What Is Impetigo? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Q: How do you get impetigo?

Impetigo develops when toxins from bacteria ( Staphylococcus aureus or Streptococcus pyogenes ) leave a protein in the top layer of skin, causing a blister. Impetigo is very contagious. It can spread through direct skin-to-skin contact or by touching items an infected person touches, such as towels, bedsheets, toys, or clothing.

Signs and Symptoms of Impetigo

Symptoms of impetigo vary depending on the type you have.

Nonbullous Impetigo

One or more skin sores that spread to other parts of the body
Itchiness
Swelling
Yellow or honey-colored crust

Bullous Impetigo

Large fluid-filled blisters, especially on the trunk and buttocks
Dark-colored skin crusts

Ecthyma

Painful blisters
Sores
Thick crusts
Scarring

Is It Impetigo or Something Else?

While many doctors and dermatologists can diagnose impetigo by looking at the skin, taking a culture from the area can help them identify what type of bacteria it is and which antibiotic it will respond to.

These diseases may resemble impetigo:

Scabies
Chicken pox
Cold sores
Skin allergies
Ringworm
Bug bites
Medication reactions

The primary difference between impetigo and other skin conditions is their cause, duration, and accompanying symptoms. For example, ringworm can also produce bumps and scaly patches but is caused by a fungus.

Scabies has a similar appearance, but it's caused by an infestation of tiny mites on the skin. It is associated with a sense of itchiness on the entire body, too.

Cold sores and chicken pox are viral infections.

Causes and Risk Factors for Impetigo

Impetigo is caused by either the Staphylococcus aureus bacteria, which can cause a staph infection, or the type of group A streptococcus responsible for strep throat.

The bacteria enter the skin through an injury and infect the top layer of skin. Any type of skin injury puts you at risk for impetigo. This includes minor injuries, such as a scrape or a cut. Having an insect bite increases the risk of impetigo.

Sometimes impetigo develops when the skin hasn't been injured. Because this is a highly contagious skin infection, coming in close contact with someone who has an active infection raises your risk.

Impetigo is easily passed through skin-to-skin contact and by sharing toys, bed linens, and towels. Crowded areas, such as a childcare center, can hasten the spread of impetigo, and children are at risk if they play sports that involve skin-to-skin contact, such as wrestling and football.

Because the bacteria can thrive in warm, humid weather, these infections are more likely to occur in the summer and in tropical regions. Swimmers are also at risk, particularly if they touch an infected surface or share a towel with someone who is infected.

How Is Impetigo Diagnosed?

A doctor or dermatologist can usually identify impetigo by examining the look and location of the lesions; lab tests aren't usually necessary.

If there's any ambiguity, your doctor may want to examine a sample of the pus to confirm the presence of bacteria. Taking a sample from the sore can also help your doctor determine which antibiotic will work best to clear the infection.

What's the Incubation Period for Impetigo?

The time between exposure and the development of sores and blisters varies for each person. In most cases, a rash develops within 4 to 10 days of exposure to the bacteria.

Prognosis of Impetigo

The outlook for impetigo is good with or without treatment. Still, skin sores and blisters usually heal more quickly with treatment, and you're less likely to spread the infection to other people. Impetigo often heals within four weeks without treatment and one week with treatment. Even though impetigo goes away on its own within two to six weeks, treatment is recommended due to the contagious nature of this skin infection.

Treatment and Medication for Impetigo

Even though impetigo goes away on its own within two to six weeks, treatments like these are recommended due to the contagious nature of this skin infection.

Topical Creams

Less-severe cases often respond quickly to a topical ointment or cream. Your doctor may prescribe one of these antibiotic creams to apply to the affected area:

mupirocin (Bactroban)
retapamulin (Altabax)
ozenoxacin (Xepi)

Retapamulin is approved for children as young as 9 months old, whereas mupirocin can treat adults and children 12 years and older.

Ozenoxacin is for adults and children age 2 months and older.

Oral Antibiotics

Children or adults with widespread or advanced sores may need an oral antibiotic.

