Cause This skin infection is usually caused by Staphylococcus aureus or group A Streptococcus bacteria.

Symptoms Impetigo often appears in skin areas already injured from a scrape, cut, or rash. It can appear anywhere on the skin but often attacks the area around the mouth in children. When caused by group A Streptococcus it begins as tiny blisters; these eventually burst to reveal small, wet patches of red skin that may weep fluid. Gradually, a tan or yellow-brown crust covers the affected area. Impetigo caused by Staphylococcus may cause larger blisters containing fluid that is first clear, then cloudy. These blisters are less likely to burst. It is more common in hot, humid weather.

How It Spreads A child touching the infected area and then another part of the body can spread the infection. Playmates touching the infected skin can also become infected. Contact with the child's linens, towels, and clothing can also transmit the infection.

Incubation Period The incubation period lasts from a few days to several weeks. Usually, 7 to 10 days pass between the time of infection and the appearance of blisters.

How Long Symptoms Last Without treatment, most blisters go away within two weeks. If treated with an antibiotic, healing should begin within three days. A child should stay home from school or child care for at least 24 hours after antibiotic treatment has begun.

When to Call Your Child's Doctor Call your child's doctor if your child has signs of impetigo, especially if she has been exposed to someone with the infection. If your child is currently being treated, call the doctor if her skin does not begin to heal in three days. Also call the doctor if the child develops a fever or if the affected area becomes red, warm, or tender to the touch.

How the Diagnosis Is Made The doctor examines the skin or takes a culture of the infected area.

Treatment The doctor will prescribe an oral antibiotic for 7 to 10 days.

Home Treatment Wash infected areas gently with clean gauze twice a day using antisep tic soap. If the skin is crusted, soak it first in soapy water to remove layers of crust. To keep your child from spreading the infection to other parts of the body, cover the infected area with loose gauze and tape or a plastic bandage. Keep your child's fingernails trimmed.

Prevention Give your child a daily shower or bath. Keep injured areas clean and covered. If someone in the family has impetigo, use an antibacterial soap and make sure each person uses a separate towel. If necessary, substitute paper towels for cloth ones until the impetigo is gone. Keep the infected person's linens, towels, and clothing separate, and wash them with hot water.

Contagious Periods Sores are contagious until the child has been treated with antibiotics for longer than 24 hours.

Complications Blisters usually do not leave scars and rarely lead to complications.

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