How are school sores diagnosed?

• If you think your child has school sores (impetigo), you should see your doctor
• They’ll usually be able tell what it is, simply by looking at the rash
• Sometimes a skin swab may be taken, if the diagnosis is uncertain.

What is the treatment for school sores (impetigo)?

• your doctor will usually prescribe a topical antibiotic cream to apply until the impetigo rash is gone
• The cream may work better if the crusts on the lesions are softened and removed before applying it. This can be done by giving the child a warm bath and gently bathing the lesions with either a disposable cloth, or one that can be washed at a high temperature afterwards.
• doctors may suggest using bleach baths to remove crusts- this might sound “extreme” but it’s just a way of adding a small amount of disinfectant to bath water, thereby reducing the bacterial count on the child’s skin. It’s also used as a treatment for infected eczema. Instructions for safely making a bleach bath can be found on the Royal Childrens Hospital website.
• if the rash is very widespread or more severe, oral antibiotics may be advised by your doctor- it is very important to finish the full course of antibiotics, to ensure the infection does not come back.
• if a child repeatedly gets school sores, it may mean they’re carrying it on their body, often in the nose. Your doctor may take swabs and prescribe a course of nasal antibiotic cream.
• If a child is scratching at sores, you may need to apply a waterproof dressing
• It’s important to reduce spread to other children by keeping your child at home from school or childcare for 24 hours after treatment has been started.
• Hygiene measures like regular hand-washing are important. Clothing, bedding and towels used by the child should ideally be cleaned separately, in a hot wash and tumble dried. Where possible, toys should also be cleaned.

How do you prevent school sores from spreading?

Preventing the spread of impetigo involves strict hygiene measures. Children with impetigo should be kept home from school or daycare until they have been on antibiotics for at least 24 hours and the sores are no longer weeping​. Key preventive measures include:

• Hand Hygiene: Regular hand washing with soap and water is essential for everyone in the household.
• Personal Items: Avoid sharing personal items such as towels, clothing, and bed linens.
• Cleaning and Covering Wounds: Keep any cuts, abrasions, or insect bites clean and covered.
• Nail Hygiene: Keep fingernails short and clean to prevent bacteria from spreading through scratching​.
• Linen Care: Wash the infected person’s clothes, towels, and bed linens separately in hot water, and dry them in the sun or a hot dryer​.

Complications

While impetigo is generally a mild infection, it can lead to complications if not properly treated. These complications include cellulitis, an infection of the deeper layers of the skin, and post-streptococcal glomerulonephritis, a rare kidney condition. Other serious complications, although rare, include sepsis and rheumatic fever​.

How soon can my child return to childcare or school?

Your child can go back to child care or school after they’ve had 24 hours of treatment, and once the sores are completely covered by dressings.  It is important to complete the course of treatment fully, otherwise the infection may come back.

Can school sores cause scarring?

• Generally not, though if a child scratches the lesions badly, a scar could form
• If scratching of impetigo is a problem, cut the child’s fingernails and apply a new waterproof dressing to the troublesome lesions each day, after applying the treatment.