Impetigo

Impetigo is a common contagious skin infection that may be caused by two germs — Streptococcus pyogenes and Staphylococcus aureus. Recommended treatment depends on which germs are causing impetigo. With the right treatment, impetigo usually goes away within two to three weeks.

What Are the Signs of Impetigo?

Impetigo usually occurs as a rash on the face, neck, and hands of young children and infants. Children who are in diapers usually get it around the diaper area. Impetigo occurs rarely in adults, usually after another skin infection. The signs of impetigo include red sores that pop easily and leave a yellow crust, fluid-filled blisters, itchy rash, skin lesions, and swollen lymph nodes. The sores can be uncomfortable and painful.

What Head Start Programs Should Know About Impetigo

See PDF version: What Head Start Programs Should Know About Impetigo

How Does Impetigo Spread?

Impetigo is typically spread through skin-to-skin contact with an individual who has impetigo, but it can also be spread by contact with objects someone with impetigo has touched (for example, towels, blankets, and toys).

Who Is at Risk?

Certain individuals and situations make them more likely to develop impetigo. These include:

  • Children 2 to 6 years of age.
  • Crowded environments (for example, child care and Head Start centers).
  • Having skin irritated by other conditions, such as eczema.
  • Warm and humid weather.
  • Having skin abrasions (such as insect bites) or dermatitis (itchiness, inflammation of the skin, sometimes caused by allergic reactions).
  • Having a weakened immune system.

How to Talk to Children about Impetigo

  • Emphasize the importance of hand washing. Hand washing helps prevent a lot of diseases.
  • Keep explanations age-appropriate; make up a song to make hand washing fun.
  • If children have questions, take time to listen and answer their questions.
  • Be honest. Answer questions based on the facts and as age-appropriate.
  • Speak in a calm tone of voice, using reassuring words.
  • Include parents and caregivers on talks about hygiene, hand washing and preventing the spread of impetigo.

Implications for Head Start Programs

It is recommended that children with impetigo be excluded from the Head Start center until 24 hours after treatment is started and as the doctor advises.

Staff absences may represent the primary challenge to most Head Start programs. Absences may be related to staff asked to stay at home, or may be caused by worried employees who fear exposure to Impetigo in the workplace. Effective risk communication and education can help prevent unnecessary absences from work due to fear of impetigo.

Programs should review their emergency plans and staff availability to ensure adequate coverage, if needed.

How Can Programs Limit the Spread of Impetigo?

If a child in your facility has impetigo and has been cleared by a doctor to return to the Head Start program:

  • Good hygiene is the most important step to prevent spread.
  • Make sure all children and adults use good hand washing techniques — including using scrubbing with soap for 20 seconds or using alcohol-based gels (hand sanitizer). Soap and water is preferred if hands are visibly soiled.
  • Use a clean towel or fresh paper towel to dry the body or hands.
  • Make sure to clean and disinfect toys.
  • Infected areas should be washed with mild soap and running water or with an approved sanitizer.
  • Soiled clothes, linens, towels, and personal items should never be shared with another child and sent home in a sealed plastic bag.
  • Wear gloves when applying antibiotic ointment that a doctor may recommend and wash your hands after removing gloves.

Where Can I Learn More?

What Head Start Parents Should Know About Impetigo

See PDF version: What Head Start Parents Should Know About Impetigo

How Does Impetigo Spread?

Impetigo is typically spread by skin-to-skin contact with an individual who has impetigo, although it may also be spread by touching things someone with impetigo has touched (for example, towels, bedding, and toys).

Who Is at Risk?

Certain individuals and situations make them more likely to develop impetigo. These include:

  • Children 2 to 6 years of age.
  • Crowded environments (for example, child care and Head Start centers).
  • Already irritated skin.
  • Warm and humid weather.
  • Having skin abrasions (such as insect bites) or dermatitis (itchy, inflammation of the skin, sometimes caused by allergic reactions).
  • Having a weakened immune system.

How Is Impetigo Diagnosed?

If you suspect your child has impetigo, you should have your child see his/her doctor.

Should My Child with Impetigo Be Excluded from Head Start?

Children diagnosed with impetigo should remain out of the center until the sores have stopped blistering or crusting, or until 24 hours after starting treatment your doctor recommended. Your child's Head Start center might ask for a note from your doctor to clear your child to return.

How to Stop the Spread of Impetigo?

  • Make sure your family uses good hand washing techniques — including scrubbing your hands with soap and water for at least 20 seconds or using alcohol-based gels (hand-sanitizer). Use soap and water if hands are visibly soiled.
  • Fingernails should be kept short.
  • Cover parts of the skin that are infected, if possible.
  • Children with impetigo should be encouraged to not touch the sores.
  • Cuts and scratches should be kept clean.
  • Use a clean towel or fresh paper towel to dry the body or hands.
  • Clothes, linens, towels, and personal items should be washed at least once a day if the child has impetigo and do not share these items with another child in your home.
  • Wear gloves when applying antibiotic ointment that a doctor may recommend and wash your hands after removing gloves.
  • Clean and disinfect toys.

How to Talk to Children about Impetigo

  • Reinforce hand washing. Good hand washing is not only good for children's health in preventing colds and flus; but it also helps children feel like they can make a difference.
  • If children have questions, make time to listen and answer their questions.
  • Speak in a calm tone of voice. Use reassuring words.
  • Keep all explanations easy for your child to understand. Make up a song to make hand washing fun.

Where Can I Learn More?

Impetigo. HHS/ACF/OHS. 2016. English.

Last Reviewed: April 2016

Last Updated: April 12, 2016