Impetigo (School Sores)

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Impetigo a contagious infection of the skin is most common among children, especially those who have eczema. It is caused by a strain of a bacteria, either the streptococcus or staphylococcus type.

Symptoms

Impetigo is contagious until the scabs are dried up and have fallen off. It usually starts off as an small itchy spot somewhere around the mouth, the nostrils or behind the ear. It can also begin on fingers, arms or the upper body. Impetigo located on fingers can cause cuticle infections.

Impetigo usually breaks out in connection with a cold, but impetigo can also occur without the cold. The bacteria can more easily remain in skin that is irritated or damp. The spot develops into a blister, followed by formation of more blisters and red spots. These often leak water or pus before they eventually break and become exuding wounds. Sometimes the bacteria can cause an itchy redness in a child’s genital area.

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What can I do?

The child is contagious as long as the wounds are moist. Children who attend preschool or family should be at home until the sores look completely dry out. Schoolchildren who understand that it is important to wash their hands frequently can be in school. However, they should not be involved in activities such as gymnastics, swimming and cooking.

Try to limit the contagion by washing the child’s and your own hands often with soap and water. You should avoid direct contact with the rash, but if you get in contact with the rash, wash hands thoroughly. Good hygiene is essential, and be sure to change towels after contact. Both adults and children should use disposable paper towels. Change clothes and pillow cases every day, and then wash them in hot water (at least 140 degrees). You should try to get the child to avoid scratching or touching the wounds. You can cut the child’s nails, making it easier to keep them clean, while more difficult to tear into the wounds. Wipe doorknobs and everything else that come in contact with your hands, and wash all toys (including stuffed toys) if possible.

If the child has a fever and the affected area is well defined on the skin, you can try treating it yourself. Wash the affected area thoroughly with liquid soap and water both in the morning and the evening. You can also wash it with chlorhexidine, which can be purchased in most pharmacies. Make sure to pat dry with a disposable towel. Even if it might hurt to apply chlorhexidine, it can soak up and remove the scabs formed on the blisters while washing. It is also easier to remove the crusts if you put a wet towel and compress on the wounds for a while before washing. In the beginning, the scabs might come back soon, but by repeating the treatment, the bacteria will stop growing, so wounds usually dries out afterwards.

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Should I seek medical care?

Impetigo can be treated by removing the scabs and wash several times a day so that the wounds and blisters dry out. Mupirocin ointment may be used. If the wounds do not heal after self-treatment, or if the rash continues to spread over the body, you should contact a healthcare provider. You should also seek medical care if the impetigo affect a large area of the skin or if you have a fever simultaneously.

Treatment

Oral antibiotics can be considered if there is a fever and widespread impetigo. A bacterial culture will be taken before antibiotic treatment is started.

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Sources:

Impetigo: Diagnosis and Treatment. HOLLY HARTMAN-ADAMS, MD; CHRISTINE BANVARD, MD; and GREGORY JUCKETT, MD, MPH, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, West Virginia Am Fam Physician. 2014 Aug 15;90(4):229-235.