Published: July 2025 | Last Updated: August 31, 2026 | Medical Sources Checked: August 31, 2026
Your child has a small sore near the nose.
By the next day, it looks wet.
Then a golden crust appears.
You may wonder if it is just a scratch.
It could be childhood impetigo.
Impetigo is a common bacterial skin infection.
It spreads easily.
It is especially common in young children.
The good news is that it is usually easy to treat.
Early care also helps stop it spreading to siblings, classmates, and other parts of your child's skin.
This guide explains impetigo symptoms in children, what honey colored crusts mean, treatment, antibiotics, contagious periods, school and daycare rules, prevention, and the signs that need medical care.
For more help with children's skin problems, visit our Childhood Skin Problems Guide or the main Child Health and Safety Guide.
Quick Answer
Childhood impetigo is a contagious bacterial skin infection.
It often starts as small sores or blisters.
They can break open.
They may leak fluid.
Then they often form a golden or honey colored crust.
The face is a common place.
It often appears around the nose and mouth.
It can also appear on the arms, legs, hands, or other areas.
Doctors usually treat impetigo with a topical medicine or an antibiotic taken by mouth.
The choice depends on the type of impetigo, how much skin is affected, your child's age, local medical guidance, and antibiotic resistance.
Do not use leftover antibiotics or another person's antibiotic cream.
Important Medical Note
I am not a dermatologist or A doctor, and this content does not replace professional medical advice. What I share comes from real-life experience, extensive research, and consultation with healthcare providers. Always consult qualified medical professionals for diagnosis and treatment of any health condition.
What Is Childhood Impetigo?
Impetigo is a bacterial skin infection in children.
Two bacteria are common causes.
- Staphylococcus aureus
- Streptococcus pyogenes
A child can have one or both bacteria involved.
The bacteria infect the outer layers of the skin.
Impetigo can begin where the skin is already damaged.
A tiny scratch may be enough.
An insect bite can also open the skin.
Eczema can make the skin more susceptible to infection.
Sometimes impetigo starts on skin that looked normal before the infection appeared.
What Does Childhood Impetigo Look Like?
The classic clue is a honey colored crust rash.
But impetigo does not always start that way.
It may begin as:
- Small spots
- Red or darker areas
- Small blisters
- Wet sores
- Pus-filled bumps
The sores can break.
Fluid dries on the skin.
This creates the golden brown crust many parents notice.
The area may itch.
It can also feel sore.
How Does Impetigo Look on Brown and Black Skin?
Do not look only for bright red skin.
Redness can be harder to see on brown and black skin.
The skin around the sores may look:
- Brown
- Purple
- Gray
- Darker than normal skin
The crust may still look yellow, gold, or brown.
Also look for wet sores, blisters, swelling, warmth, and spreading.
Where Does Impetigo Usually Appear?
Impetigo around the mouth is very common.
It also often affects the nose.
Other common areas include:
- Hands
- Arms
- Legs
- Areas around insect bites
- Areas with scratches
- Areas affected by eczema
Impetigo can appear almost anywhere on the body.
If your child has an unclear rash near the lips or chin, see our Childhood Rash Around Mouth Guide.
What Are the Types of Impetigo?
There are two main forms.
Non-bullous impetigo
This is the most common type.
It often starts as small spots or bumps.
They can become small pustules.
The sores break open.
Then the classic honey colored crust forms.
The face and limbs are common locations.
Bullous impetigo
Bullous impetigo in children causes larger fluid-filled blisters.
The blisters may be soft and fragile.
They can break and leave raw-looking skin with a thin crust.
Bullous impetigo can affect the trunk, arms, legs, or skin folds.
Babies with suspected bullous impetigo should receive medical assessment.
Impetigo Versus a Normal Scratch
A normal scratch should slowly dry and heal.
Impetigo tends to spread.
New sores may appear nearby.
You may see:
- Wet skin
- Golden crusts
- New small sores
- Increasing itch
- More spots after scratching
If a small cut starts spreading instead of healing, ask a healthcare professional to look at it.
Impetigo Versus Eczema
Eczema usually causes dry and itchy skin.
But scratching eczema can damage the skin.
Bacteria can then enter.
This can lead to infected eczema or impetigo.
Signs of possible infection include:
- New wet areas
- Golden crusts
- Pus
- Increasing pain
- Fast change
If your child's normal eczema suddenly looks very different, contact a healthcare professional.
Impetigo Versus Ringworm
Ringworm is caused by fungus.
Impetigo is caused by bacteria.
