Conditions
Impetigo: honey-colored crusts on the skin in children and adults
Impetigo is a bacterial skin infection that causes sores or small blisters that ooze and form honey-colored crusts, usually on the face around the nose and mouth, or on the arms and legs. It is very common in young children and spreads easily. The doctor evaluates it by video and, if appropriate, prescribes and we send the prescription to your pharmacy.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
- A rash with fever and spots that don’t fade when you press a glass on them
- A red, warm, swollen area spreading fast around the sores, or red streaks
- A child who is very listless, hard to wake or looks very ill
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At a glance
Impetigo
Common symptoms
- Red, itchy sores or small blisters
- Blisters that ooze yellow fluid
- Honey-colored crusts over the sores
- Sores on the face around the nose and mouth, or on the arms and legs
- Other names
- Impetigo in children · School sores
- Treatment
- Antibiotic ointment or antibiotic by mouth, only when the medical evaluation calls for it
- Possible complication
- Rarely, a kidney problem (post-streptococcal glomerulonephritis) one to two weeks later
On this page(8)
What is impetigo?
Impetigo is a skin infection caused by strep or staph bacteria. It is most common in children 2 to 5 years old, but anyone can get it. In adults it sometimes follows another skin problem or a cold. If you have a red, warm, painful lump with pus instead, see boils.
It is more frequent in hot, humid climates like Puerto Rico’s. It spreads through direct contact with the sores or the fluid that comes from them, and it spreads easily in day care and schools. By scratching, a child can spread it to other parts of the body. It can also start on skin damaged by insect bites or by scratching from scabies.
How we treat impetigo by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. Impetigo is diagnosed by how it looks: show the sores on camera in good light, or send photos through the secure link we send you.
The doctor asks when it started, how many sores there are, whether there is a fever and whether anyone else at home or at day care has it. From there she evaluates, diagnoses and treats. If appropriate, the doctor prescribes and we send the prescription to your pharmacy.
We see children of all ages and adults. If the patient is under 21, a parent or legal guardian must be on camera with ID for the whole visit. The patient needs to be physically in Puerto Rico during the visit. See also our online doctor for kids.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send the prescription to your pharmacy. If needed, you get a doctor’s note for school or work.
What the visit costs
Impetigo is handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after the visit is included at no extra charge. See all prices.
Impetigo symptoms
What you usually see:
- Red, itchy sores or small blisters
- Blisters that ooze yellow fluid
- Honey-colored crusts over the sores
- Sores on the face around the nose and mouth, or on the arms and legs
Impetigo treatment and going back to school
When there are only a few sores, treatment is usually an antibiotic ointment. If there are many sores or the infection is more widespread, an antibiotic by mouth may be needed. The doctor decides which is appropriate. Use it exactly as directed. Impetigo almost always clears, though it often comes back in young children.
When can my child go back to school or day care? According to the CDC, a person with impetigo can return to school or work at least 12 hours after starting antibiotics, with the sores covered. Until then, avoid close contact with other children. A doctor’s note is included: see doctor’s note.
- Gently wash the sores, without scrubbing, several times a day.
- Cover the sores with a bandage or gauze.
- Use separate towels and washcloths, and don’t share clothes or personal items.
- Wash your hands well after touching the sores.
When to get in-person care or go to the ER
Get your child seen in person if the sores spread over a large part of the body, if there is a fever, if it is a young baby, or if it isn’t improving with treatment. For safety, go to the emergency room or call 911 if you notice any of these signs; see also cellulitis:
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
- A rash with fever and spots that don’t fade when you press a glass on them
- A red, warm, swollen area spreading fast around the sores, or red streaks
- A child who is very listless, hard to wake or looks very ill
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can impetigo be treated by video?
Is impetigo contagious?
When can my child go back to school with impetigo?
What are the yellow crusts on my child’s face?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (6)
- Impetigo (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- About Impetigo (CDC) (opens in a new tab) (accessed 2026-10-02)
- Clinical Guidance for Group A Streptococcal Impetigo (CDC) (opens in a new tab) (accessed 2026-10-02)
- Impetigo (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-10-02)
- Scabies (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Boils (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)