Impetigo (school sores) treatment

A parent notices a cluster of red sores around their child’s nose and mouth that have crusted over into a tell-tale “honey-coloured” scab. The childcare centre rings to say the child can’t come back until it’s treated. It’s a small problem, but a genuinely disruptive one — and increasingly, you can have it sorted at a community pharmacy. Many pharmacies can now assess impetigo and, where state and territory rules allow, supply treatment so the family can get on with their week.

What is impetigo?

Impetigo, commonly called “school sores”, is a contagious bacterial skin infection caused by Staphylococcus aureus or Streptococcus bacteria. It usually starts where the skin is already broken — around the nose and mouth, or at the site of a scratch, insect bite or patch of eczema. Small blisters or red sores appear, weep, and dry into the characteristic golden-yellow crust.

It is most common in children, especially in warm, humid conditions, and it spreads very easily — through direct skin contact and via towels, bedding and toys. That contagiousness is why childcare centres and schools ask that it be treated and covered before a child returns. It is generally a mild infection, but it does need treatment to clear it and to stop it spreading to others (and to other parts of the body).

Who is it for?

A pharmacy service suits otherwise well people with a small area of typical, uncomplicated impetigo. Eligibility, including any age limits, varies by state and territory.

The pharmacist will ask how long the sores have been there, how many there are and where, whether anyone else in the household is affected, and about allergies, other skin conditions and medicines. They’ll look at the affected skin to confirm the pattern fits impetigo rather than something else.

You should see a doctor instead if the infection is widespread or rapidly spreading, if there are large fluid-filled blisters, if the person is generally unwell or feverish, if they have a weakened immune system, if the sores are around the eyes, if impetigo keeps coming back, or if it is complicating a significant area of eczema. Recurrent or severe infection sometimes needs a different approach and, occasionally, a swab to guide treatment.

How it works at the pharmacy

In a private consulting area, the pharmacist examines the affected skin and runs through their checklist. If your situation fits the protocol, they will manage it in one of a few ways depending on how localised it is. For a small, localised patch, an antiseptic or antibiotic ointment or cream applied to the sores may be enough. For more widespread impetigo, an oral antibiotic course may be needed — which, in participating states, the pharmacist can supply, or otherwise refer for.

The hygiene advice is just as important as the medicine, because it’s what stops the infection spreading:

Wash the sores gently and keep them covered with a watertight dressing where practical.
Don’t share towels, face washers, bedding or clothing, and wash these in hot water.
Keep fingernails short and discourage scratching and picking.
Wash hands well after touching the sores.
Keep children home from childcare or school until 24 hours after starting treatment and until the sores are covered or dried up, in line with local exclusion rules.

There is usually a fee for the consultation and any medicine. Phone ahead, as the service depends on a trained pharmacist being available.

Safety and when to see a doctor

Most impetigo clears within a week or so of starting treatment. See a doctor if it isn’t improving after a few days, if it is spreading despite treatment, if the person becomes unwell or feverish, if the skin around the sores becomes hot, swollen and increasingly painful (which can signal a deeper infection called cellulitis), or if infections keep recurring. In some communities, including parts of regional and remote Australia, impetigo is common and is taken seriously because untreated streptococcal skin infection can occasionally lead to kidney and other complications — another reason getting it treated promptly is worthwhile.

How it’s regulated in Australia

Pharmacist treatment of impetigo is part of the broader expansion of community pharmacy scope of practice, run under state and territory arrangements rather than a single national scheme. Queensland’s scope of practice program has been the most advanced, with other states and territories operating their own pilots and trials. Pharmacists who supply treatment complete additional training, work to defined clinical protocols, and are registered with the Pharmacy Board of Australia. The conditions covered and the exact rules vary by jurisdiction and continue to change.