Impetigo in Babies and Toddlers
Content reviewed against published AAP, CDC, Mayo Clinic guidelines
Last reviewed:
Impetigo is a highly contagious bacterial skin infection common in infants and young children. It causes red sores that can rupture, ooze, and form a distinctive honey-colored crust. It most often appears around the nose, mouth, and on hands, but can occur anywhere on the body.
Key takeaways
- Impetigo is a highly contagious bacterial skin infection common in infants and young children.
- Duration: With antibiotic treatment, sores typically heal within 7-10 days. Without treatment, impetigo may resolve in 2-3 weeks but can spread significantly.
- Go to ER if: Rapid spreading of redness and swelling suggesting cellulitis
- No vaccine currently available
Symptoms
How It Presents by Age
0-6 months
May present as bullous impetigo with large, fragile blisters. Newborns are particularly vulnerable and can develop widespread infection quickly.
Risk level: Moderate to high — can spread rapidly in neonates
6-12 months
Often appears around the diaper area, nose, or mouth. Can be mistaken for diaper rash when in the groin region.
Risk level: Moderate
1-3 years
Classic presentation with honey-crusted sores, often around nose and mouth. Frequently occurs after minor skin injuries or insect bites.
Risk level: Low to moderate
3-5 years
Most common age group affected. Spreads easily in daycare settings. Usually non-bullous form with characteristic golden crusts.
Risk level: Low
Treatment
Topical antibiotics
Mupirocin (Bactroban) ointment applied 2-3 times daily for 5-7 days is first-line treatment for limited impetigo.
Oral antibiotics
Prescribed for widespread impetigo or when topical treatment fails. Common options include cephalexin or dicloxacillin for 7 days.
Wound care
Gently wash affected areas with soap and water, removing crusts to allow antibiotic penetration. Pat dry and apply prescribed ointment.
Prevent spreading
Keep sores covered with loose bandages. Cut fingernails short and use mittens for babies to prevent scratching and spreading.
Home Care
- Gently wash crusted areas with warm soapy water 2-3 times daily
- Soak crusts with a warm wet washcloth to soften before gently removing
- Keep affected areas covered with clean, loose bandages
- Wash hands frequently after touching infected areas
- Use separate towels and washcloths for the infected child
- Wash clothing and bedding in hot water daily
- Trim fingernails short to prevent scratching and spreading
When to Worry
Go to the ER if:
- Rapid spreading of redness and swelling suggesting cellulitis
- High fever with widespread skin infection
- Signs of sepsis — lethargy, poor feeding, mottled skin
- Facial swelling especially around the eyes
- Dark brown or cola-colored urine (possible post-streptococcal glomerulonephritis)
Call your doctor if:
- Sores are not improving after 3 days of prescribed treatment
- New areas of infection appear during treatment
- Infection is near the eyes
- Child has underlying eczema and develops signs of infection
- Swollen lymph nodes or increasing redness around sores
- Recurrent episodes of impetigo
Keep an eye on:
- Sores are spreading despite 48 hours of antibiotic treatment
- Redness is expanding around the sores
- Child develops fever with the skin infection
- Sores are deep or painful rather than superficial
- Dark or tea-colored urine (sign of post-streptococcal complications)
Prevention
- Wash hands frequently with soap and water
- Keep fingernails short and clean
- Clean and cover cuts, scrapes, and insect bites promptly
- Treat eczema to maintain skin barrier
- Do not share towels, clothing, or personal items
- Bathe regularly
- Keep infected children home from daycare until 24 hours after starting antibiotics
Contagion & Incubation
Incubation
1-10 days after exposure to bacteria
Contagious for
Contagious until sores heal or until 24-48 hours after starting antibiotic treatment
Duration
With antibiotic treatment, sores typically heal within 7-10 days. Without treatment, impetigo may resolve in 2-3 weeks but can spread significantly.
Frequently asked questions
How long does impetigo last?
How does impetigo spread?
When should I take my baby to the ER?
Can impetigo be prevented?
When can my child return to daycare?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Illnesses
Bottom line
Impetigo is treatable with appropriate medical care. Seek emergency care if rapid spreading of redness and swelling suggesting cellulitis.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.