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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually, for localised impetigo in an otherwise well adult, with a topical or oral antibiotic prescribed after photo and video review; Mobi Doctor does not see children, and a newborn with blisters or impetigo spreading fast with fever needs in-person care.
- What it is: a superficial bacterial infection of the top skin layer by Staphylococcus aureus or Streptococcus pyogenes; about 7 in 10 cases are the honey-crusted form, the rest the blistering (bullous) form, and it needs broken skin to start.
- How long: treated impetigo stops spreading 48 hours after the first dose and clears in 7 to 10 days; untreated it takes 2 to 3 weeks to heal and stays contagious until every sore has dried and crusted over.
- How it spreads: by direct skin contact and shared towels, flannels, bedding and razors, even in scrupulously clean homes; scratching carries it to new sites on the same person.
- Back to school or work: children return to school or nursery, and adults to close-contact work, once the sores have crusted over or 48 hours after starting antibiotic treatment, whichever comes first.
- Emergency: call 112 if a baby with blisters is floppy, feverish or not feeding, or if impetigo with fever comes with confusion, fast breathing or a racing heart.
Online care suits localised impetigo in an otherwise well adult; Mobi Doctor does not see children at the moment. A newborn baby with blisters, impetigo spreading quickly with fever, or a child who is drowsy, not drinking or clearly unwell needs in-person care instead. See the referral criteria below before booking.
Can an online doctor treat impetigo?
Often, yes. Impetigo produces distinctive golden, honey-coloured crusts, so clear photographs plus a video consultation can usually provide enough information to recognise it and prescribe a topical or oral antibiotic.[3] Widespread or blistering impetigo, a newborn baby, a child who is unwell, and infection that keeps coming back need in-person assessment.
Listen: Impetigo Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with impetigo
- Recognisable in a photo: the crusted, honey-coloured sore, most often around the nose and mouth, is one of the more identifiable patterns in skin medicine, and a sharp close-up usually carries the assessment.
- The right antibiotic, the right way: a few sores are often treated with a cream, while widespread or blistering impetigo needs tablets. The doctor matches route to spread, and prescribes only after assessing you.
- A school or nursery plan for parents: impetigo is very contagious, so parents leave knowing the standard rule for when a child can go back and the hygiene steps that stop it looping through the household.
- Honest referral when it matters: a poorly baby, spreading redness with fever, or repeated bouts are flagged for in-person care rather than another cream.
📷 Photograph the sores in daylight with no cream on them: one close-up of a crusted or blistered spot and one wider shot showing how many areas are involved. Note whether you can see fluid-filled blisters or only golden crusts, because that changes the treatment.
What the doctor checks in an online impetigo consultation
The assessment is structured around the features that decide cream versus tablets, and impetigo versus its look-alikes. In an impetigo consultation, the doctor will typically assess:
- Crusts or blisters: golden crusts point to non-bullous impetigo, while fluid-filled blisters that leave a raw, shiny base suggest the bullous form, which is more common in babies and usually needs oral treatment.[3]
- How much skin, and where: a couple of spots near the nose behave very differently from crusts scattered across the face, trunk or limbs.
- Age and how the person is in themselves: a well toddler with two sores is straightforward; a newborn, or any child with fever, poor feeding or drowsiness, is not an online problem.
- Whether it sits on other skin trouble: impetigo often complicates an itchy rash or eczema, and both the infection and the underlying skin then need treating.
- Recurrence and contacts: repeated bouts, and other affected household members, which change advice and sometimes prompt swabs in person.
- Allergies: penicillin allergy in particular, because it steers the choice of oral antibiotic.
- Look-alikes: cold sores (herpes), a fresh eczema flare, scabies or a fungal patch can all mimic early impetigo, and the doctor checks the story fits before treating.
What does impetigo look like?