The following antibiotics are used to treat impetigo:

amoxicillin and clavulanate (Augmentin)
dicloxacillin (Dycill)
cephalexin (Keflex)
clindamycin (Cleocin)
doxycycline (Vibramycin)
minocycline (Minocin)
trimethoprim and sulfamethoxazole (Bactrim)
macrolides

These treatments can help symptoms clear quickly, however, it's important to complete the full course of antibiotics. Stopping medication too soon can trigger a recurring infection and increase the risk of antibiotic resistance. Some people need antibiotic injections to help clear a severe infection.

Complementary Therapies

Along with prescription medication to get rid of the infection, practice good skin care at home to aid healing.

Soak your skin in warm, soapy water to remove dirt and crusts daily. And keep your skin covered with a bandage until you're no longer contagious. If your child has recurring impetigo, their dermatologist can explain how to give a bleach bath, which can clear bacteria from the skin. With a small amount of bleach in the water, this home remedy for impetigo is safe.

Otherwise, using a new towel each time you shower, in addition to not sharing towels, will help minimize the spread of infection.

Preventing Impetigo

Even though impetigo isn't a serious medical condition, you should take steps to protect yourself and your child from this infection. The goal isn't only to treat impetigo but also to stop or prevent its spread.

Because impetigo can spread from person to person, be diligent and act quickly after you or your child comes in contact with an infected person or objects an infected person has touched.

One of the best ways to prevent impetigo is to have your child wash their hands with warm, soapy water immediately after contact with someone who has the infection.

If you don't have soap or water readily available, use antibacterial hand gel to help prevent an infection.

Cuts, scrapes, and insect bites are common in children. To prevent an infection after a skin injury, it's important to clean the injury immediately. You should also keep injuries or bites loosely covered with a bandage until the skin heals.

Here are additional steps to take if you or your child has impetigo:

Wash clothes, linens, and towels every day.
Don't share personal items with family members.
Wear gloves when caring for infected skin wounds.
Keep your child's nails trimmed to prevent injury from scratching.
Wash hands frequently.
Keep your child home from school or childcare for 24 to 48 hours after starting antibiotics.
Regularly disinfect any surfaces touched by an infected person.

Complications of Impetigo

Though rare, these complications of impetigo can occur.

Cellulitis

This occurs when a bacterial infection affects the tissue under the skin and spreads to the lymph nodes and bloodstream. Untreated cellulitis can become life-threatening.

To prevent cellulitis, take quick action whenever there's a skin wound. Clean the wound daily and apply protective topical ointment to prevent an infection. See a doctor if you show early signs of a skin infection, such as increased pain, redness, or blistering.

Glomerulonephritis

Poststreptococcal glomerulonephritis is a “complicated immunologic phenomenon that occurs when the initial infection causing impetigo, generally the bacteria known as group A strep, causes an immune reaction where the body forms antibodies against some of its own cells,” says Rick Pescatore, DO, an emergency medicine specialist.

“This is a process called molecular mimicry, which can occur when a true antigen like group A strep has a similar structure to the body's own antigens. These immune complexes deposit in the kidney, causing inflammation and damage to the renal system.”

Sometimes there's no way to prevent this complication. But you can lower your risk by treating a strep infection early. You can also protect your kidneys from damage by reducing high blood pressure and controlling your blood sugar if you have type 2 diabetes.

Staphylococcal Scalded Skin Syndrome

Staphylococcal scalded skin syndrome (SSSS) most commonly affects babies and young children and is caused by toxins released by staph bacteria. Symptoms include a rash, fever, and blisters that break easily, leaving moist, painful areas of skin. Large sections of the top layer of skin may also peel off, giving the appearance of skin that's been scalded or burned. Kids with this infection might be irritable and tired. SSSS is a medical emergency and needs prompt treatment.

Scarring

Impetigo typically heals without scarring in the vast majority of cases, says Dr. Pescatore. “Left untreated, though, the infection can progress to deeper infections like ecthyma, which is associated with scarring.”

Avoid scratching or picking at sores to prevent scarring.

Research and Statistics: How Common Is Impetigo?

An estimated 162 million children worldwide have impetigo at any given time,

but it mainly affects children ages 2 to 5.

The incidence of impetigo is equal among male and female children, though it's more common in male adults.

