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

• If it’s in a wound, see Wound Infection
• If doesn’t look like impetigo, see Localized Rash with Unknown Cause

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