Children's Hospital Colorado

Impetigo - Infected Sores

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Coin-shaped sores on the skin covered by scabs
  • The infected crusts are the color of honey
  • Skin infection caused by a bacteria

Symptoms of Impetigo

  • Sores smaller than 1 inch (2.5 cm)
  • Often covered by a soft, yellow-brown scab or crust
  • Scabs may drain pus or yellow fluid off and on
  • Starts as small red bumps. These change quickly to cloudy blisters or pimples. Then, they become open sores which drain fluid or pus.
  • Sores increase in size
  • Any sore or wound that grows and doesn't heal is usually impetigo.

Cause of Impetigo

  • A skin infection caused by a bacteria. It starts in a small break in the skin. Examples are a scratch or insect bite.
  • The most common bacteria are Staph and Strep. If the child has a sore throat, they may also have Strep throat. A rapid Strep test will give the answer.
  • Impetigo often spreads and increases in number from scratching.

Call Doctor or Seek Care Now

  • Pink or tea-colored urine
  • Fever and spreading redness around the impetigo
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Spreading redness around the impetigo and no fever
  • Fever or sore throat are present
  • Sore is larger than 1 inch (2.5 cm) across
  • Sores and crusts inside the nose
  • Impetigo gets worse after 48 hours on antibiotic ointment
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Impetigo in 2 or more children (such as siblings or play groups)
  • Child plays contact sports (Reason: to prevent spread)
  • 3 or more impetigo sores (Reason: May need an oral antibiotic. Many of these children also have a Strep throat)
  • Not healed up after 1 week on antibiotic ointment
  • You have other questions or concerns

Self Care at Home

  • Mild impetigo (1 or 2 sores that started with a scratch or insect bite)

Care Advice for Impetigo

  1. What You Should Know About Impetigo:
    • Impetigo is a skin infection. Most often, it starts in a scratch or insect bite.
    • It usually responds to treatment with any antibiotic ointment.
    • Here is some care advice that should help.
  2. Remove Scabs:
    • Soak off the scab using soap and warm water. The bacteria live underneath the scab.
  3. Antibiotic Ointment:
    • Put an antibiotic ointment (such as Polysporin) on the sores. No prescription is needed. You can also use one you already have.
    • Do this 3 times per day.
    • Cover it with a bandage (such as Band-Aid) to prevent scratching and spread.
    • Repeat the washing, ointment and dressing 3 times per day.
  4. Do Not Pick at the Sores:
    • Help your child not to scratch and pick at the sores. This spreads the impetigo.
  5. Return to School:
    • Impetigo is spread to others by contact with skin lesions.
    • Wash the hands often. Try not to touch the sores.
    • For mild impetigo (1 or 2 sores), can go to school if it is covered.
    • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours. Then your child can go back to school.
    • Contact Sports. In general, needs to be on antibiotics for 3 days before returning to sports. There must be no pus or drainage. Check with the team's trainer if there is one.
  6. What to Expect:
    • Sore stops growing in 1 to 2 days.
    • The skin is healed in 1 week.
  7. Call Your Doctor If:
    • Impetigo sore gets bigger after 48 hours on antibiotic ointment
    • Gets new impetigo sore on antibiotic ointment
    • Not healed up in 1 week
    • You think your child needs to be seen
    • Your child becomes worse

Care Advice for Impetigo

Impetigo of Elbow

This shows impetigo on the elbow. Impetigo is a skin infection caused by bacteria. The infection causes a red sore which leaks fluid. This area will then dry and become crusty.

Impetigo of Left Cheek

This shows impetigo on the face. Impetigo is a skin infection caused by bacteria. The infection causes a red sores which leaks fluid. This area will then dry and become crusty.

Disclaimer

The information contained in these topics is not intended nor implied to 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.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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