Impetigo

Impetigo is a superficial bacterial skin infection most commonly seen in young children, though adults can also be affected. It is caused by Staphylococcus aureus or Streptococcus pyogenes, and presents as distinctive honey-coloured crusted sores or blisters, usually appearing around the nose, mouth, or on the limbs. It is highly contagious and spreads readily in schools, nurseries, and households across Medway and Gillingham.

Parents often recognise the golden-crusted sores and are understandably anxious to get treatment quickly, not least because children with impetigo are excluded from school until the infection is under control. The NHS Pharmacy First service means you do not need to wait for a GP appointment — our pharmacist Sukhdip Bahia can assess the extent of the infection and supply appropriate treatment, whether topical or oral.

Medway Pharmacy on Canterbury Street in Gillingham is ideally placed to help families in the Medway towns. Sukhdip has treated many cases of impetigo under the Pharmacy First pathway and can advise both on treatment and on the practical steps needed to prevent the infection from spreading to other family members.

Symptoms of impetigo

• Clusters of small blisters or sores that burst and form honey-coloured crusts
• Sores most commonly around the nose, mouth, or on exposed skin
• Itching or soreness at the site of the sores
• Mild redness and weeping of the affected skin
• Sores that spread if touched and then that area is touched elsewhere
• Usually no fever (but mild fever may occur in widespread cases)

Who is eligible for Pharmacy First Impetigo treatment?

The Pharmacy First impetigo pathway covers non-bullous impetigo in adults and children aged 1 year and over. It does not cover bullous impetigo (where there are large, fluid-filled blisters rather than crusty sores), nor recurrent episodes of impetigo, both of which require GP assessment. For localised impetigo — defined as 3 or fewer lesions — topical treatment is typically appropriate. For widespread impetigo with 4 or more lesions, oral antibiotics are needed.

What can the pharmacist prescribe?

For localised non-bullous impetigo (up to 3 lesions), our pharmacist can supply hydrogen peroxide 1% cream (Crystacide) as a first-line topical antiseptic treatment, or topical fusidic acid 2% cream where clinically indicated. For widespread impetigo (4 or more lesions), oral flucloxacillin is the appropriate treatment. Patients allergic to penicillin can be prescribed oral clarithromycin or topical retapamulin instead. The pharmacist will also provide hygiene advice: regular handwashing, avoiding touching the sores, not sharing towels or bedding, and keeping fingernails short.

What to expect at Medway Pharmacy

Impetigo cases at Medway Pharmacy tend to cluster in spring and autumn when children return to school and nurseries after holiday breaks. Sukhdip sees multiple cases each week during these peak periods, and the Pharmacy First pathway means that most families can leave with a prescription on the same visit. For families in Gillingham, Chatham, Rainham, and the surrounding areas of Medway, this represents a significant time saving compared to waiting for a GP appointment.

Frequently asked questions

When to see a GP or call 999

While Pharmacy First covers many cases of Impetigo, you should seek further care if:

• You have bullous impetigo (large, fluid-filled blisters rather than crusted sores)
• This is a recurrent episode of impetigo
• The infection is spreading or not responding to treatment
• The patient is a newborn or infant under 1 year — seek urgent medical assessment