Impetigo is a common, very contagious bacterial infection of the surface of the skin, caused mainly by Staphylococcus aureus and Streptococcus pyogenes. It is most frequent in young children but happens at any age, and it favours warm weather and skin that is already broken by a graze, a bite or eczema.[1] It is not a sign of poor parenting or a dirty home; it spreads easily even in scrupulously clean households.
Non-bullous impetigo (the common type)
This starts as tiny red spots or blisters that quickly burst and dry into the classic golden-brown, stuck-on crust, usually around the nose and mouth but anywhere the skin has been scratched. It is often itchy rather than painful, and scratching carries the bacteria to fresh sites, so new patches appear nearby.[3] On darker skin the redness can be subtle and the crust is the clearest sign.
Bullous impetigo and ecthyma
Bullous impetigo forms larger, fragile fluid-filled blisters, most often on the trunk of babies and young children; when they burst they leave a raw, glazed area with a thin rim of scale. Ecthyma is a deeper, punched-out, ulcerated form that heals more slowly and can scar. Both usually need oral antibiotics and closer follow-up, and a blistered newborn should be seen in person the same day.[3]
How impetigo spreads, and school or nursery exclusion
How it passes from person to person
Impetigo spreads by direct skin contact and on shared objects: towels, flannels, bedding, clothing, toys and even the hands that touch a sore and then a doorknob. The fluid and crusts are infectious, and scratching moves the bacteria both to other people and to new spots on the same person. Keeping nails short, covering sores loosely where practical, and not sharing towels or face cloths all cut transmission, and handwashing after touching the skin matters more than any deep-cleaning ritual.
When can a child go back to school or nursery?
Guidance is consistent: a child with impetigo should stay away from school, nursery or childcare until the sores have dried and crusted over, or until 48 hours after starting antibiotic treatment, whichever comes first.[1][4] The same applies to adults in close-contact jobs. Starting treatment therefore does more than clear the skin faster; it shortens the time off. The doctor will tell you plainly which day counts as day one so you are not guessing.
Which impetigo treatment might the doctor recommend?
Treatment follows how much skin is involved and whether you are otherwise well. This is the framework the doctors use, aligned with the cited guidance:[2]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| A few crusted spots, otherwise well (localised non-bullous) | Topical treatment: hydrogen peroxide 1% cream, or a topical antibiotic[2] | Usually yes | No improvement after a short course, or the sores keep spreading |
| Widespread crusts, or several separate areas | A short oral antibiotic course (for example flucloxacillin; a macrolide if penicillin-allergic) | Usually yes | Feeling unwell, high fever, or spreading despite oral antibiotics |
| Fluid-filled blisters (bullous), especially in a baby | Oral antibiotics; young infants assessed in person first | Case-dependent; a newborn, no | Newborn or unwell infant: same-day in-person care |
| Impetigo on top of eczema, or recurring bouts | Treat the infection and the underlying skin together | Usually yes | Frequent recurrence may need swabs or a carriage check in person |
| Fever, rapidly spreading redness, or feeling generally unwell | Prompt in-person assessment | No | Always; possible cellulitis or a deeper infection |
Not sure if it is impetigo? A doctor can tell you in one consultation.
See available times →Treatment options for impetigo
What you can do yourself
Gentle care helps alongside treatment: soak and soften the crusts with warm water, pat the skin dry with a towel used by no one else, and wash that towel hot afterwards. Keep fingernails short, discourage scratching, and wash hands after touching the sores or applying any cream. Cover the area loosely if it is being knocked or touched. Antiseptic care and hygiene reduce spread, but a true impetigo that is not settling needs a prescribed antibiotic rather than pharmacy antiseptics alone.
Prescription treatment after your consultation
A prescription is never issued without a consultation. After assessment, localised impetigo is often treated topically first, with hydrogen peroxide 1% cream or a topical antibiotic, while widespread or blistering infection is treated with a short course of oral antibiotics.[2][5] Antibiotics are used deliberately, not by default: they are prescribed when there are clear signs of bacterial infection, courses are kept short to reduce resistance, and a topical antiseptic is preferred where it will do the job.[2] If you are penicillin-allergic, tell the doctor, because it changes the tablet chosen. Any prescription can be used at a pharmacy near you.
