What is impetigo?

Impetigo is a bacterial skin infection caused by Streptococcus and/or Staphylococcus bacteria. It is also called 'school sores'. It mostly affects pre-school and primary school-aged children, however people of all ages can get impetigo.

What are the symptoms of impetigo?

Impetigo causes sores on the skin.

The sores are usually red and itchy. They often start as blisters that break open and leak a clear fluid or pus for a few days. At the beginning they may be red, moist and weepy. After this, a flat, crusty yellow or 'honey-coloured' scab can appear.

These sores can occur anywhere on the body but usually appear on the skin around the nose and mouth, arms and legs.

People who have a lot of sores may also have a fever and/or swollen lymph nodes.

Very rarely, impetigo can lead to more serious illnesses such as Sepsis, or complications affecting the heart (rheumatic fever and rheumatic heart disease) or kidneys (post-streptococcal glomerulonephritis).

How is it spread?

Impetigo is highly infectious.

Impetigo spreads when people directly touch impetigo sores or the fluid from sores,​ and spread the infection via their hands to other parts of their body. It also spreads by touching surfaces or objects which have been contaminated by the sores, including clothing, sheets and towels.

The bacteria can cause infection by entering broken skin such as cuts, bites or scratches.

Who is at most risk?

Impetigo is dangerous for babies. This is because a baby's immune system is not fully developed. It is important for people with impetigo to keep away from newborns and young babies.

People with skin conditions or a cut, scratch or bite may also be at risk. This could include:

• eczema
• scabies
• insect bites
• head lice.

How is it diagnosed?

Doctors usually diagnose impetigo by looking at the sores. Sometimes they may test for the bacteria with a swab.

How is it treated?

Impetigo is treated with antibiotic ointment or, in some cases, oral antibiotics.

Antibiotic ointment should be applied until the sores have completely healed.

If oral antibiotics are given it is important to finish the whole course of treatment as prescribed by your doctor even if the impetigo has started to clear.

To take care of sores:

• clean them every 8 - 12 hours with soap
• soak visible crusts and gently wipe them away with a wet disposable cloth
• pat them dry, using a clean towel each time
• if antibiotic ointment is recommended, apply ointment according to your doctor's or pharmacist's instructions
• cover sores with a waterproof dressing.

Avoid scratching the sores to prevent further spread of infection.

Speak to your doctor if you or your child become unwell, including if:

• sores spread past the nose, mouth, arms and legs
• a fever develops
• a new rash starts despite treatment.

If your doctor is not available, call healthdirect on 1800 022 222 (24-hour helpline).

How can people avoid spreading impetigo?

To avoid spreading impetigo:

• keep sores clean and covered with a waterproof dressing until they have healed. This stops people from touching or scratching them
• discard used dressings as soon as they are taken off
• wash your hands with soap and running water for 20 seconds after touching or cleaning sores and after handling contaminated objects such as dressings, sheets and towels
• avoid sharing clothes, towels or bed sheets with anyone who has impetigo
• avoid bathing children in the same bathwater if any child has impetigo
• wash clothes, sheets and towels used by someone with impetigo every day, ideally in hot water
• keep your child home from school, childcare and other group settings until at least 24 hours of antibiotic treatment has started. All sores on exposed skin should be covered when returning to usual activities such as school.

Information for schools and childcare centres

To stop the spread, schools and childcare centres can:

• educate teachers, children and families on the importance of hand washing, covering sores with a waterproof dressing and staying home if sick
• provide hand washing products including soap dispensers, running water, and paper towels
• encourage and allow time for children and staff to wash their hands between activities, including before eating and after going to the toilet
• clean commonly used surfaces and objects frequently with detergent, including counters, desks, sheets, towels and toys. This is important if they have been used by a child with impetigo or are visibly dirty
• encourage children to not share towels, drink bottles, cups, clothes and utensils.

Schools and childcare centres are encouraged to contact their local Public Health Unit (PHU) on 1300 066 055 if advice on outbreak control is required.

Resources on preventing infectious diseases in childcare settings can be found in the 5th Edition of Staying Healthy: Preventing infectious diseases in early childhood education and care services​.

For further information speak to your doctor, call healthdirect on 1800 022 222 for free 24-hour health advice or call your local Public Health Unit on 1300 066 055.​