What is impetigo?

Impetigo is a contagious skin infection that causes an itchy rash and blisters. It is common in children and less common in adults. Impetigo is sometimes called 'school sores'.

Impetigo can be dangerous for newborn babies. Children and adults with impetigo should stay away from babies.

Children must not go to school or childcare until 24 hours after starting antibiotics, or until the rash has cleared and blisters have dried out.

What are the symptoms of impetigo?

Impetigo usually starts as an itchy, red rash with small blisters. It most often appears around the mouth and nose. The rash can also appear on your arms and legs.

The blisters are filled with water or pus and burst easily, leaving yellowish crusts. These crusts fall off without leaving scars.

Sometimes, larger blisters form that don't break open as quickly. This type is called bullous impetigo. It may appear on your:

• neck
• torso
• armpits
• groin

You may also have a fever and swollen lymph nodes (glands).

What causes impetigo?

Impetigo is usually caused by Staphylococcus or Streptococcus bacteria. These bacteria live on the skin or in the nose of many healthy people without causing problems. They may enter your skin through:

• small cuts or scrapes
• insect bites
• a rash

Once they enter your skin, they can cause impetigo symptoms.

Certain factors can make a person more likely to get impetigo, including:

• warm and humid weather
• poor hygiene
• skin conditions such as eczema or scabies
• if you have a weakened immune system

The infection spreads easily through touch. This may be either directly from skin-to-skin contact or by sharing items such as towels, clothing or bedding.

When should I see my doctor?

Speak to your doctor if you or your child has symptoms of impetigo.

Treatment is important to help stop it from spreading to other people.

How is impetigo diagnosed?

Your doctor can often diagnose impetigo by looking at your rash and blisters. They may also take a swab to test for the type of bacteria.

How is impetigo treated?

Impetigo can often be treated with antibiotics in the form of a cream or ointment applied directly to the skin. Your doctor may prescribe antibiotic tablets if there are many blisters or if you or your child has a fever.

Here are some tips to help your skin heal:

• Wash your sores gently with soap and water to remove any crusts.
• Cover any exposed sores with a watertight dressing.
• Try not to scratch the rash.

What are the complications of impetigo?

Complications of impetigo are rare. Sometimes the infection can spread to a deeper layer of skin (cellulitis). Blisters that have been scratched open may become infected.

In newborn babies, the infection may spread quickly and lead to severe complications if left untreated, such as:

• pneumonia (inflammation of their lungs)
• osteomyelitis (bone infection)
• sepsis (when the body damages its own tissues and organs in response to an infection)

Can impetigo be prevented?

You can often help prevent impetigo by keeping good hygiene and stopping the spread of germs.

Here are some tips to lower the chance of spreading impetigo:

• Bathe or shower daily.
• Wash your hands often, especially after putting cream on the sores.
• Teach your child not to scratch or pick at their sores.
• Don't share anything that touches your skin, such as towels, bedding and clothes.

Family members should also wash their hands regularly and avoid touching impetigo sores.

Most people are no longer contagious after 24 hours of treatment, or once the blisters have dried and healed. Avoid childcare, school or work until you are no longer contagious.

Resources and support

• For more information about the symptoms, diagnosis, management and prevention of impetigo, see the NSW Health and WA Department of Health fact sheets.
• The Australasian College of Dermatologists also has more information about impetigo.
• Queensland Government has information about Streptococcus bacteria.

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available from 7 am to midnight (AET), 7 days a week (including public holidays).

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.