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Pediatric Impetigo

What is impetigo?

Impetigo is a superficial infection of the skin caused by bacteria. The lesions are often grouped together, have a red base, and are open but close over to form a honey-colored crust.

Impetigo is contagious and can be spread throughout a household, with children reinfecting themselves or other family members.

What causes impetigo?

Common bacteria, some of which are found normally on the skin, cause impetigo. The infection occurs when the bacteria enter an open area in the skin. The most common bacteria that cause impetigo include the following:

  • Group A ß - hemolytic streptococcus
  • Staphylococcus aureus

Impetigo is more common in children, but adults may also get the infection. Impetigo is made worse by poor hygiene and warm temperatures.

What are the symptoms of impetigo?

Impetigo usually occurs on the face, neck, arms, and limbs, but the lesions can appear on any part of the body. Impetigo starts as a small vesicle, or fluid-filled lesion. The lesion then ruptures and the fluid drains, leaving areas that are covered with honey-colored crusts.

The lesions may all look different, with different sizes and shapes. The child may also have swollen lymph nodes (small lumps that are located mostly in the neck, arm, under the arm, and in the groin area). Lymph nodes become enlarged when a child's body is fighting an infection.

The symptoms of impetigo may resemble other skin conditions, so always consult the child's physician for a diagnosis.

How is impetigo diagnosed?

Impetigo is usually diagnosed based on a complete medical history and physical examination of the child. The lesions of impetigo are unique, and usually can be confirmed with just a physical examination. In some cases, the child's physician may order a culture of the lesion to confirm the diagnosis and identify the type of bacteria that is present.

What is the treatment for impetigo?

Specific treatment for impetigo will be determined by the child's physician based on the following criteria:

  • The child's age, overall health, and medical history
  • Extent of the condition
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Child or parent’s opinion or preference

Treatment may include:

  • Oral antibiotics (for multiple lesions)
  • Topical antibiotic applied directly to the lesions
  • Washing daily with an antibacterial soap to help decrease the chance of spreading the infection
  • Proper hand washing technique by everyone in the household (to help decrease the chance of spreading the infection)
  • Keeping the child's fingernails short to help decrease the chance of scratching and spreading the infection
  • Avoid sharing of garments, towels, and other household items to prevent the spreading of the infection
Children's Team

Children's Team





The Division of Dermatology at Children's National Hospital continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair and nails.

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