Impetigo at School: Treatment, Exclusion, and What to Tell Teachers
My School Agent | 8 July 2026
You spot it at breakfast. Small red sores around your child's nose and mouth. By lunchtime, they've turned into honey-coloured crusts. By 3pm, the school office has called.
Impetigo looks worse than it is. But it spreads like gossip in a Year 6 classroom, so schools take it seriously.
What Is Impetigo?
It's a bacterial skin infection. Highly contagious. Caused by either staphylococcus or streptococcus bacteria. It mainly affects children aged 2 to 6, but anyone can get it.
The NHS says it's one of the most common skin infections in young children. It spreads through direct contact or by touching contaminated surfaces. Towels, toys, school PE kits. Anything a child has touched.
It usually starts with red sores that quickly burst and develop a golden-brown crust. The sores can appear anywhere but often cluster around the nose and mouth. Sometimes they're itchy. Sometimes they don't bother the child at all.
Which is part of the problem. Your child feels fine. They don't understand why they can't go to school.
Two Types You Might Hear About
Non-bullous impetigo is the common one. Small blisters that burst quickly and leave the crusty patches. This is what most parents recognise.
Bullous impetigo is less common. Larger blisters filled with fluid. They last longer before bursting. Both types are treated the same way.
Treatment: Antibiotic Cream or Tablets
Your GP will usually prescribe an antibiotic cream. Fusidic acid is common. You apply it to the sores three or four times a day for about a week.
If the infection has spread, or the cream isn't working, they might prescribe antibiotic tablets instead. Usually flucloxacillin or erythromycin.
The sores start to heal within a few days. The crusts fall off. New skin grows underneath. It doesn't usually scar.
Keep the area clean. Gently wash with warm soapy water and pat dry. Don't pick at the crusts, though try telling that to a five-year-old.
The School Exclusion Rule
NHS guidance says children should stay off school until 48 hours after starting treatment, or until the sores have crusted over and healed.
That second part trips people up. If you're using antibiotic cream and the sores are still weeping after 48 hours, keep them home. Once they're crusted over and not oozing, they can go back.
Some schools insist the sores must be completely healed. That's not the official guidance. Crusted and covered is enough.
If your school pushes back, point them to the Health Protection in Schools and Other Childcare Facilities guidance from UK Health Security Agency. It's free online and very clear.
What Schools Sometimes Get Wrong
I've heard schools ask for a doctor's note before allowing a child back. Not necessary. NHS guidance doesn't require it.
I've also heard schools send children home mid-day because they spot a sore. If the sores are crusted and covered, and treatment has started, that's an overreaction.
Impetigo spreads easily, yes. But once treatment has begun and sores are healing, the risk drops significantly. Schools are understandably cautious. But they should follow NHS guidance, not make up their own rules.
Covering the Sores
If the sores are on exposed skin like hands or face, cover them with a waterproof dressing if possible. This reduces the chance of spreading bacteria.
For sores around the mouth, covering isn't practical. Just make sure your child washes their hands regularly and doesn't share food, drinks, or face towels.
Inform the school exactly where the sores are and whether they're covered. It helps them decide whether your child can join PE or swimming. Usually swimming is off-limits until the sores are fully healed.
How to Stop It Spreading at Home
Impetigo spreads through touch. Keep your child's towels, flannels, and bedding separate. Wash them at 60°C or higher.
Keep fingernails short to reduce scratching. If your child scratches the sores, the bacteria spread to other parts of their body. Or to siblings.
Wash hands frequently. Before meals, after touching the sores, after applying cream. Use soap and warm water, not just hand sanitiser.
If siblings develop sores, they'll need treatment too. Check everyone in the house.
The "It Looks Worse Than It Is" Conversation
Your child will probably feel fine. No fever, no pain. Just crusty sores that look alarming.
Other parents at the school gate might stare. Or step back. Impetigo has a reputation. But it's not a sign of poor hygiene or neglect. It's just a common childhood infection that happens to be visible.
Explain to your child why they need to stay home even though they feel well. "The cream needs time to work. We don't want your friends to catch it." Keep it simple. Two days off school isn't the end of the world.
When to Go Back to the GP
If the sores haven't started healing after a few days of treatment, or if they're spreading despite the cream, go back to the GP. You might need a stronger antibiotic.
Rarely, impetigo can lead to complications like cellulitis or kidney problems. But that's uncommon if you catch it early and treat it properly.
The School Call at 3pm
When the school office calls to say they've spotted sores, don't panic. Book a GP appointment, start treatment, keep them home for 48 hours or until crusted over, and inform the school.
Impetigo looks dramatic. But it clears up fast, and it doesn't mean you've done anything wrong.
My School Agent tracks exclusion periods for illnesses like impetigo so you know exactly when your child can return. No guessing, no conflicting advice from the school WhatsApp. Just clear NHS-backed guidance when you need it.