Ringworm often creates a round or ring-shaped scaly patch.
Impetigo more often creates wet sores and golden crusts.
Read our Childhood Ringworm Guide if the skin looks circular or scaly.
Impetigo Versus Cold Sores
Cold sores are caused by herpes simplex virus.
They often form groups of small painful blisters around the lips.
Impetigo may also appear near the mouth.
This can make the two conditions difficult to tell apart.
Do not guess if the appearance is unclear.
A clinician can check the skin.
Impetigo Versus Childhood Rashes
Many childhood skin problems can cause spots.
Impetigo has its own pattern.
It usually affects smaller areas and creates sores or crusts.
A viral rash often affects larger areas of the body.
If your child has widespread spots or several types of skin changes, use our Childhood Rashes Guide.
What Causes Childhood Impetigo?
The infection starts when bacteria reach the skin.
Skin damage can make this easier.
Common starting points include:
- Scratches
- Small cuts
- Insect bites
- Eczema
- Scabies
- Other itchy rashes
Scratching can create tiny skin breaks.
That gives bacteria a place to enter.
Is Poor Hygiene the Cause of Impetigo?
No.
A clean child can still get impetigo.
Children touch other children.
They play closely.
They get cuts and bites.
They scratch itchy skin.
These normal childhood activities can help bacteria spread.
Good hygiene lowers the chance of spread.
It does not mean a child with impetigo is dirty.
Who Is More Likely to Get Impetigo?
Impetigo can affect anyone.
It is more common in young children.
Risk may be higher with:
- Close contact at daycare or school
- Warm humid weather
- Eczema
- Scabies
- Scratches and cuts
- Insect bites
- Contact sports
- Crowded living conditions
Children who scratch itchy skin often may spread bacteria from one place to another.
How Does Childhood Impetigo Spread?
Contagious impetigo can spread through direct skin contact.
It can also spread through objects.
These may include:
- Towels
- Washcloths
- Bedding
- Clothes
- Sports equipment
- Shared toys
A child can also spread the infection around their own body.
They scratch one sore.
Then they touch another area.
This is why short nails and handwashing matter.
How Long Is Childhood Impetigo Contagious?
This answer depends on the medical guidance used where you live.
In the United States, CDC guidance says a person with group A strep impetigo can return to school or work at least 12 hours after starting appropriate antibiotic treatment.
The sores on exposed skin should be covered.
The child should also be well enough to return.
Some schools or healthcare providers use a 24-hour rule.
In the United Kingdom, NHS guidance says impetigo is considered contagious until 48 hours after prescribed treatment starts.
Without treatment, NHS guidance advises waiting until the sores have dried and crusted.
Always follow your child's clinician, school, daycare, and local public health rules.
Can My Child Go to School With Impetigo?
Do not use one worldwide rule.
Requirements differ by country.
They can also differ between schools.
Before returning, make sure you know:
- How long treatment has been used
- Whether exposed sores must be covered
- Whether your child feels well enough for school
- Your school's infection policy
Tell the school or daycare if your child has confirmed impetigo.
This can help staff watch for other cases.
What About Contact Sports?
Contact sports can spread skin infections more easily.
Wrestling and similar sports involve close skin contact.
Sports organizations may use stricter return rules than schools.
Your child's sores should not be leaking.
Ask the doctor, school trainer, or sports organization when your child can safely return.
How Is Childhood Impetigo Diagnosed?
A doctor can often diagnose impetigo by looking at the skin.
A test is not always needed.
The doctor looks at:
- The sores
- The crust
- The location
- How quickly it spread
- Other symptoms
A skin swab may be useful when impetigo keeps returning.
A swab may also be used if treatment is not working.
It can help identify the bacteria and guide antibiotic choice.
How Is Childhood Impetigo Treated?
Impetigo treatment in children depends on how much skin is affected.
It also depends on whether the infection is bullous or non-bullous.
Local antibiotic resistance matters too.
This is why treatment can differ between countries.
Medicine applied to the skin
A clinician may recommend treatment placed directly on a small local area.
Depending on local guidelines, this may include an antiseptic treatment or a prescription topical antibiotic.
Do not choose an antibiotic cream yourself just because another child used it.
Oral antibiotics
An antibiotic taken by mouth may be needed when:
- There are many sores
- The infection is widespread
- Bullous impetigo is present
- The child is unwell
- Topical treatment is not appropriate
The exact antibiotic depends on local guidance and resistance patterns.
Give prescribed medicine exactly as directed.
