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Impetigo: Signs and symptoms

What you see and feel differs with the type of impetigo. There are two types.

Non-bullous impetigo

Impetigo on 5-year-old girl’s leg
Non-bullous impetigo on 5-year-old girl’s leg. The sores have broken open, so you see redness and honey-colored crusts.
This is the most common type. It goes through these stages:

  • Starts with one or more sores, which are often itchy

  • The sores quickly burst, and the skin can be red or raw where the sores have broken open

  • Glands near the sores may feel swollen

  • Crusts, usually honey-colored, form

  • The skin heals without scarring, unless scratching cuts deep into the skin

The infection can spread to other areas of the body, where you’ll see this process begin all over again. This is one reason treatment is so important.

Bullous impetigo

Bullous impetigo on 12-year-old girl’s arm
Bullous impetigo on 12-year-old girl’s arm. This type causes painless, fluid-filled blisters.
This type causes fluid-filled blisters, but without redness on the surrounding skin. When a person has bullous impetigo, you’ll see it progress as follows:

  • Blisters appear that contain a cloudy or yellow fluid.

  • The blisters become limp and transparent and then break open.

  • Crusty sores form where the blisters have broken open.

  • The skin tends to heal without scarring.


Ecthyma can develop when impetigo goes untreated. This is a more serious type of infection because it goes deeper into the skin. When a person has ecthyma, you’ll see:

Ecthyma can develop when impetigo goes untreated
Ecthyma: This began as a pus-filled blister on top of an insect bite and turned into the open sore you see here.

  • Painful blisters

  • Blisters turn into deep, open sores

  • Thick crusts develop, often with redness on the surrounding skin

Because the infection goes deeper into the skin, you may see scars once the skin heals.

If notice any of these signs on your child’s skin (or your own skin), you should see your dermatologist, pediatrician, or family doctor. All types of impetigo are very contagious.

Treatment can help clear the infection and prevent the infection from spreading to others.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Habif TP, Campbell, JL, et al. “Impetigo.” In: Dermatology DDxDeck. Mosby Elsevier, China, 2006: Card#46.

Tuchman M and Weinberg JM. “Bacterial infections.” In: Kelly AP and Taylor S. Dermatology for Skin of Color. (first edition). The McGraw-Hill Companies, Inc. China, 2009:413-4.