This condition is more common in warm, humid climates, and it often occurs in children and adults during the summer and fall in the United States.

Impetigo can also occur when the skin is already irritated by eczema, poison ivy, or another skin problem.

Bullous impetigo tends to occur more often in infants, accounting for about 90 percent of cases in children younger than 2.

Common Questions & Answers

What are the first signs of impetigo?

Impetigo is a common and highly contagious skin infection that mostly affects children. This condition causes open sores that ooze, as well as larger blisters. The first sign of impetigo is a patch of red, itchy skin, usually around the nose, mouth, hands, or feet.

How do you get impetigo?

Impetigo develops when toxins from bacteria (Staphylococcus aureus or Streptococcus pyogenes) leave a protein in the top layer of skin, causing a blister. Impetigo is very contagious. It can spread through direct skin-to-skin contact or by touching items an infected person touches, such as towels, bedsheets, toys, or clothing.

Can you go to school with impetigo?

Children are more vulnerable to impetigo because their immune systems aren't fully developed yet. The infection can spread quickly in schools and day care centers, so keep your child home until they are no longer contagious, typically 24 to 48 hours after starting antibiotic treatment.

What is the best treatment for impetigo?

Impetigo is often treated with a topical antibiotic ointment. Wash the affected area with warm, soapy water before applying the medicine, then wash your hands after application. For a severe infection, you may need a prescription oral antibiotic. Complete the whole course of medication, even if you feel better, to prevent a recurring infection.

Why do adults get impetigo?

Impetigo is common in children, but adults can get it, too. This can happen if you touch the sores or personal items of an infected person, or if you have a skin injury, a weakened immune system, or a skin condition like dermatitis or scabies.

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Resources

Impetigo: Symptoms and Causes. Mayo Clinic. April 19, 2023.
Impetigo: Signs and Symptoms. American Academy of Dermatology Association.
Impetigo: Diagnosis and Treatment. American Academy of Dermatology. March 11, 2021.
Ringworm (Body): Symptoms and Causes. Mayo Clinic. April 26, 2022.
Scabies: Symptoms and Causes. Mayo Clinic. July 28, 2022.
Chickenpox: Symptoms and Causes. Mayo Clinic. April 19, 2023.
Cold Sore: Symptoms and Causes. Mayo Clinic. January 5, 2024.
Impetigo. Kids Health. March 2023.
Impetigo: Who Gets and Causes. American Academy of Dermatology.
Impetigo. NHSInform. February 27, 2025.
Impetigo. Stat Pearls. July 31, 2023.
Teaching Kids to Wash Their Hands. Stanford Medicine Children's Health.
10 Tips to Prevent Spreading Impetigo, and Avoid Getting It Again. American Academy of Dermatology.
Cellulitis: Symptoms and Causes. Mayo Clinic. May 16, 2025.
Glomerulonephritis: Symptoms and Causes. Mayo Clinic. February 24, 2024.
Staphylococcal Scalded Skin Syndrome (SSSS) in Children. Johns Hopkins Medicine.
Abrha S et al. Intolerable Burden of Impetigo in Endemic Settings: A Review of the Current State of Play and Future Directions for Alternative Treatments. Antibiotics (Basel). December 15, 2020.

Jacquelyn Dosal, MD

Medical Reviewer

Castle Connolly Top Doctor

Jacquelyn Dosal, MD, is a board-certified dermatologist practicing at The Dermatology House in Park City, Utah. Her areas of expertise include acne, rosacea, integrative treatments of inflammatory skin diseases, as well as laser treatment of the skin and injectables.

Dr. Dosal writes cosmetic questions for the certifying exams for the American Board of Dermatology. She is also the deputy editor for the American Academy of Dermatology's podcast, Dialogues in Dermatology.

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Valencia Higuera

Author

Valencia Higuera is a writer and digital creator from Chesapeake, Virginia. As a personal finance and health junkie, she enjoys all things related to budgeting, saving money, fitness, and healthy living. In addition to Everyday Health, Higuera has written for various publications, including Healthline, GOBankingRates, MyBankTracker, and The Mortgage Reports.

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