What Is Impetigo? Symptoms, Treatment, and Pictures

If you have children, or work with them, you may be familiar with impetigo. Impetigo is a contagious skin infection that can quickly spread through classrooms and households. If someone in your home (or classroom) has recently been diagnosed with impetigo, here’s everything you need to know about treating it and making sure it doesn’t spread to others.

What are the symptoms of impetigo?

Impetigo can affect any part of the body. But, it’s most common on the face (around the nose and mouth), hands, and forearms. In younger children, the diaper area can also be involved. 

People may experience these symptoms with impetigo:

• Itchy crusts or scabs

• Painful blisters

• Enlarged lymph nodes near the infection

• Fever (with bullous impetigo and ecthyma)

What are the different types of impetigo?

There are three main types of impetigo. Here’s what each one looks like.

Nonbullous impetigo

This is the most common type. It starts as tiny blisters that break open and leak fluid. Eventually a yellow, brown, or tan crust forms over the area (sometimes called “honey-colored”).

Bullous impetigo

This type causes large blisters filled with clear fluid that becomes cloudy. These blisters are less likely to break than nonbullous impetigo. When they do, they ooze a yellow fluid and crust over before healing. 

Ecthyma

Ecthyma is a rare condition that happens when impetigo involves the deeper layers of the skin. It forms deep, round, open sores that have a red or violet border. 

Pictures of impetigo

Here are some pictures of what impetigo looks like on different skin tones. 

Nonbullous impetigo

Impetigo on the face with honey-colored crust.

Impetigo on the legs.

Bullous impetigo

Large blisters in bullous impetigo.

Bullous impetigo on the legs.

What causes impetigo?

An infection with the skin bacteria group A Streptococcus and Staphylococcus aureus causes impetigo. This bacteria typically lives on the skin and doesn’t normally cause any issues. But if there’s a break in the skin, the bacteria can get into the wound and cause an infection. 

How is impetigo transmitted?

When you touch the infected skin, the bacteria transfers to your hands. If you touch another part of your body, the bacteria can pass to that new area and cause an infection. Similarly, if you touch impetigo and then touch another person, you can pass impetigo to that person.

Can adults get impetigo?

Yes. Anyone (including adults) can get impetigo. But it’s most common in infants and young children. This is because young children don’t understand that they shouldn’t touch or scratch areas infected with impetigo. On top of that, kids don’t wash their hands as much, making them more likely to spread impetigo than adults. 

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So it shouldn’t come as a surprise that impetigo outbreaks tend to occur at day cares, preschools, and playgrounds. Children often pass the infection to each other and adult caregivers.

Teens who play certain types of contact sports, like wrestling, may also get impetigo at higher rates. That’s because they are more likely to touch other people’s skin. 

How is impetigo diagnosed?

A healthcare professional will diagnose impetigo by looking at the infected skin. They may also send a culture of the skin to see exactly which bacteria is causing the infection. They’ll do this by rubbing a cotton swab on the infected area and then sending it to a laboratory. The results are usually available in 3 to 5 days. 

How is impetigo treated?

One of the best ways to treat impetigo is with general wound care — that means washing the area with soap and water to remove bacteria.

Minor cases of impetigo sometimes go away on their own, but most people will need treatment with antibiotics. Antibiotics help impetigo heal faster and prevent the infection from getting worse. They also prevent impetigo from spreading to other people. Both topical and oral antibiotics can treat impetigo.

Topical antibiotics

Topical antibiotics, like prescription creams and ointments, can treat mild cases of impetigo. Studies show that the best topical antibiotics for impetigo are:

• Mupirocin

• Retapamulin

Oral antibiotics

Severe forms of impetigo — and impetigo that has spread to multiple areas of the body — need oral antibiotics. The most common antibiotic for impetigo is cephalexin. In some situations, prescribers also recommend amoxicillin or clindamycin to treat impetigo.

Studies show that topical and oral antibiotics sometimes don’t work against impetigo because of antibiotic resistance. It’s important to follow up with a healthcare professional if you’re using antibiotics and your impetigo:

• Doesn’t get better after 3 to 5 days 

• Spreads

• Becomes more painful, red, or swollen — or you develop a fever

These are signs that your infection isn’t responding to antibiotics. 

If I come into contact with impetigo, is there anything I can do to prevent infection?

If someone in your household or classroom has impetigo, don’t panic. While impetigo is very contagious, there’s still a lot you can do to prevent passing it to others. Here are some things you can do to limit the spread of impetigo:

• Clean the infected area with soap and water a few times a day.

• If possible, keep the infected area covered with clothing or a bandage.

• Encourage everyone to wash their hands frequently.

• Always wash your hands with soap and water after touching or cleaning the infected area.

• Wash the clothes and towels the person with impetigo uses every day (and pillowcases, if impetigo is on the person’s face).

• Use antibiotics for the entire length of the prescription — don’t stop when the impetigo starts to get better.

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Written by:

Jennifer Sample, MD

After a fellowship, Dr. Sample worked as the medical director at the University of Kansas Hospital Poison Center (The University Of Kansas Health System Poison Control Center), which served the state of Kansas for poison exposures. In 2007, she returned to Children’s Mercy Hospital in Kansas City, Missouri, as a consultant in clinical pharmacology and medical toxicology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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