Community Health Network

Impetigo - Infected Sores
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Symptom
Description

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Call?

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Impetigo of Left Cheek

Impetigo of Elbow

Definition

Bacterial skin infection causing 1 or more coin-shaped sores

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 is usually impetigo)
Impetigo often spreads and increases in number from scratching

Cause

Superficial bacterial infections of small breaks in the skin

Return to School

For mild impetigo (1 or 2 sores), child 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 to school or contact sports

If not, see these topics

It's in a wound, see WOUND INFECTION
Doesn't look like impetigo, see RASH - LOCALIZED AND CAUSE UNKNOWN

Should I
Call?

Care at
Home

When to Call Your Doctor

	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 am and 4 pm) 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) Sores and crusts are also inside the nose Impetigo becomes worse after 48 hours on antibiotic ointment
	Call Your Doctor During Weekday Office Hours If
	You have other questions or concerns Impetigo in 2 or more children (e.g., sibs, childcare groups) Child plays contact sports (Reason: to prevent spread) 3 or more impetigo sores (Reason: may need an oral antibiotic because many of these children also have strep throat infection) Not completely healed after 1 week on antibiotic ointment
	Parent Care at Home If
	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)

Symptom
Description

Care at
Home

HOME CARE ADVICE FOR MILD IMPETIGO

Reassurance:
- Impetigo is a superficial skin infection that usually starts in a scratch or insect bite.
- It usually responds to treatment with any antibiotic ointment.
Remove Scabs: Soak off the scab using an antibacterial soap and warm water. The bacteria live underneath the scab.
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.
Avoid Picking: Discourage scratching and picking which spreads the impetigo.
Contagiousness: Â
- Impetigo is contagious by skin to skin contact.
- Wash the hands frequently and avoid touching the sore.
- 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 to school.Â
- Contact Sports: Generally, needs to receive antibiotic treatment for 3 days before returning to the sport. There can be no pus or drainage. Check with team's trainer if there is one.
Expected Course: Sore stops growing in 1 to 2 days and skin is healed in 1 week.
Call Your Doctor If:
- Impetigo increases in size after 48 hours on antibiotic ointment
- New impetigo sore occurs on antibiotic ointment
- Not completely healed in 1 week
- Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Symptom
Description

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Disclaimer: This information is not intended 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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 8/5/2007

Content Set: Pediatric HouseCalls Online