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By Casey De Farria
Casey De Farria
14 Feb, 2022

Impetigo – prevention, symptoms, and treatment of ‘school sores’

Impetigo – pronounced ‘im-pet-eye-go’ is an infection of the skin caused by bacteria. It causes sores on the skin, which are usually itchy. Parents sometimes worry about impetigo because it can look quite serious, but it is usually a mild infection that is easy to treat.

It is often referred to as ‘school sores’ due to how common it is among young kids, particularly school children.

Signs and symptoms

  • Impetigo may start with a blister or a group of blisters – often on the face near the mouth and nose, or on the arms and legs, but they can appear anywhere on the body!
  • There can be small spots around the first sores, spreading outwards.
  • The sores may start out as blisters that burst and become weepy, before being covered with a crust.
  • There is often superficial peeling on the edge of the sore.
  • Impetigo is usually itchy.
An example of how impetigo can look on little ones

How is impetigo spread?

  • Children with impetigo are very infectious (contagious). Impetigo is usually spread through contact with the fluid or crusts of an impetigo sore, or via things that have been on the sore.
  • The infection is caused by staphylococcus or streptococcus bacteria. These bacteria can live on the skin, in the throat or nose, or on other parts of the body without causing a problem, but sometimes they can cause an infection such as impetigo. Impetigo can occur on healthy skin, but it usually happens when the skin has already been damaged by a scratch, bite or a disease affecting the skin, such as eczema or chickenpox.
  • A sore takes about one to three days to develop after contact with fluid or crusts from a sore.
  • Children itching at the sores often spreads the infection to nearby skin or to other parts of their own body.
  • A sore can be infectious for as long as it is weeping. It will usually stop being infectious about 24 hours after starting antibiotic treatment, once it has begun to heal.

Did you know? impetigo is more common during the warmer months!

If your child has signs and symptoms of impetigo, take them to see a GP. The doctor will make sure the sores are impetigo. 

Treatment for impetigo

  • Your doctor may prescribe antibiotic medicine in the form of a cream, ointment, tablets, or syrup. Continue any creams or ointments that you have been prescribed until all sores are healed. The sores should clear up in a few days with treatment.
  • A daily 10 minute bleach bath may help to reduce the amount of bacteria on your child’s skin and reduce the risk of the impetigo spreading. We know, the term ‘bleach bath’ sounds scary – but it is safe and beneficial as long as it is done correctly: Use regular White King Bleach 4% chlorine: add 12 mL for every 10 L of water.
  • It is important to remove the crusts from the sores, to allow any ointments treating the sores to reach the infection properly. The best way to do this is to soak your child in a bleach bath for 20–30 minutes, while wiping the crusts away with an unused, wet disposable cloth (e.g. a Chux).
  • Try to prevent your child scratching the sores as much as possible to avoid scarring, bleeding or further infection. Cover the sores with a watertight dressing, and cut your child’s fingernails.
  • Keep your child home from child care, kindergarten or school until 24 hours after starting medical treatment. After this time, they can be around other children again, but cover up their sores completely with dressings.

    Take your child back to the GP if:
  • The sores are spreading or getting worse, even after treatment
  • Your child has become unwell, for example, with a fever
  • You are worried for any other reason.
  • If your child gets impetigo repeatedly your doctor may do a nose swab to test for bacteria in the nose. Your child may need antibiotics, which are delivered into the nose, to prevent further instances of impetigo.

Reducing the spread!

  • A daily bath or shower with soap and water may reduce the risk of impetigo. Antiseptic soaps can be used, but these may irritate the skin of some people.
  • Encourage your child to practise good hygiene, including regular hand washing and throwing away used tissues. Cut your child’s fingernails short and keep them clean.
  • Make sure that grazes or cuts are thoroughly washed. If your child is scratching a sore, cover it with a watertight dressing.
  • People coming in contact with someone with impetigo need to wash their hands regularly.
  • Put all dressings from impetigo sores in a bin with a lid as soon as they are taken off.
  • If your child has impetigo, wash their clothes, towels and bed linen separately from the rest of the family. Wash them in hot water and dry in the sunshine or a hot tumble dryer. Toys can be washed using a mild disinfectant.

Remember – impetigo is not necessarily a sign of poor hygiene – much like headlice, it can easily happen to anyone!

Reference and further reading:

Impetigo – RCH Fact Sheet.

Images from: Dermnet NZ

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