Main 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).
• Impetigo often spreads and increases in number from scratching.
• Main cause: superficial bacterial infections of small breaks in the skin.

See More Appropriate Topic

• If it's in a wound, see WOUND INFECTION.
• If doesn't look like impetigo, see RASHES, LOCALIZED AND CAUSE UNKNOWN.

(To go directly to these topics, click on the links following this document.)

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.

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

• You think your child needs to be seen.
• Fever or sore throat are present.
• Large sore (larger than 1 inch across or 2.5 cm).

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.
• Sores and crusts are also inside the nose.
• Impetigo in 2 or more children (e.g., sibs, childcare groups).
• 3 or more impetigo sores (reason:  need an oral antibiotic because many of these children also have strep pharyngitis or rhinitis).

Parent Care at Home

• 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).

Home Care Advice for Infected Insect Bite or Cut

1. Remove Scabs:  Soak off the scab using an antibacterial soap and warm water.  The bacteria live underneath the scab.
   
   
2. Antibiotic Ointment:  Apply an antibiotic ointment 3 times per day.
   
   Use Bacitracin or Polysporin ointment 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.
   
   
3. Avoid Picking:  Discourage scratching and picking which spreads the impetigo.
   
   
4. Contagiousness:  For mild impetigo (1 or 2 sores), can attend school or day care if it is covered.  For severe impetigo, child needs to take an oral antibiotic for more than 24 hours before returning.
   
   
5. Expected Course:  Sore stops growing in 1 to 2 days and skin is healed in 1 week.
   
   
6. Call Your Doctor If:
   
   Impetigo increases in size after 48 hours on antibiotic ointment.
   
   New impetigo sore occurs.
   
   Not completely healed in 1 week.
   
   Your child becomes worse or develops any of the "Call Your Doctor" symptoms.

Parent Care for Pediatric Symptoms. Copyright © 2000. Barton D. Schmitt, MD, FAAP

See related topics:

• Rashes, Localized and Cause Unknown
• Wound Infection