Impetigo - Infected Sores | Seattle Children's Hospital

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Impetigo - Infected Sores

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Definition

  • Bacterial skin infection causing 1 or more coin-shaped sores

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 is usually impetigo)
  • Impetigo often spreads and increases in number from scratching

Cause

  • Superficial bacterial infections of small breaks in the skin

Return to School

  • For mild impetigo (1 or 2 sores), child can attend school or day care if it is covered
  • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours before returning to school or contact sports

When to Call Your Doctor for Impetigo - Infected Sores

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 am and 4 pm) If

  • You think your child needs to be seen
  • Fever or sore throat are present
  • Large sore (larger than 1 inch across or 2.5 cm)
  • Sores and crusts are also inside the nose
  • Impetigo becomes worse after 48 hours on antibiotic ointment

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Impetigo in 2 or more children (e.g., sibs, childcare groups)
  • Child plays contact sports (Reason: to prevent spread)
  • 3 or more impetigo sores (Reason: may need an oral antibiotic because many of these children also have strep throat infection)
  • Not completely healed after 1 week on antibiotic ointment

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 Mild Impetigo

  1. Reassurance:
    • Impetigo is a superficial skin infection that usually starts in a scratch or insect bite.
    • It usually responds to treatment with any antibiotic ointment.
  2. Remove Scabs: Soak off the scab using an antibacterial soap and warm water. The bacteria live underneath the scab.
  3. 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.
  4. Avoid Picking: Discourage scratching and picking which spreads the impetigo.
  5. Contagiousness:
    • Impetigo is contagious by skin to skin contact.
    • Wash the hands frequently and avoid touching the sore.
    • 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 more than 24 hours before returning to school.
    • Contact Sports: Generally, needs to receive antibiotic treatment for 3 days before returning to the sport. There can be no pus or drainage. Check with team's trainer if there is one.
  6. Expected Course: Sore stops growing in 1 to 2 days and skin is healed in 1 week.
  7. Call Your Doctor If:
    • Impetigo increases in size after 48 hours on antibiotic ointment
    • New impetigo sore occurs on antibiotic ointment
    • Not completely healed in 1 week
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 8/5/2007

Copyright 1994-2009 Barton D. Schmitt, M.D.

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Summer 2009: Good Growing Newsletter

In This Issue

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  • Family Meals, Healthier Meals
  • The Risks of Bed Sharing
  • Be Sun Smart

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Summer 2009 (PDF)