Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Impetigocontagious, crusting blisters, mainly in children
Impetigo, also known as school sores, is a superficial skin infection that mainly occurs in children. It causes red spots with superficial blisters that quickly break and dry into yellow or brown crusts. It is usually harmless and clears on its own, but it is very contagious, which is why treatment is often chosen.
What is impetigo?
Impetigo (officially impetigo vulgaris or impetigo contagiosa) is a superficial infection of the skin that mainly occurs in children. It is usually harmless and clears on its own, but it is very contagious to other children. That is why treatment is often chosen, also because the skin then heals faster.
How do you or your child get impetigo?
Impetigo is caused by two kinds of bacteria: streptococci or staphylococci. Some staphylococci cause impetigo with blisters (impetigo bullosa). The infection mainly occurs in young children and passes easily from one to another, so it is very contagious. The risk of infection is greater where many children are together, such as at school. Because someone is often contagious for several days before symptoms appear, keeping a child at home once skin changes show is too late to prevent spread. Good hygiene in the first 48 hours after starting treatment is then extra important. The risk is greater with poor hygiene, with a wound on the skin and in children who already have a skin disease such as eczema. Most children with impetigo are otherwise healthy. Adults can also get impetigo, with a greater chance in those who already have a skin condition.
What does impetigo look like?
The first signs are red skin with very superficial blisters, which you usually do not see because they break quickly. The blister fluid dries into yellow or brown crusts, which can grow larger. In time the crusts dry up and fall off on their own; the skin underneath stays red for a while but heals without a scar. In a severe course children can be ill with fever and swollen lymph nodes. Impetigo can occur anywhere but is most often seen on the face (especially around the nose and mouth), on the arms and on the legs. In healthy people the infection clears on its own within two to three weeks.
Is impetigo contagious?
Yes. Impetigo is very contagious. It spreads easily through direct contact and via toys, clothing or towels. Someone is often contagious for several days before symptoms appear; good hygiene in the first 48 hours after starting treatment is extra important.
How is the diagnosis made?
The diagnosis can almost always be made from how the spots look. In case of doubt and in severe infections, a swab can be taken for a culture.
What treatments are there?
For limited impetigo, treatment is a cream or ointment with an antibiotic, for example fusidic acid or mupirocin. To prevent resistance, these creams must never be used for longer than two weeks. For an extensive infection, and when children are ill, treatment is antibiotics as tablets, capsules or a syrup, for example flucloxacillin, azithromycin or clarithromycin.
Can impetigo be cured?
Impetigo usually clears on its own within two to three weeks, without scars. In darker skin, temporarily lighter or darker patches can remain. Serious consequences, such as a deep skin infection or a kidney inflammation, are very rare.
What can you do yourself?
Good hygiene is extra important to limit further infection. It can also spread via toys, clothing or towels. So wash hands regularly, of the patient and those around them, if needed with a disinfectant wash, and do not share laundry. Try to prevent scratching and keep nails short.
Frequently asked questions about impetigo
Is impetigo contagious?
Yes, very. It spreads easily through direct contact and via toys, clothing or towels. Someone is often contagious for several days before symptoms appear.
Should my child stay home from school?
Because a child was already contagious before the crusts appeared, staying home no longer prevents the spread. Good hygiene in the first 48 hours after starting treatment matters more.
How long does it last?
In healthy people impetigo clears on its own within two to three weeks. Treatment speeds healing and reduces contagiousness.
How is it treated?
For limited impetigo, an antibiotic cream (fusidic acid or mupirocin), for a maximum of two weeks. For an extensive infection, antibiotics in tablet form.
Does it leave scars?
Usually not. In darker skin, temporarily lighter or darker patches can remain. Serious complications are very rare.