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North East Valley Division of General Practice, Victoria, Australia.

Impetigo (school sores) information sheet
www.health.vic.gov.au/ideas/bluebook/impetigo_info.htm

What is impetigo?

Impetigo is a contagious skin infection usually caused by either Staphylococcus or Streptococcus bacteria. It is most commonly found in children although it may also occur in adults.

Impetigo may affect skin anywhere on the body but commonly occurs in the area around the nose and mouth. It first appears as a small itchy, inflamed area of skin which blisters. The blisters rupture, release a yellow fluid and develop honey-coloured crusts and form scabs. New blisters develop in the same area or in different parts of the body and may ooze fluid which is highly contagious.

Impetigo is easily diagnosed by the doctor. Occasionally a skin swab may be taken to identify the bacteria responsible for the infection.

How is impetigo spread?

Impetigo is extremely contagious. It can be spread from one person to another through touch or shared items such as clothes and towels. However, a person can also spread it to another part of their own body through scratching or picking at the blisters and scabs.

Who is most at risk of developing impetigo?

Children are most at risk of developing impetigo. Children and adolescents may be more likely to develop impetigo if the skin has already been irritated or injured by other skin problems such as eczema, insect bites, skin allergy or recent cuts or abrasions.

How long does it take until symptoms start?

The incubation period will vary depending on the particular bacteria.

It is usually 1–3 days for streptococcal and 4–10 days for staphylococcal infections.

How is impetigo treated?

• Impetigo is most often treated with antibiotics, either orally or with bactericidal ointment. It is important to follow the recommended treatment and complete the course of antibiotics.
• Treatment involves washing the sores and crusts every 12 hours or as directed with the prescribed soap or lotion. After each wash pat dry.
• Healing should begin within 3 days and the infection eliminated in 7–10 days.
• If the sores spread and get worse despite treatment or the child becomes unwell with fever, see your doctor.
• Cover the sores with an airtight dressing if the child is returning to school in order to reduce the risk of spreading the infection.
• The child’s clothes, towels and bedclothes should be changed at least once a day.
• Always remember to wash your hands after touching scabs or sores or handling infected clothing.

How long does impetigo remain infectious?

If untreated, oozing sores remain infectious for as long as they persist.

When can children return to school or child care?

Children can return to school or child care after treatment has started and the sores are completely covered with a watertight dressing.

How can impetigo be prevented?

• Encourage children to wash their hands regularly and always use their own towel and facecloth.
• Cut your child’s nails short and encourage them not to scratch scabs or pick their nose.
• Keep injured areas of skin clean and covered to minimise the chance of any bacterial infection, including impetigo.
• Always wash your hands after touching sores or scabs and use gloves if possible when treating infected children.
• Keep children with impetigo away from other children for the period of exclusion. This is until antibiotic treatment has commenced and the sores are covered with a watertight dressing.

Further information

• Your local doctor
• Better Health Channel
  www.betterhealth.vic.gov.au
• Victorian Department of Human Services
  Telephone: 1300 651 160
• Impetigo (school sores)