Impetigo is a common superficial skin infection of children caused by bacteria (Streptococcus or Staphylococcus). Impetigo is an infectious condition and children can catch it from one another. It often complicates other skin conditions (secondary infection) where the skin is broken, e.g. cuts, eczema, nappy rash, scabies, papular urticaria and cold sores. If impetigo persists or recurs, always look for one of these underlying skin conditions.

The rash of impetigo starts as a group of small blisters, which soon burst leaving a raw area that becomes covered by a yellow crust of dried serum. The rash is not painful and does not itch. Even when extensive the child is usually well and has no fever. Without treatment the rash may last for weeks and often spreads to other areas. In small infants, impetigo may present as pus filled blisters (bullous impetigo) which later burst leaving crusts or scabs.

Treat by gently removing the crust, after soaking the area in warm water or a dilute antiseptic solution (e.g. Savlon). Dry and apply 2% vioform ointment, 10% povidone iodine (Betadine) ointment or an antibiotic ointment, e.g. mupirocin (Bactroban). Impetigo should heal in a few days if correctly treated. If the impetigo is widespread, give an oral antibiotic such as flucloxacillin or erythromycin for 7 days.

Sometimes the infection can spread to deeper layers of the skin to cause veld sores (ecthyma). They present as crusted ulcers, particularly on the lower legs of older children. Treatment is the same as for impetigo.