Impetigo: What treatments work?

For less extensive infections with impetigo, the evidence shows that particular antibiotic ointments are effective.

Impetigo is an itchy and sometimes painful skin infection. It is common, especially in young children. About 1 in 50 children in European countries get medical attention for impetigo (2%). It is more common in tropical and developing countries. An outbreak of impetigo usually spreads on the skin of the person who has it, and it can spread easily to other people as well.

The condition typically causes sores that form yellow-ish scabs, mostly on the face, arms or legs. The scabs dry up and fall off without leaving permanent scars. It is caused by a bacterial infection.

It can take a few weeks till the infection goes away by itself. Treatment might be needed if the infection looks bad, the skin is very itchy or if it is important to stop the infection spreading.

To compare the effectiveness of different treatment options, researchers gathered and systematically assessed all the relevant trials. This showed that internationally, there are least 36 different options for handling impetigo.

Although the researchers found 57 trials involving more than 3,500 people with impetio, no single form of treatment has been really thoroughly tested.

For infections that are not very extensive, the research shows that antibiotic ointments with fusidic acid or mupirocin can help. It also appears that some antibiotic tablets might be able to help relieve impetigo. They probably have more adverse effects than ointments though. Oral antibiotics are usually used in children who have very extensive infection, because using large amounts of ointment for days is not very practical.

As a first treatment option, disinfectant lotions or ointments that do not have antibiotics are often suggested. However, the evidence suggests these might not be effective.