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Causes of impetigo or school sores

Impetigo or school sores develop when a common bacteria (usually Streptococcus A or Staphylococcus aureus) gets into a cut, scratch or sore on your child's skin. Because the skin is broken, it can't act as a barrier against the bacteria.

The bacteria grow in the sore and stop it from healing normally. The bacteria can spread if other parts of the body come into contact with the original sore. This can cause more impetigo sores to develop.

Impetigo is highly contagious. It's quite common for there to be outbreaks in schools and child care centres.

Impetigo often occurs on top of other skin problems like eczema, scabies, insect bites or chickenpox.

Impetigo is more common in the warmer months.

Symptoms of impetigo or school sores

In the early stages of impetigo, all you might notice are flat red spots or small blisters on any part of your child's body. These spots are especially common around the face (particularly the mouth and nose), hands and legs.

The spots might fill up with yellow or green pus, burst or crust over. The bacteria are in the liquid and crusts of the sores. If you don't treat the sores, they might get bigger and more of them might grow.

Impetigo can be itchy or tender.

When to see your doctor about impetigo or school sores

You should see your GP if:

  • a sore on your child's body is surrounded by an area of red skin
  • your child has a crusted or weeping sore, especially if the sore is getting larger or spreading
  • your child is also generally unwell or has a fever
  • you think your child has impetigo.

Tests for impetigo or school sores

Your GP will take a swab of the infected sores and send it for testing. This can work out what bacteria is causing the impetigo infection and the antibiotic that will work best against it.

Treatment of impetigo or school sores

If the impetigo sores are small and aren't blistering, apply an antibiotic cream and be extra careful about skin hygiene and handwashing. This can prevent the sores from spreading and allow them to heal.

But most cases of impetigo need a prescribed medication like an antibiotic ointment, tablet or liquid. Your child will need to use the antibiotic for at least seven days, and she must take the full course of antibiotics, or the infection might come back again.

In between putting the ointment on the infected spots, gently wash your child's skin with soap or an antibacterial solution, then pat dry.

You can remove the crusts from your child's skin by getting him to soak in the bath for 20-30 minutes to soften the scabs. You can then gently wipe away the crust with a towel.

Prevention of impetigo or school sores

Wash any bites, cuts, grazes or areas of eczema carefully and keep them clean. These can be points of entry for the bacteria that cause impetigo.

Impetigo can spread rapidly to other parts of the body if your child touches the sore and then scratches somewhere else. Explain this to your child, and encourage her not to pick at the sores.

Keep your child's fingernails short and make sure he washes his hands often, until the infection has cleared up.

Use separate towels for different areas of impetigo, and don't use these towels to dry unaffected areas of your child's body.

Use hot water to wash towels, bed linen, soft toys and anything else that has come into contact with blood, pus or sores. Dry in hot sun or in a hot clothes dryer.

Impetigo is highly contagious. Keep your child home from child care, preschool or school, and cover all the sores with watertight dressings. After your child starts antibiotic treatment, wait at least 24 hours before sending her back to child care, preschool or school.