Why Antibiotic Choice Matters
Antibiotics are important medicines.
Bacteria can become resistant when antibiotics are overused or used incorrectly.
This is called antibiotic resistance.
Do not use:
- Old antibiotic cream
- Another person's antibiotics
- Leftover tablets
- A shorter course than prescribed
Ask your child's clinician what is appropriate.
Should I Finish the Antibiotic Course?
Follow the exact instructions given by the clinician or pharmacist.
Do not stop treatment early just because the skin looks better unless the prescriber tells you to stop.
The treatment plan was chosen for your child's infection.
How to Clean Impetigo Sores
Keep care gentle.
Wash your hands first.
Clean the skin with soap and water.
Do not scrub hard.
Dry the area gently.
Apply prescribed treatment as directed.
Wash your hands again.
A healthcare professional may recommend covering exposed sores with a clean dressing.
Should I Remove the Crust?
Do not pick it.
Do not pull hard crusts from the skin.
Gentle washing or soaking may soften loose crust.
Follow the instructions given with your child's treatment.
Picking can cause bleeding.
It can also spread bacteria.
Should Impetigo Be Covered?
Covering exposed sores can help protect the skin.
It can also reduce direct contact with other people.
Use a clean dressing when advised.
Change it if it becomes wet or dirty.
Wash your hands before and after touching the dressing.
Can I Use Over-the-Counter Antibiotic Ointment?
Do not assume any antibiotic ointment will treat impetigo.
The correct treatment differs by country.
Bacterial resistance also differs by area.
Ask a pharmacist or doctor before treating suspected impetigo.
Are Natural Remedies Safe for Childhood Impetigo?
Do not delay proven treatment while trying home remedies.
Tea tree oil, essential oils, vinegar, garlic, and other mixtures can irritate a child's skin.
They are not replacements for medical treatment.
Honey should not be used as a substitute for prescribed impetigo treatment.
The safest plan is to have suspected impetigo assessed and use the treatment recommended for your child.
What Can I Do at Home?
Home care supports medical treatment.
It does not replace it.
Wash hands often
Wash your hands before and after touching infected skin.
Help your child wash their hands too.
Keep nails short
Short nails make scratching less damaging.
They can also reduce the amount of bacteria trapped under nails.
Do not share towels
Give the child their own towel and washcloth.
Wash bedding and clothes
Wash items that touch infected skin.
Follow normal fabric washing instructions and local health advice.
Clean washable toys
Clean toys that have had close contact with the child.
Keep sores covered when advised
This can reduce touching and spread.
How Can I Stop Impetigo Spreading to Siblings?
Children living together share many things.
That makes household spread possible.
While your child is contagious:
- Avoid sharing towels
- Avoid sharing washcloths
- Avoid sharing pillows when possible
- Wash hands often
- Clean shared toys
- Keep sores covered when advised
- Do not let children pick each other's sores
Watch siblings for new sores.
Get advice if another child develops the same pattern.
Can Impetigo Spread Around the Body?
Yes.
A child may scratch one sore and move bacteria to another place.
New sores can then appear.
This is called self-spread.
Keeping nails short and treating the infection can help stop it.
How Long Does Childhood Impetigo Take to Heal?
With effective treatment, improvement often begins within a few days.
The skin still needs time to heal.
Crusts may remain while new skin forms underneath.
Contact your clinician if the infection is getting worse instead of better.
Also call if there is no clear improvement within the time your clinician told you to expect.
Does Impetigo Leave Scars?
Most ordinary impetigo heals without permanent scars.
Picking and scratching can damage the skin.
A deeper infection can also increase the risk of marks.
After healing, the skin may look lighter or darker for a while.
This colour change can take time to fade.
When Should I Call the Doctor?
Contact a healthcare professional if:
- You think your child has impetigo
- The sores are spreading
- Several areas are affected
- The sores are painful
- The child has a fever
- The child looks unwell
- The skin around the sores becomes very red or swollen
- The infection is near the eye
- Treatment is not working
- The infection keeps returning
Young babies deserve extra care.
NICE recommends specialist advice for bullous impetigo, particularly in babies aged 1 year or younger.
When Is Impetigo More Urgent?
Get prompt medical care if your child has signs that the infection may be going deeper.
Watch for:
- Rapidly spreading redness
- Strong pain
- Hot swollen skin
- Fever with spreading skin infection
- Red streaks
- A child who looks very ill
These signs may point to cellulitis or another more serious infection.
What Is Cellulitis?
Cellulitis is a deeper bacterial skin infection.
