Impetigo - Infected Sores

Is this your child's symptom?

  • Coin-shaped sores on the skin covered by scabs
  • The infected crusts 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.

When to Call for Impetigo - Infected Sores

When to Call for Impetigo - Infected Sores

Call Doctor or Seek Care Now

  • 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

Contact 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
  • Fluid-filled blisters on the face
  • Impetigo gets worse after 48 hours on antibiotic ointment
  • You think your child needs to be seen, but the problem is not urgent

Contact 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)

Call Doctor or Seek Care Now

  • 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

Contact 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
  • Fluid-filled blisters on the face
  • Impetigo gets worse after 48 hours on antibiotic ointment
  • You think your child needs to be seen, but the problem is not urgent

Contact 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 for Impetigo

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.

Remove Scabs:

  • Soak off the scab using soap and warm water. The bacteria live underneath the scab.

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 to prevent scratching and spread.
  • Repeat the washing, ointment and dressing 3 times per day.

Do Not Pick at the Sores:

  • Help your child not to scratch and pick at the sores. This spreads the impetigo.

Return to School:

  • Impetigo is spread to others by contact with skin lesions.
  • 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.

What to Expect:

  • Sore stops growing in 1 to 2 days.
  • The skin is healed in 1 week.

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

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:38 Version 0.1

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February 12, 2026
There have been cases of measles in NC, with exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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