Impetigo (Infected Sores)

Main 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)
  • Impetigo often spreads and increases in number from scratching
  • Main cause: superficial bacterial infections of small breaks in the skin

See More Appropriate Topic

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

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

  • You think your child needs to be seen
  • Fever or sore throat are present
  • Large sore (> 1 inch across or 2.5 cm)

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Sores and crusts are also inside the nose
  • Impetigo in 2 or more children (e.g. sibs, child care groups)
  • 3 or more impetigo sores (Reason: need an oral antibiotic because many of these children also have strep pharyngitis or rhinitis)

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 Infected Insect Bite or Cut

  1. Remove Scabs: Soak off the scab using an antibacterial soap and warm water. The bacteria live underneath the scab.
  2. Antibiotic Ointment: Apply an antibiotic ointment 3 times per day.
    • Use Bacitracin or Polysporin ointment 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.
  3. Avoid Picking: Discourage scratching and picking which spreads the impetigo.
  4. Contagiousness: For mild impetigo (1 or 2 sores), can attend school or day care if it is covered. For severe impetigo, child needs to take an oral antibiotic for > 24 hours before returning.
  5. Expected Course: Sore stops growing in 1 to 2 days and skin is healed in 1 week.
  6. Call Your Doctor If
    • Impetigo increases in size after 48 hours on antibiotic ointment
    • New impetigo sore occurs
    • Not completely healed in 1 week
    • Your child becomes worse or develops any of the “Call Your Doctor Now” symptoms