The skin may become:
- Hot
- Red or dark
- Swollen
- Painful
A child may also have fever.
Cellulitis needs medical assessment.
Can Impetigo Cause Kidney Problems?
Rarely, a kidney condition called post-streptococcal glomerulonephritis can happen after a group A strep skin infection.
It usually develops after the original infection.
Contact a healthcare professional promptly if your child recently had impetigo and develops:
- Dark or tea colored urine
- Blood in the urine
- Swelling around the eyes
- Swelling of the feet
- Reduced urine
This complication is uncommon.
But parents should know the warning signs.
Why Does Impetigo Keep Coming Back?
Some children get repeated impetigo.
There may be several reasons.
The child may have eczema.
They may have frequent skin breaks.
Bacteria may also live in the nose without causing symptoms.
If impetigo keeps returning, a doctor may take a skin swab.
They may also consider a nasal swab.
Special treatment to reduce bacterial carriage may be recommended.
Do not try decolonization treatments yourself.
Can Eczema Make Impetigo Come Back?
Yes.
Dry itchy skin creates a cycle.
The child scratches.
The skin breaks.
Bacteria get in.
Good eczema care can help protect the skin barrier.
For a broader guide to children's skin, read Childhood Skin Problems.
How to Prevent Childhood Impetigo
You cannot prevent every infection.
Simple habits can reduce risk.
Clean cuts and scratches
Wash minor injuries with soap and water.
Try to stop scratching.
Treat itchy skin problems.
Keep nails short.
Care for eczema
Healthy skin is a better barrier against bacteria.
Wash hands
Teach children to wash their hands after touching sores, bites, or scratches.
Do not share personal items during infection
This includes towels and washcloths.
Clean sports cuts quickly
Children who play contact sports often get small skin injuries.
Clean them soon after they happen.
Can Insect Bites Turn Into Impetigo?
Yes.
An insect bite itself is not impetigo.
But a child may scratch it.
That breaks the skin.
Bacteria can then infect the area.
This is one reason impetigo can appear on the arms and legs in warm weather.
Can Scabies Lead to Impetigo?
Yes.
Scabies causes strong itching.
Scratching damages the skin.
This can allow bacteria to enter and cause impetigo.
Treating the cause of the itching matters as well as treating the bacterial infection.
Should I Take a Photo of the Sores?
Yes.
A photo can help track the infection.
Take it in good light.
Take another photo later if the area changes.
This can help your child's clinician see how quickly it spread.
Do not delay medical care just to take photos.
My Parent Approach to a New Crusted Sore
Over decades of parenting, I have learned not to treat every skin spot with whatever cream happens to be in the cupboard.
I first look at the pattern.
Is it wet?
Is there a golden crust?
Is it spreading?
Is the child scratching?
Is there fever?
Does the skin look hot and swollen?
I take a photo.
I stop towel sharing.
I encourage handwashing.
And when the sore looks infected, I ask a qualified healthcare professional instead of guessing.
That approach comes from real family experience, extensive research, and conversations with healthcare providers.
It does not replace a diagnosis.
Helping a Child Feel Comfortable
Visible sores can upset a child.
They may feel embarrassed.
They may worry that friends will stare.
Keep your explanation simple.
Tell them it is an infection that can get better.
Tell them they did nothing wrong.
Do not blame them for scratching.
Help them follow the treatment routine.
Praise them for washing their hands and leaving the sores alone.
Conclusion
Childhood impetigo is common, contagious, and usually treatable.
Look for wet sores, blisters, and the classic honey colored crust.
Get the right diagnosis.
Use prescribed treatment correctly.
Wash hands.
Keep personal items separate while the infection is contagious.
Follow your local school or daycare return rule because guidance can differ between countries.
If the sores spread quickly, become painful, or your child develops fever or looks unwell, contact a healthcare professional.
For your next step, bookmark the Parnthub Child Health and Safety Guide so you can quickly find reliable help when another childhood symptom appears.
Related Parnthub Guides
- Child Health and Safety Guide
- Childhood Skin Problems
- Childhood Rashes Guide
- Childhood Fever and Rash
- Childhood Skin Bumps
- Childhood Rash Around Mouth
- Childhood Ringworm
- Childhood Hives
- Molluscum Contagiosum
Trusted Medical References and Sources
This guide was checked against pediatric, dermatology, public health, and antimicrobial prescribing guidance. All five resources below were publicly accessible without a paid subscription or login when checked on August 31, 2026.
