Impetigo (School Sores): Spotting It and Stopping the Spread
Impetigo, often called school sores, is a common and very contagious skin infection caused by bacteria. It usually appears as red sores or blisters that burst and form a honey coloured crust, most often around the nose and mouth. It affects children far more than adults.
It is one of the most common skin infections in Australian children, and while it looks alarming, it is rarely serious and clears up well once treated. The bacteria live on the skin and enter through small breaks, such as a scratch, an insect bite, or patches of eczema. If your child already has sensitive skin, our guide to eczema in children explains how broken skin can let infection in. Most children stay otherwise well, without a high fever or feeling unwell, which is one reassuring sign that this is impetigo rather than something more serious.
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Impetigo usually starts as small red spots or tiny blisters that quickly break open and weep. As they dry, they form the golden or honey coloured crust that is the most recognisable sign. The sores are often itchy but not usually painful, and they tend to cluster around the nose, mouth, hands and any area of broken skin.
There are two common patterns. The crusted type is the most frequent and shows the classic scabby, honey coloured surface. A blistering type produces larger, clear blisters that last a little longer before crusting. Both spread easily, especially when a child scratches and then touches another part of their body or another person. Because the rash can look similar to other childhood conditions, it helps to compare it with hand, foot and mouth disease and molluscum contagiosum, which have their own distinct patterns.
Impetigo earns its nickname because it moves quickly through classrooms, daycare and households wherever children are in close contact. It spreads through direct skin to skin touch and through shared items such as towels, bedding, clothing and toys. Scratching an itchy sore carries the bacteria under the fingernails, which is how it travels to new spots on the same child and on to others.
Good hygiene makes a real difference. Wash hands often, keep your child's fingernails short, use separate towels and face washers, and wash these on a hot cycle. Cover the sores with a light dressing where you can, which reduces both scratching and spread. These simple steps, alongside treatment, are usually enough to bring an outbreak under control at home within a week or so, and once treatment starts the risk of passing it on drops quickly.
Children with impetigo are asked to stay away from school or daycare until treatment has started and the sores are covered. Under the exclusion guidance used in New South Wales, a child can usually return once appropriate treatment has begun, provided any sores on exposed skin are covered with a watertight dressing. Rules vary between states and territories, so always check your own state's requirements or ask your child's school.
Because a parent often needs to stay home while a child is excluded, you may need proof for your employer. A doctor can issue a medical certificate covering the time you take to care for your child. Keeping sores covered and hands clean means most children miss only a day or two, and the exclusion is really about protecting classmates rather than a sign your child is very unwell.
Impetigo is treated with antibiotics, and the choice depends on how much skin is involved. For a small, localised patch, a doctor may recommend a topical antibiotic applied directly to the sores after gently soaking off the crusts. For more widespread or stubborn impetigo, a short course of oral antibiotics may be needed. Your doctor will decide which approach suits your child.
Finishing the full course exactly as directed matters, even once the sores look better, because stopping early lets the infection return. This careful approach is part of using antibiotics responsibly, which our clinicians explain in why we don't always prescribe antibiotics. Most children improve within a few days of starting treatment, and the sores usually heal without scarring. Alongside the medicine, keeping the skin clean and covered speeds recovery and limits spread to the rest of the family.
See the same doctor each time
It is worth having a doctor confirm impetigo and start the right treatment, particularly for the first episode or if sores are spreading. See a doctor promptly if the sores are growing quickly, if the surrounding skin becomes red, swollen, warm or painful, if your child develops a fever, or if the rash is not improving after a couple of days of treatment. Newborns and very young babies should always be reviewed.
A fever alongside a rash can have many causes, and our guide to when a child's fever is worth worrying about helps you judge. Rarely, the same bacteria behind impetigo cause other illness, so it is reasonable to have any child who seems genuinely unwell checked. If your child is struggling to breathe, is very drowsy or hard to rouse, call 000 immediately.
Abby Health is an online-first clinic, so you can have an Australian GP look at your child's sores from home, seven days a week, without a waiting room. Impetigo suits a telehealth consult well, because a doctor can often recognise the honey coloured crusts on a clear photo or video and talk through treatment options with you in one appointment.
You can choose to see the same doctor each time, so your family's history is understood and there is no need to start over at each visit. If your child needs to stay home, we can also help with a carer's medical certificate for your employer. Book through our everyday family clinic whenever it suits you. Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply. This is general information only and not a substitute for personal medical advice. If your child is seriously unwell or struggling to breathe, call 000.
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