What should you know about first stage of impetigo?

Impetigo is a contagious bacterial infection of the surface of the skin. Early lesions may look like tiny blisters, red patches, or shallow sores around the nose and mouth, on the hands, or where skin has been scratched. They can break and form sticky golden or brown crusts; this is [Crusting Skin](/symptoms/skin-crusting/). Existing irritation, insect bites, or eczema such as [Atopic Dermatitis](/conditions/atopic-dermatitis/) can provide a route for bacteria to enter, but impetigo can also occur on otherwise healthy skin.

The appearance can overlap with other rashes, so a clinician may assess the pattern, speed of spread, and whether there are signs of a deeper infection.

Gently wash the affected skin, pat it dry, and avoid picking the crusts. Wash hands after touching the area, keep towels and face cloths separate, and clean frequently handled surfaces. Cover sores loosely when practical and avoid close skin contact until a clinician advises that it is safe. A small localised infection may be treated with [Topical Antibiotic Therapy](/treatments/medical-dermatology/topical-antibiotic-therapy/); wider or persistent infection may need [Antibiotics For Skin Infection](/treatments/medical-dermatology/antibiotic-therapy-for-skin-infection/). Use medicines exactly as prescribed.

Arrange prompt medical review if sores are spreading, painful, recurrent, affecting the eyes, or not improving with the advised treatment. Seek urgent care for fever, marked swelling, rapidly spreading redness, severe tenderness, weakness, or reduced alertness. Babies, people with reduced immunity, and anyone with extensive skin involvement should seek advice early.

Ask whether the rash is impetigo or another infection, whether a swab is needed, which treatment suits the number and location of sores, and when normal contact can resume. Ask how to protect household members and what to do if the infection returns.