Impetigo

Impetigo is a very common and highly contagious bacterial infection that affects the skin.

It is caused by either:

• staphylococcus aureus (“golden staph”)
• streptococcus
• a mixture of both these bacteria

The bacteria can infect the skin in 2 main ways:

• through a cut, insect bite or other injury – primary impetigo
• through skin damaged by head lice, scabies or eczema – secondary impetigo

Incubation period

The incubation period is the length of time it takes from being infected by someone else with impetigo, to showing symptoms. It will take 4-10 days before you show any symptoms.

Impetigo has an incubation period of: 4-10 days

How do you get impetigo?

Impetigo is very easily spread by:

• direct contact
• sharing towels, face cloths or other personal items from an infected child (or adult)

You can’t catch impetigo from a person whose rash blisters are scabbed up and dry.

Symptoms of impetigo

• Tender red spots – this is the most common symptom of impetigo and they can especially occur all of the face (mostly around the mouth or nose), but also to other areas, such as the chest and hands
• Blisters – the red spots can develop into blisters, which are filled with a thick yellow pus that exudes when the blisters burst
• Golden-coloured scabs – this happens when the blisters start to heal

Treatment of impetigo

• See a doctor – any child with suspected impetigo needs to see a doctor who can perform an examination to diagnose this condition
• Topical antibiotic – if the impetigo is mild, the doctor will prescribe a topical antibiotic to apply on the rash
• Saline solution – the doctor may recommend soaking the impetigo scabs in a saline solution, to soften them, before applying the topical antibiotic (in milder cases of impetigo)
• Oral (or intravenous) antibiotic – stronger antibiotics may be required if the impetigo is severe, given either orally (a tablet) or intravenously (by a needle into the vein)
• Separate personal care – the child’s brush, comb and towel should be kept separate to everyone else’s in the family, to prevent the infection from spreading
• Wash everything separately – wash all the child’s towels, bedclothes and other items of clothing that may be in contact with the impetigo rash at high temperature (to kill the bacteria) and ensure to wash separately from the rest of the family laundry

Complications

Impetigo doesn’t normally cause any complications.

These complications generally occur only in children (and adults) who may have a very impaired immune system:

• cellulitis – an infection of the deeper layers of the skin and underlying tissue
• scarlet fever – a rare bacterial infection that causes a fine, pink rash across the body
• guttate psoriasis – a non-infectious skin condition that can develop in children and teenagers after a bacterial infection
• septicaemia (a type of sepsis) – a bacterial infection of the blood
• Staphylococcal scalded skin syndrome (SSSS) – a serious skin condition that looks like the skin has been scalded with boiling water
• post-streptococcal glomerulonephritis – an infection of the small blood vessels in the kidneys

In very rare cases, impetigo may lead to some scarring, particularly if you scratch at the blisters, crusts or sores

Vaccination

There’s currently no vaccine for impetigo.

If your child has impetigo, keep them away from childcare, kindergarten or school for at least 24 hours after starting antibiotics treatment.

Adults with the illness should also stay off work for at least 24 hours after starting antibiotics treatment.

Reducing risk of infection

Strategies to reduce infection:

• if your child gets impetigo, keep them away from school and other children
• discuss the impetigo infection with your doctor
• ensure you and your child/children wash hands with a sanitising hand soap
• wash toys and clothes in detergent that has a sanitising effect
• wipe down surfaces with a 70% alcohol solution
• don’t share eating utensils, linens, towels or other personal items with anyone else

References

• About impetigo. CDC USA. Accessed 10 July 2024
• Impetigo. National Library of Medicine USA. Accessed 10 July 2024

Last reviewed and updated: 10 July 2024