What is impetigo?

Impetigo is an infection of the skin. When it affects just the surface, it’s called superficial impetigo. Impetigo can also affect deeper parts of the skin. This is called ecthyma. It may occur on healthy skin. Or it may occur where the skin was injured by a cut, scrape, or insect bite.

Impetigo is most common in children from ages 2 to 5. It is contagious. This means it’s easily passed from one person to another. It can be spread around a household. Children can infect other family members, and can reinfect themselves.

What causes impetigo?

Impetigo is caused by bacteria. The bacteria that can cause it include:

• Group A beta-hemolytic streptococcus
• Staphylococcus aureus

Who is at risk for impetigo?

Impetigo is more common in children, but adults may also have the infection. A child is more likely to get impetigo if he or she:

• Has close contact with to others with impetigo
• Does not keep clean (poor hygiene)
• Is in warm, moist (humid) air
• Has other skin conditions, such as scabies or eczema

What are the symptoms of impetigo in a child?

Symptoms can occur a bit differently in each child. They also vary depending on which bacteria caused it. Symptoms can include:

• Red bumps
• Sores that are filled with fluid, draining fluid, or crusted over
• Areas that are red, swollen, and may itch
• Swelling of nearby lymph glands (nodes)

The bumps or sores can be painful and appear anywhere on the body. But they are most common on the face, arms, and legs.

The symptoms of impetigo can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is impetigo diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. A sample of the pus from the sores may be sent to a lab. This is called a culture. It’s done to see what type of bacteria caused the infection. It can help the doctor decide the best antibiotic for treatment.

How is impetigo treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

• Prescription antibiotic cream or ointment. This is most often done for mild impetigo. Over-the-counter antibiotic cream or ointment is usually not advised.
• Antibiotic pills or liquid by mouth (oral). This is most often advised if your child has several areas of impetigo or ecthyma. It may also be advised if more than one person in a household has impetigo.
• Cleaning and bandaging. You will need to gently washing affected areas of your child’s skin with mild soap and water. Cover areas that are draining fluid. Make sure to wash your hands before and after caring for your child’s impetigo.

What are possible complications of impetigo?

Possible complications of impetigo can include:

• Worsening or spreading of the infection
• Scarring, which is more common with ecthyma

Impetigo caused by beta-hemolytic strep bacteria can cause:

• Kidney damage (poststreptococcal glomerulonephritis)
• Fever, joint, and other problems (rheumatic fever)

What can I do to prevent impetigo in my child?

You can help to prevent impetigo and prevent it from spreading to others. The following may help:

• Keep your child out of daycare or school for 24 hours after starting antibiotic treatment. Your child can return after 24 hours. Cover any draining sores with bandages.
• Make sure your child and everyone else in your household washes his or her hands well. This means using soap and water and scrubbing well.
• Don't share personal items such as towels or washcloths.
• Have everyone in the household use their own towels for drying hands and for after bathing. Do not share towels.
• Keep your child's fingernails short. This can help prevent your child scratching and spreading the infection.

When should I call my child's healthcare provider?

Call the healthcare provider if your child has a skin infection after being in contact with anyone who has impetigo.

Key points about impetigo in children

• Impetigo is an infection that affects the skin. It’s caused by bacteria. 
• It causes skin sores. The sores may be red and painful, and contain fluid called pus. They may drain and crust.
• Impetigo is usually treated with antibiotic cream, ointment, pills, or liquid.
• Keeping the skin clean may help to prevent the spread of impetigo. It is very important to wash hands well after caring for your child.
• Impetigo can spread in a household. Don't share towels, washcloths, or other personal items.
• Your child can return to daycare or school 24 hours after starting antibiotic treatment.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.