Stopping impetigo coming back
Because impetigo takes hold where the skin barrier is broken, preventing the next bout means looking after the skin underneath. Treat eczema and dry skin well, manage the itch that leads to scratching, and clean and cover grazes and insect bites promptly. During an active infection, keep towels, flannels and bedding personal and wash them hot, and do not share razors or face cloths.
Recurrent impetigo sometimes reflects bacteria carried in the nose or in a household member who has mild, unnoticed sores, so repeated bouts are worth a proper look rather than repeated creams. If impetigo keeps returning in the same person or keeps passing between family members, the doctor may suggest swabs and a decolonisation plan, which is arranged in person where local pathways require it.
When impetigo is treated online, and when you need in-person care
Treated online: localised non-bullous impetigo in otherwise well adults; more widespread impetigo that needs a short oral antibiotic course; impetigo complicating a known eczema flare, treating both together; and reviews when a first treatment has not cleared the skin on schedule.
In-person care: a newborn or young infant with blisters, or any child who is feverish, drowsy, not feeding or clearly unwell, all needing same-day in-person care; impetigo with spreading redness, swelling and pain that suggests cellulitis; ecthyma and slow-healing ulcerated sores; and frequently recurring infection where swabs and a carriage check belong in person. Impetigo is one of many skin conditions the doctors assess online, and the same photo-and-video process helps separate it from look-alikes such as ringworm or an eczema flare.
When to get in-person care
See a doctor in person promptly if impetigo is spreading fast, if the surrounding skin becomes red, hot, swollen and painful, or if a baby or child develops a fever, is not feeding or drinking, or seems drowsy or floppy. If anyone shows signs of a serious infection or allergic reaction, such as a widespread rash with breathing difficulty, swelling of the face or throat, confusion or a very high temperature that will not come down, call 112 immediately.
Is impetigo contagious?
Highly. Impetigo spreads by direct contact and shared towels, flannels and bedding, and it moves quickly through households, nurseries and contact sports.
How long are you infectious? Until the patches have crusted and dried, or until 48 hours after effective antibiotic treatment has started, whichever comes first. That 48-hour line is the standard rule for returning to school, nursery and close-contact work.
Practical protection: no sharing of towels or razors, hot-wash bedding, keep nails short, and cover the patches where practical. Treatment usually needs a prescription, which is exactly the kind of decision a video consultation settles quickly.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Upload your skin photos, then speak to a licensed doctor: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your plan and school or nursery advice: if treatment is right, the prescription follows the consultation. If your doctor decides you need to be seen in person, you get a full refund.
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Frequently asked questions about impetigo
What is impetigo?
Impetigo is a common, highly contagious bacterial infection of the top layer of the skin, caused by Staphylococcus aureus or Streptococcus pyogenes. It starts as red sores or blisters, usually around the nose, mouth, hands or limbs, that burst and dry into golden, honey-coloured crusts. Impetigo is commonest in children aged two to five but affects adults too, and it is superficial rather than dangerous in most cases.
What causes impetigo?
Impetigo is caused by Staphylococcus aureus or streptococcus bacteria, often carried harmlessly in the nose, entering skin that is already broken by a graze, insect bite, eczema, scabies, a cold sore or shaving. Warm humid weather, crowded households, contact sports, shared towels and scratching spread impetigo, and diabetes or a weakened immune system make it more likely.
What does impetigo look like?
Impetigo looks like red sores that quickly burst, weep and dry into yellow-brown, honey-coloured crusts, typically around the nose and mouth, that spread outward and to new sites with scratching; the crusts are highly recognisable in clear photographs. Bullous impetigo forms larger, fragile fluid-filled blisters on the trunk, arms or legs that leave a thin crust when they burst. Impetigo itches but rarely hurts.