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Centers for Disease Control and Prevention: Clinical Guidance for Group A Streptococcal Impetigo
This CDC clinical resource explains the bacteria that cause impetigo, honey colored crusts, diagnosis, topical and oral antibiotic treatment, complications, prevention, and return to school guidance.
https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/impetigo.html
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NHS: Impetigo
This NHS resource explains symptoms, contagious periods, treatment, school and nursery exclusion, recurrent impetigo, hygiene, and prevention.
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American Academy of Dermatology: Impetigo Diagnosis and Treatment
This dermatologist-developed guide explains diagnosis, topical and oral antibiotic treatment, skin care, covering sores, recurrent infection, and contagious periods.
-
American Academy of Pediatrics, HealthyChildren.org: Impetigo
This pediatric resource explains signs of impetigo, how doctors diagnose it, topical versus oral antibiotics, cleaning sores, covering lesions, and steps to reduce spread.
https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Impetigo.aspx
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National Institute for Health and Care Excellence: Impetigo Antimicrobial Prescribing
This evidence-based guideline explains localized and widespread impetigo treatment, antibiotic stewardship, treatment failure, recurrent infection, skin swabs, and when specialist care is needed.
https://www.nice.org.uk/guidance/ng153/chapter/Recommendations
Medical source note: Treatment choices and school return rules can differ by country. Follow the advice of your child's healthcare professional and local public health or school guidance.
About the Author
Adel Galal is the founder of Parnthub, a father of four, and a grandfather of four with more than 33 years of parenting experience.
His work combines decades of hands-on family experience with extensive research and consultation with healthcare providers.
Over the years, Adel has learned that parents need clear information without unnecessary fear.
His goal is to help families understand what they are seeing, what practical steps they can take, and when professional medical care matters.
Adel is not a dermatologist or doctor. Parnthub health information is educational and does not replace diagnosis or treatment from qualified medical professionals.
Frequently Asked Questions About Childhood Impetigo
What does impetigo look like on a child?
Impetigo often starts as small sores or blisters. They can break open, leak fluid, and form golden or honey colored crusts. The face around the nose and mouth is a common location.
What causes childhood impetigo?
Impetigo is caused by bacteria, commonly Staphylococcus aureus or Streptococcus pyogenes. The bacteria can enter through scratches, cuts, insect bites, eczema, or other damaged skin.
Is childhood impetigo contagious?
Yes. Impetigo spreads through direct skin contact and through contaminated items such as towels, bedding, and washcloths. A child can also spread it from one part of their own body to another.
How long is impetigo contagious after antibiotics?
The answer depends on local guidance. CDC guidance allows return to school at least 12 hours after appropriate antibiotic treatment when the child is well and exposed sores are covered. NHS guidance uses 48 hours after treatment begins. Follow your local healthcare and school rules.
Can my child go to school with impetigo?
Children usually need to stay home for a period after treatment begins. The exact period varies by country and school policy. Follow your child's clinician and local school or daycare rules.
Does impetigo need antibiotics?
Antibiotics are commonly used for impetigo, but the exact treatment depends on the type and extent of infection and local guidelines. Some systems also use a topical antiseptic for selected local cases. A clinician or pharmacist can choose the right treatment.
Can I use antibiotic cream I already have?
No. Do not use old, leftover, or another person's antibiotic medicine. The bacteria and recommended treatment can vary, and incorrect use contributes to antibiotic resistance.
How can I stop impetigo spreading to siblings?
Wash hands often, do not share towels or washcloths, clean items that touch the infected skin, keep nails short, and cover exposed sores when advised. Follow the treatment plan carefully.
Can eczema cause impetigo?
Eczema itself does not cause impetigo. Scratching eczema can break the skin and allow bacteria to enter. Children with eczema may therefore have a higher risk of bacterial skin infection.
Can insect bites turn into impetigo?
Yes. Scratching an insect bite can damage the skin. Bacteria can enter the broken area and cause impetigo.
When should I worry about impetigo?
Get medical advice if the sores spread rapidly, become very painful, the surrounding skin becomes hot or swollen, your child develops fever, treatment is not working, or the child looks very unwell.
Does impetigo leave scars?
Ordinary impetigo usually heals without permanent scars. Scratching, picking, or deeper infection can increase the risk of marks. Temporary lighter or darker skin can remain after the infection clears.
Why does my child's impetigo keep coming back?
Repeated impetigo may be linked with eczema, repeated skin damage, or bacteria carried in the nose. A clinician may take skin or nasal swabs and decide whether further treatment is needed.
