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Impetigo - Infected Sores

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Does this describe your child's symptoms?

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Impetigo of Left Cheek

Impetigo of Elbow

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

  • The most common bacteria are Staph and Strep

Return to School

  • For mild impetigo (1 or 2 sores), child can attend school or child 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

If not, see these topics

  • It's in a wound, see WOUND INFECTION

  • Doesn't look like impetigo, see RASH - LOCALIZED AND CAUSE UNKNOWN

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When to Call Your Doctor

call now

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

  • You think your child needs to be seen urgently

call within 24 hours

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

  • You think your child needs to be seen, but not urgently

  • 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 within 24 hours

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

home care

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)

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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 (no prescription needed).

    • Examples are Bacitracin or Polysporin 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 child 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 "Call Your Doctor" symptoms.

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