What should you know about impetigo on scalp treatment?

Impetigo is a contagious bacterial infection that can begin where the skin is scratched, irritated, or affected by another itchy condition. On the scalp, small blisters or moist sores may break and leave yellow-brown crusts. Crust can cling to hair, making the area harder to clean without rubbing. Itching can spread bacteria under fingernails and to other people through shared brushes, hats, towels, or pillowcases. A crusted patch is not enough to confirm the diagnosis; several scalp conditions can look similar.

A clinician may recommend a topical antibiotic for a limited area or an oral antibiotic when infection is more extensive, difficult to reach through hair, or not responding as expected. Use only the medicine prescribed and follow its directions. Gently wash the scalp, soften loose crusts with water, and pat dry; do not pick or forcibly pull crust from hair. Wash hands after touching the area, keep nails short, and avoid sharing personal items. Launder pillowcases, towels, hats, and hair tools, and pause close contact until a clinician says the infection is no longer likely to spread. More detail is available about Topical Antibiotic Therapy.

Arrange prompt medical review if sores are spreading, painful, draining heavily, or accompanied by fever, marked swelling, or tender glands. Seek urgent help for swelling near the eye, severe headache, unusual drowsiness, or a rapidly worsening illness. A clinician should also assess scalp impetigo in a young child, recurrent episodes, or infection that does not improve with the prescribed plan. Crusting skin elsewhere may provide useful context for the assessment.

Ask whether the scalp changes fit impetigo or another condition, whether treatment should be topical or oral, how to clean crust around hair safely, and when school, work, swimming, or close contact can resume.