Impetigo: What to Know About This Contagious Skin Infection Common in Toddlers

Impetigo is a highly contagious skin infection that affects toddlers and children. Learn how to identify, treat, and prevent it.

Illustration of a toddler with an impetigo rash on her face

Dennis Madamba for Parents

If your child goes to daycare or preschool, you know that exposure to other children can come with consequences, including an increased risk of illness. One relatively common childhood illness is the contagious skin infection called impetigo. This rash-producing condition accounts for 10% of skin conditions in children, according to the National Institutes of Health (NIH). Here’s how to identify, treat, and prevent impetigo in kids.

What Is Impetigo?

Impetigo is a highly infectious bacterial skin infection that primarily affects toddlers and children ages 2 through 5, according to the Centers for Disease Control and Prevention (CDC). It can happen at any age, though. 

While impetigo can occur anywhere on the body, it's mainly seen on exposed skin around the nose, mouth, arms, and legs.

Is Impetigo Contagious?

Impetigo is a very contagious bacterial skin infection. It can spread easily among children playing together.

“Bacteria need a portal of entry in order to cause impetigo. When the impetigo is scratched, the bacteria transfer under the fingernails and then are implanted at the site of the next scratch, which causes enough trauma at times to create a new lesion,” says Maya K. Thosani, M.D., FAAD, FACMS, a dermatologist and Mohs surgeon with Modern Dermatology in Scottsdale, Arizona. “Children often have small cuts and scrapes, and so when they play together, the impetigo can spread rather quickly.”

Children with untreated impetigo will be a threat for contagion at school and in activities that can cause mass spread, such as contact sports with communal equipment, says Dr. Thosani. “Your pediatricians, family physicians, and dermatologists are well versed in how to treat this condition, and the earlier the treatment is initiated, the easier the course of the disease is,” she adds.

What Causes Impetigo in Kids?

Impetigo is caused by one of two strains of bacteria. The most common cause is staphylococcus aureus (S. aureus or "staph"), followed by group A streptococcus ("strep"). 

Despite impetigo often presenting around the mouth, it’s important to note it isn’t the same as a cold sore caused by the herpes simplex virus (HSV).

How Is Impetigo Transmitted?

A child can get impetigo through skin-to-skin contact with someone who has the sores. It also spreads if you come in contact with fluid from the sores through objects like toys or bedding.

Impetigo Symptoms in Kids

Impetigo symptoms can take up to 10 days after exposure to appear. This makes it easier to pass to other people because it can take a few days before you realize you're infected.

Here's what the symptoms of impetigo look like:

  • Impetigo begins as reddish sores
  • They get itchy, sometimes painful, and begin to ooze clear fluid or pus
  • Crusty yellow or "honey-colored" scabs can form over the sores
  • Sores begin to heal and affected skin may look red (this typically does not leave scars)

Risk Factors for Impetigo 

While anyone can get impetigo, these factors increase the risk:

  • Young age
  • Group settings like schools, child care centers, and summer camps
  • Broken skin from injury 
  • Scabies infection
  • Skin conditions like eczema
  • Warm, humid climates
  • Lack of proper hand-washing and other body cleansing

Treatment for Impetigo in Kids

Once you suspect your child has impetigo, you should see their health care provider. Sores will need to be identified by a medical professional, and a skin culture may be taken to help provide the right course of treatment. Since this is a bacterial infection, antibiotics would be the best treatment.

"A topical antibiotic cream (mupirocin) is the standard treatment for impetigo," says Deny Engleman, M.D., FACMS, FAAD, a board-certified dermatological surgeon at the Shafer Clinic Fifth Avenue in New York City. "Since this is only available by prescription, a medical visit is required to diagnose and treat this condition."

An oral antibiotic like amoxicillin may be needed in more complicated cases, including when there are many sores.

Health care providers may also recommend keeping sores clean and covered to prevent spreading. This keeps kids from scratching, which can further extend the infection and may cause scarring.

How Long Does Impetigo Last?

Impetigo symptoms can start improving within 24 hours of treatment. It’s usually no longer contagious after 48 hours of antibiotic treatment. Without treatment, you must wait until the sores have scabbed over and healed before joining a group setting. That can take a few weeks.

Are There Complications of Impetigo?

Without treatment, severe cases of impetigo may result in a deeper infection, such as an abscess, cellulitis, or erysipelas. 

“If left untreated, impetigo can spread and cause discomfort and scarring,” Dr. Thosani points out. “It is important to treat and reduce spread to self and others to shorten the clinical course of the infection.” 

This is why experts recommend parents seek medical help, especially when conservative measures to treat impetigo fail.

How To Prevent Impetigo

People can get impetigo more than once, and the best way to prevent it is practicing good hygiene. Impetigo can be self-inoculating, meaning it can be spread from one body part to another by the individual through scratching or contamination, according to Dr. Engelman. "Prevention is best achieved by keeping the skin clean and avoiding contact with known infected individuals," adds Dr. Engelman.

Encourage kids to wash their hands often. You should also make sure to clean and care for wounds. Cut nails to avoid scratching, which can spread the rash and cause infection. 

Another line of defense is washing an infected person's bedding, towels, and clothing. That’s critical because impetigo can quickly spread to other household members. Don't forget to clean high-touch areas with an antibacterial disinfectant because impetigo can last on dry surfaces for weeks.

Finally, notify your child’s school so they can take necessary precautions as well.

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