GUIDE
Impetigo is a bacterial infection that looks like honey-colored crusty sores. It's very contagious but easy to treat with antibiotics.
Those crusty, oozing sores around your baby's mouth showed up fast and look terrible. The good news is that impetigo responds quickly to treatment. The important thing is keeping it from spreading.
Impetigo is a superficial bacterial skin infection caused by Staphylococcus aureus or Group A Streptococcus — the same bacteria behind staph infections and strep throat. It is the most common bacterial skin infection in children, and it is extremely contagious.
The classic presentation is hard to miss once you know what to look for: small red bumps that quickly turn into fluid-filled blisters, which then rupture and form the signature honey-colored crust. It looks like someone smeared dried honey on your baby's face. It typically starts around the mouth and nose but can spread to any part of the body your baby touches with contaminated fingers.
Impetigo needs the bacteria to enter through a break in the skin — a scratch, cut, insect bite, or eczema patch. This is why it is so common in babies: they scratch themselves, they have eczema, they get bug bites, and they put their hands everywhere. The bacteria find a way in.
| Type | What It Looks Like | Where | Treatment |
|---|---|---|---|
| Non-Bullous Impetigo (classic) | Starts as small red bumps → quickly develops into blisters → blisters rupture → honey-colored crusted sores | Around the mouth and nose (most common), but can appear anywhere on the body | Topical mupirocin (Bactroban) for limited cases. Oral antibiotics for widespread or resistant cases. |
| Bullous Impetigo | Large, fluid-filled blisters (bullae) that are fragile and rupture easily, leaving raw, weeping areas | Anywhere — trunk, arms, legs, diaper area | Oral antibiotics usually required. More common in newborns and infants. |
| Ecthyma (deep impetigo) | Punched-out ulcers covered by thick, dark crust. Goes deeper than regular impetigo into the dermis. | Legs, feet, buttocks | Oral antibiotics required. May scar. See pediatrician promptly. |
The most important thing about impetigo management is not the treatment — it is the containment. This infection spreads easily to other body parts and other people.
| Action | Details |
|---|---|
| Cover the sores | Loosely bandage or cover the sores with gauze to prevent contact. Change the covering when it gets soiled. |
| Wash hands — a lot | Wash your baby's hands frequently. Wash your own hands after touching the sores or applying medication. This is the most important prevention step. |
| Separate towels and bedding | Do not share towels, washcloths, pillowcases, or clothing with other family members until the sores are healed. Wash linens in hot water. |
| Trim fingernails short | Short nails reduce the ability to scratch sores open and spread the bacteria to other body parts via scratching. |
| Clean the sores gently | Soak off crusts with warm water and a soft cloth before applying topical antibiotic. Removing the crust allows the medication to reach the infection. |
| Complete the antibiotics | Finish the entire course of antibiotics even if the sores look better after a few days. Stopping early increases the risk of recurrence and antibiotic resistance. |
| Milestone | Daycare Status | Home Care |
|---|---|---|
| Diagnosis | Child should stay home. Notify daycare. | Start antibiotics as prescribed. Cover sores. |
| 24 hours on antibiotics | Most daycares allow return after 24 hours on antibiotics — check your specific policy. | Sores are beginning to dry. Keep covering them. |
| 48-72 hours | Sores should be noticeably improved. Crusts drying. | Continue antibiotics. Continue hygiene measures. |
| 5-7 days | Sores should be mostly healed. | Complete full antibiotic course (usually 7-10 days for oral). |
| 7-10 days | Fully cleared. Normal activity. | Antibiotics complete. Monitor for recurrence. |
Antibiotics need to be given on schedule, and sleep deprivation makes it hard to remember if you already gave the morning dose. Log each medication dose in tinylog with timestamps so you never double-dose or miss one.
Impetigo that is not responding to treatment or is accompanied by fever needs re-evaluation. Complete the full course of antibiotics to prevent recurrence.
Impetigo is caused by bacteria that are everywhere — on the skin, in the environment, in the noses of healthy people. It enters through a break in the skin, which in babies is usually a scratch, insect bite, or eczema patch. Clean babies get impetigo. It is not a reflection of how you care for your child.
Before applying topical antibiotic, use a warm, wet cloth to gently soak and remove the honey-colored crusts. If you apply medication on top of the crust, it cannot reach the infection underneath. Be gentle — do not scrub. Soak and let the crust soften and lift off.
Eczema-damaged skin is an open door for impetigo bacteria. If your baby has eczema and you notice honey-colored crusting on or near eczema patches, that is likely impetigo superinfection. Tell your pediatrician — the eczema management and impetigo treatment need to happen simultaneously.
About 20% of children with impetigo have recurrence within a few weeks. If it keeps coming back, your pediatrician may check for nasal carriage of staph (bacteria living in the nostrils that keep reinfecting) and treat with mupirocin nasal ointment.
This guide is for informational purposes only and is not a substitute for professional medical advice. Impetigo requires antibiotic treatment prescribed by your pediatrician. If sores are spreading, your baby has a fever, or treatment is not working, seek medical care.
