Impetigo is one of the most common bacterial skin infections in young children, and it is readily recognisable once familiar — the characteristic honey-coloured crusting around the mouth or nose, or on any area of broken skin, is quite distinctive. It spreads quickly in nursery and school settings through direct contact, and it requires straightforward but prompt treatment to reduce the spread and the duration.
Understanding what impetigo looks like, how it is treated, and the isolation guidelines prevents unnecessary spread while enabling parents to manage the condition confidently at home.
Healthbooq supports parents in tracking and managing common childhood skin conditions, providing context for decisions about treatment and when to seek medical assessment.
What Impetigo Looks Like
Impetigo begins as small red sores that quickly develop into fluid-filled blisters (vesicles or bullae). These blisters burst easily, leaving a moist area that dries to produce the characteristic golden-yellow, honey-coloured crust that is impetigo's hallmark. The sores most commonly appear around the nose and mouth, but can appear anywhere on the body — and often begin at sites of pre-existing skin damage, including eczema plaques, insect bites, or minor cuts, because bacteria enter more readily where the skin barrier is broken.
In bullous impetigo (a less common form caused specifically by certain strains of Staphylococcus aureus), the blisters are larger and more prominent, and the surrounding skin may look more clearly inflamed. Bullous impetigo is more common in newborns and young infants.
Children with active eczema are at significantly higher risk of impetigo because the disrupted skin barrier provides an easy entry point for bacteria. Impetigo occurring on eczematous skin is called "eczema herpeticum" if caused by herpes simplex virus — a different and more serious condition — or "secondary bacterial infection of eczema" if bacterial. Any child with eczema who develops sudden widespread or rapidly worsening skin infection should be seen promptly.
Treatment
For localised impetigo affecting a small area, topical antibiotic treatment is appropriate and effective. In the UK, hydrogen peroxide 1% cream (Crystacide) is available over the counter and is appropriate for adults; topical fusidic acid is the first-line antibiotic cream on prescription for children. The sores should be gently cleaned with cooled boiled water before applying the cream, and the treatment continued for the full prescribed course (typically five to seven days) even if improvement is visible earlier.
For more extensive impetigo, multiple affected sites, or impetigo in infants, oral antibiotic treatment (typically flucloxacillin or cefalexin) is needed. A GP assessment is appropriate in these circumstances and whenever impetigo affects a baby under one year.
Preventing Spread
Impetigo is highly contagious through direct contact and through sharing towels, flannels, bedding, and clothing. The affected child should have their own towel and flannel, bedding should be washed frequently, and the sores should be kept covered where practical. Hand washing — both the child's and the carer's — is the most important prevention measure for spread within the household.
Children with impetigo should stay away from nursery or school until 48 hours after antibiotic treatment has started and the sores are beginning to dry and crust, or until all sores are completely dried and crusted if no antibiotic treatment is used.
Key Takeaways
Impetigo is a common, highly contagious bacterial skin infection that mainly affects young children, presenting as red sores that quickly blister, burst, and develop a golden-yellow or honey-coloured crust. It is caused by Staphylococcus aureus or Streptococcus pyogenes and spreads readily through direct contact and shared items. Treatment with topical antibiotic cream (hydrogen peroxide cream or fusidic acid) is effective for localised cases; oral antibiotics are required for more extensive infections. Children with impetigo should stay away from nursery or school until 48 hours after starting treatment or until sores are dried and crusted.
