Last edited 07/2021 and last reviewed 10/2022

Impetigo is a highly contagious, superficial skin infection caused by Staphylococcus aureus, Streptococcus pyogenes, or both.

Infection is usually primary but may also complicate other skin disease, such as scabies or eczema.

Key points (1):

  • localised non-bullous impetigo:
    • hydrogen peroxide 1% cream (other topical antiseptics are available but no evidence for impetigo)
    • if hydrogen peroxide unsuitable or ineffective, short-course topical antibiotic
  • Widespread non-bullous impetigo:
    • short-course topical or oral antibiotic
    • ttake account of person’s preferences, practicalities of administration, previous use of topical antibiotics because antimicrobial resistance can develop rapidly with extended or repeated use, and local antimicrobial resistance data
  • Bullous impetigo, systemically unwell, or high risk of complications:
    • short-course oral antibiotic
    • do not offer combination treatment with a topical and oral antibiotic to treat impetigo
    • *5 days is appropriate for most, can be increased to 7 days based on clinical judgement