School sores

Also known as impetigo, school sores are a common bacterial infection mainly affecting school-age children and more common in warmer months of the year. The infection causes inflamed blisters containing a yellow-looking fluid to form anywhere on the body (often the nose or mouth) where there has been a cut, scratch or small wound (or skin damaged from eczema, insect bites or chicken pox). The blisters will be weepy, and pop, forming raised wet-looking crusts on the skin. These blisters and crusts are filled with bacteria and are very contagious especially when the sores are weeping, spreading easily to other parts of the body or people and contaminating clothing and surfaces. The infection is caused by staphylococcus or streptococcus bacteria that normally live harmlessly on and inside various areas of the body such as the nose, skin and throat. If the skin is damaged, the bacteria can get into deeper layers of the skin and start to spread.

Impetigo often will start as small, itchy red spots that begin to spread outward from the original area, and get larger in size. Because the skin is itchy, when a child scratches they spread the infection from under their fingernails to other areas of the body or other people. The area of blisters can get bigger very quickly. A sore will take roughly one to three days to develop after contact with fluid or crusts from another sore or infected person. The sores are infectious as long as they are weeping but will stop being infectious about 24 hours after starting antibiotic treatment. While an infection can look unsightly, school sores aren’t dangerous if treated and will not cause any long-term damage to the skin. If left untreated, the infection can lead to skin abscesses, or spread to other areas of the body or the blood.

School sores are treated with antibiotic cream or ointment or antibiotic syrup or tablets, and sometimes both topical and oral treatment is required. The infection will clear up quickly once antibiotic treatment is begun and it is important that the full course of antibiotics is taken even if it looks like the skin has healed. It is important to cut fingernails to prevent any further skin damage and try to stop your child scratching. Cover the sores with a waterproof dressing to prevent infected fluid and crusts from spreading the infection. A crepe bandage may be needed to hold any dressings in place and to stop younger children from scratching the sores. Encourage regular handwashing with warm water and soap. When the crusts look like they are ready to fall off on their own, bathe the area in warm water to remove them gently. Change your child’s linen daily while infected, washing towels, face cloths, sleep wear and sheets in a hot wash.

Measures to prevent school sores include having a good handwashing routine – regularly with soap, discarding any used tissues or dressings safely, keeping fingernails short and clean as well as discouraging scratching. Wash any cuts or grazes thoroughly and keep a good antiseptic cream (one with hydrogen peroxide is ideal) on hand to dab onto insect bites or scratches.

Impetigo is dangerous for newborn babies as their immune system is not fully developed and may not keep the infection at bay. The infection can be life-threatening if not treated in a newborn. It is very important not to expose a young baby to impetigo and to keep them away from anyone infected.

Always go back to the doctor if:

• the sores are still there after a week
• your child has swollen lymph glands
• the sores are very red and swollen or filled with pus, rather than clear fluid
• your child has a fever or seems very unwell.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.