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Impetigo - Infected Sores

Definition

  • Coin-shaped sores on the skin
  • Covered by scabs or crusts that are the color of honey
  • Skin infection caused by a bacteria

Symptoms of Impetigo

  • Sores smaller than 1 inch (2.5 cm)
  • Often covered by a soft, yellow-brown scab or crust
  • Scabs may drain pus or yellow fluid off and on
  • Starts as small red bumps. These change quickly to cloudy blisters or pimples. Then, they become open sores which drain fluid or pus.
  • Sores increase in size
  • Any sore or wound that grows and doesn't heal is usually impetigo.

Cause of Impetigo

  • A skin infection caused by a bacteria. It starts in a small break in the skin. Examples are a scratch or insect bite.
  • The most common bacteria are Staph and Strep. If the child has a sore throat, they may also have Strep throat. A rapid Strep test will give the answer.
  • Impetigo often spreads and increases in number from scratching.

Return to School

  • For mild impetigo (1 or 2 sores), can go back if sores are covered.
  • For severe impetigo, child needs to take an oral antibiotic more than 24 hours. Then your child can go back to school.

When To Call

Call Doctor Now or Go to ER

  • Pink or tea-colored urine
  • Fever and spreading redness around the impetigo
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Spreading redness around the impetigo and no fever
  • Fever or sore throat are present
  • Sore is larger than 1 inch (2.5 cm) across
  • Sores and crusts inside the nose
  • Impetigo gets worse after 48 hours on antibiotic ointment
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Impetigo in 2 or more children (such as siblings or play groups)
  • Child plays contact sports (Reason: to prevent spread)
  • 3 or more impetigo sores (Reason: May need an oral antibiotic. Many of these children also have a Strep throat)
  • Not healed up after 1 week on antibiotic ointment
  • You have other questions or concerns

Self Care at Home

  • Mild impetigo (1 or 2 sores that started with a scratch or insect bite)

Care Advice

  1. What You Should Know About Impetigo:
    • Impetigo is a skin infection. Most often, it starts in a scratch or insect bite.
    • It usually responds to treatment with any antibiotic ointment.
    • Here is some care advice that should help.
  2. Remove Scabs:
    • Soak off the scab using soap and warm water. The bacteria live underneath the scab.
  3. Antibiotic Ointment:
    • Put an antibiotic ointment (such as Polysporin) on the sores. No prescription is needed. You can also use one you already have.
    • Do this 3 times per day.
    • Cover it with a bandage (such as Band-Aid) to prevent scratching and spread.
    • Repeat the washing, ointment and dressing 3 times per day.
  4. Do Not Pick at the Sores:
    • Help your child not to scratch and pick at the sores. This spreads the impetigo.
  5. Return to School:  
    • Impetigo is spread to others by skin to skin contact.
    • Wash the hands often. Try not to touch the sores.
    • For mild impetigo (1 or 2 sores), can go to school if it is covered.
    • For severe impetigo, child needs to take an oral antibiotic for more than 24 hours. Then your child can go back to school. 
    • Contact Sports. In general, needs to be on antibiotics for 3 days before returning to sports. There must be no pus or drainage. Check with the team's trainer if there is one.
  6. What to Expect:
    • Sore stops growing in 1 to 2 days.
    • The skin is healed in 1 week.
  7. Call Your Doctor If:
    • Impetigo sore gets bigger after 48 hours on antibiotic ointment
    • Gets new impetigo sore on antibiotic ointment
    • Not healed up in 1 week
    • You think your child needs to be seen
    • Your child becomes worse

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

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