School sores (Impetigo)

By Dr Megan Yap - PaediatricianGeneral26 Feb 2017

Oh the scourge!  Oh the affliction!  Woe is the befallen and all else run for your lives!!

One of the most awful and common infections spread by children (I reckon only topped by head lice and threadworms, ewwwwwwww!) – SCHOOL SORES (otherwise known as impetigo).

Most parents will have to deal with this infection (and the other two parasites too) sometime during their kid’s day-care/schooling lives.  It’s awful but it’s true – so you’d best get clued up about it right?

So let’s talk about it then…

So what is it? 

Impetigo is a bacterial infection of the skin.  It is HUGELY contagious and spread by contact.  The most common bacteria that cause impetigo can actually live as a “commensal” organism in your schnoz (nose) and not cause any problems at all.  Staphlococcus aureus is probably the most common one we see, but beta-haemolytic streptococcus can also be a culprit. Trouble usually arises when the skin is DAMAGED in some way and these little buggers make their way in and wreak havoc, spreading to healthy skin as well.


  • Typically the infection starts as little flat, red spots or blisters on the skin (typically on the face, hands, arms or legs initially) that are really itchy.
  • The blisters fill up with pus (that can be yellow or greenish) and they burst (mmmm… lovely innit?) initially leaving a patch of raw, red, weepy skin and then later drying out to leave the characteristic tan-golden yellow crust that looks a bit like the kid had pancakes for brekkie and dripped golden syrup over themselves.

It takes about 24-56 hours for the sores to develop after the child has contact with another child with the infection.  It spreads very quickly within the host, and to other people who come in contact with the host.

  • Spread is by skin contact with a sore, or the fluid/crust from a sore (eg soiled clothing, towels, dressings)
  • Kids will scratch the sores because they are itchy, then transmit infection (to both other people AND other parts of their body) with their hands
  • Bacteria remain active in the fluid weeping out of the sore and the dried crusts (yuk yuk!)
  • Kids can also carry this bug in their noses and can transmit by nose-picking or if they have a runny nose


  1. Impetigo is a bacterial infection and usually needs to be treated by an antibiotic that will be prescribed by your doctor. Sometimes an antibacterial ointment will be prescribed as well.
  2. Remove the crusts by bathing in warm water and wiping gently with towel. It is important to do this even if the child is on antibiotics!
  3. Chlorhexidine washes (used in place of soap especially in the case of recurrent infections) can help reduce the bacterial load, but can irritate the skin of some people with really sensitive skin.
  4. Apply a watertight dressing over the sores (after applying ointment) and cut your child’ nails short – try to keep them from scratching if you can!
  5. Your child is no longer infectious and can return to kindy/school after 24 hours of antibiotics and after the lesions are covered with dressings
  6. Keep treating until the sores have healed

Other points:

  • Wash your child’s clothes, bedlinen, towels etc in HOT water, SEPARATE from the rest of the family; hang them in the sun to dry or use a hot clothes dryer
  • Good hygiene is ESSENTIAL!! Regular handwashing with soap can limit spread (as can covering the sores), throw away used tissues and dressings straight into the BIN!
  • If your child has recurrent school sores, consider a chlorhexidine wash (in place of soap) and a course of a antibacterial NASAL ointment might be used by your doctor to attempt to eliminate their “carrier” status à talk to your doctor about this!
  • Get back to your doctor for a check up if your child becomes unwell, spikes a fever, or has persistent/recurrent/worsening impetigo on treatment.


Hope you don’t ever have to deal with this with your kid(s), but if you do – now you know what to do – don’t you?

Stay well and wash your hands!!!!!!!!

Until next time,

xxDr Megs

For more from Dr Megan Yap visit her blog – Kids Health Guru


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