Can an online doctor prescribe antibiotics for impetigo in Europe?
Yes, after a consultation. A prescription is never issued without one: the doctor reviews your photos and history by video first, then prescribes a topical or oral antibiotic for impetigo when treatment fits. Any prescription can be used at a pharmacy near you. Mobi Doctor sees adults aged 18 and over, so impetigo in a child is treated by a local doctor in person.
Is impetigo treated with a cream or with tablets?
Impetigo can be treated with either, depending on how much skin is involved: a few localised sores are often treated with a cream, such as hydrogen peroxide or a topical antibiotic, while widespread or blistering impetigo, or impetigo in someone unwell, needs an oral antibiotic course. Crusts are soaked off gently with warm water before each application so the cream reaches the infected skin.
How long is impetigo contagious, and how long does it last?
Impetigo stops being contagious 48 hours after antibiotic or hydrogen peroxide treatment starts, or once every sore has dried and crusted over if untreated, which can take two to three weeks. With treatment the sores improve within a few days and clear in 7 to 10 days without scarring, though a pink mark can linger. Impetigo not improving after a week of treatment needs review.
When can my child go back to school or nursery with impetigo?
Once the impetigo sores have dried and crusted over, or 48 hours after starting antibiotic treatment, whichever comes first. Starting treatment shortens the time off as well as clearing the skin faster, and the same rule applies to nursery, sports clubs and swimming. Until then, keep the sores covered where practical and keep towels and flannels personal.
How do I stop impetigo spreading around the house?
Stop impetigo spreading by keeping towels, flannels, bedding and razors personal and washing them hot, discouraging scratching and keeping nails short, washing hands after touching the sores or applying cream, covering the area loosely where practical, and cleaning toys and surfaces the sores have touched. The fluid and crusts of impetigo are contagious until treatment has run 48 hours or the sores have healed.
Could it be something other than impetigo?
Sometimes: cold sores (which tingle and blister in a cluster at the lip edge), a fresh eczema flare, scabies, a fungal patch, insect bites and chickenpox can all resemble early impetigo. Part of the consultation is checking that the appearance and story fit impetigo before treating it, which is why clear photos and a short history of how the sores began matter.
How can I prevent impetigo coming back?
Prevent impetigo by treating the broken skin it needs to start, such as eczema, insect bites, grazes and cold sores, washing hands often, keeping nails short, not sharing towels or razors, washing sports kit hot, and showering after contact sport. For repeated impetigo, the doctor may swab the nose for staphylococcal carriage and prescribe a short antiseptic nasal cream and body wash to clear it.
Is impetigo different in adults, in pregnancy or with eczema?
Adult impetigo often follows shaving cuts, eczema, scabies or close-contact sport and is treated the same way, with attention to the underlying skin problem. In pregnancy, impetigo is treated with pregnancy-safe antibiotics and reviewed promptly if it spreads. With eczema, impetigo spreads faster across broken skin and the eczema itself needs treating alongside the infection, or the cycle repeats.
Is impetigo serious?
Impetigo is rarely serious: it stays in the top layer of skin and clears without scarring once treated. Uncommon complications include cellulitis spreading deeper, a kidney inflammation called glomerulonephritis one to three weeks after a streptococcal impetigo, and, in newborns, a widespread blistering reaction, so a baby with blisters, anyone with fever and spreading redness, or dark urine and swelling after impetigo needs in-person care.
- Impetigo: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Impetigo: antimicrobial prescribing (NG153), NICE, National Institute for Health and Care Excellence, 2020.
- Impetigo, DermNet New Zealand Trust, reviewed 2023.
- Impetigo, HSE, Health Service Executive (Ireland), accessed August 2026.
- Interventions for the skin infection impetigo, Cochrane Review, Cochrane, 2012.
- Impetigo, NHS, National Health Service (UK), reviewed June 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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