especially if sores are picked or scratched.
• Rarely, a type of kidney inflammation called post-streptococcal glomerulonephritis, which can cause dark urine and swelling.

Long-term outlook

With proper treatment, impetigo in infants almost always heals completely without permanent marks or serious problems. The infection is very responsive to antibiotics. Even without treatment, mild cases often clear on their own, but treatment speeds healing and prevents the spread to others. The outlook is excellent.

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