What is impetigo?

Impetigo is a very contagious skin infection, also known as school sores. It is most common in children and in late summer or autumn. Impetigo is found generally on the hands and face - especially around the nose, mouth - and also commonly on the arms and legs.

What is the cause?

Impetigo is caused by one, or both, of two types of germs (bacteria) - Staphylococcus aureus and Streptococcus pyogenes - which make their way into the skin through a cut or scratch.

What are the symptoms?

Impetigo usually starts as little blisters. These then break and start to weep - usually pus, and sometimes clearer liquid. The weeping patches tend to grow. Yellow or brownish scabs then form which can burn or itch.

How is impetigo treated?

Antibiotics
As soon as you suspect impetigo, take your child to the doctor. The doctor may prescribe a course of antibiotic tablets, usually taken over seven days. Antibiotic creams and ointment can be used but now they are sometimes avoided because using them can allow the bacteria to gain resistance to the antibiotic. Carefully follow the treatment as prescribed, and care for the sores as described below. Continue taking the medicine even if the sores look to have healed.

The doctor may also prescribe an ointment to rub on the inside of the nostrils for the child and other family members - the highly infectious bacteria can hide out here and reinfect others. 

Caring for the sore
Impetigo sores can look alarming and may be difficult to manage, especially if they are on the face. While dry sores do not need to be enclosed, a weeping sore should be washed and and kept covered (dressed) in the following way: 

• Wash your own hands with warm water and soap. Dry your hands thoroughly with a clean towel, or better still, a disposable kitchen wipe. Check that your hands are free from cuts or scratches so you do not become infected.
• Wash the sore with warm water and soap. 
• Wash your hands again using the method described above.
• Perhaps also apply a simple antiseptic (eg, Savlon or Betadine or hydrogen peroxide cream), which can also help with the healing.
• Cover the weeping sore with a dry dressing. Dressings and the correct tapes to hold the dressing in place can be purchased from pharmacies.
• Change the dressing each time you remove an old one. Throw the old dressing into a plastic bag and seal it before discarding, or better still burn it.
• Wash your hands again.

Family matters

Impetigo is very contagious. Do not send a child to school or preschool with impetigo until 24 hours after antibiotic treatment has started. The infected child should not use the same towels, linen or flannels as the rest of the family.

Family bathing should be avoided until the sore is healed. Be on the lookout for new sores.

Everyone in the family must be careful about hand washing. Children can often be tempted to wash their hands more carefully if a new or special type of soap is bought. Flowing soap pump packs are ideal.

Look out for any side effects from oral antibiotic tablets. Report any diarrhoea, stomach upsets or skin rashes to your doctor or practice nurse.

For further information and support talk to your doctor or practice nurse, talk to your local pharmacist, or ask to speak to the public health nurse attached to the school.

Written by Anna Mickell RCpN. Reviewed by everybody.