Impetigo treatment through NHS Pharmacy First
Impetigo is a contagious bacterial skin infection that causes sores, blisters and distinctive golden-brown crusts. At Lemonpill, our NHS Pharmacy First service provides professional assessments and treatment for suspected impetigo, helping you access care without seeing a GP first.
- For adults and children aged 1 and over. NHS Pharmacy First assessments for non-bullous impetigo, subject to clinical eligibility.
- No GP referral needed. Contact our pharmacy team directly for an assessment.
- Prescription treatment when appropriate. Our pharmacist may supply antiseptic cream, antibiotic cream or oral antibiotics depending on the infection.
- Free NHS consultation. Normal NHS prescription charges and exemptions apply. Over-the-counter products are paid for separately.
Early treatment can help. Impetigo spreads easily through direct skin contact and contaminated items. Prompt assessment and appropriate treatment can help clear the infection and reduce the risk of passing it to others.
How your Pharmacy First consultation works
Our pharmacist follows the NHS clinical pathway for non-bullous impetigo, the most common form of this bacterial skin infection. The assessment helps identify whether the rash is consistent with impetigo and which treatment is appropriate.
- Discuss your symptoms. We will ask when the sores appeared, whether they are spreading and if you have itching, discomfort or other symptoms. We will also check your medicines, allergies, previous infections and relevant health conditions.
- Examine the affected skin. The pharmacist will visually assess the sores, blisters and crusted patches. They will check how widely the infection has spread and look for signs of a more serious skin condition.
- Agree on treatment. Depending on the findings, you may receive an antiseptic cream, prescription antibiotic treatment or advice on preventing infection from spreading. If further medical assessment is needed, we will explain the next steps.
Will I need antibiotics? Not always. Small, localised areas of non-bullous impetigo can often be treated with an antiseptic cream. Antibiotics may be recommended when antiseptic treatment is unsuitable, ineffective or the infection is more widespread.
Book your impetigo consultation
Arrange an NHS Pharmacy First assessment with Lemonpill if you or your child, aged 1 or over, have symptoms of suspected impetigo.
Our pharmacist can examine the affected skin, recommend suitable treatment and advise on preventing the infection from spreading.
Before booking: Check the urgent-care guidance above. Large blisters, rapidly spreading infection or severe illness may require a GP or urgent medical assessment.
Having trouble booking? Contact our pharmacy team for assistance.
Signs and symptoms of impetigo
Impetigo commonly affects the face, particularly around the nose and mouth, although it can develop anywhere on the body. It is especially common in young children but can affect people of all ages.
The infection often begins with small sores or blisters that break open and form characteristic crusts.
Common signs include:
- Small sores or blisters that burst easily
- Golden-yellow or honey-coloured crusts forming over the skin
- Red, irritated or discoloured patches around the sores
- Mild itching or discomfort in the affected area
- New patches developing as the infection spreads
- Occasional tenderness or swelling around infected skin
On darker skin, redness may be less noticeable. The affected area may appear darker, purple or brown, with the characteristic crusting still visible.
What causes impetigo?
Impetigo is caused by bacteria, commonly Staphylococcus aureus or Streptococcus pyogenes.
These bacteria can enter through small breaks in the skin, including cuts, scratches, insect bites or areas affected by eczema.
The infection can also spread through close contact with someone who has impetigo or by sharing contaminated towels, bedding and other personal items.
What is the difference between non-bullous and bullous impetigo?
Non-bullous impetigo is the more common form. It usually causes small sores that quickly break open and develop golden-brown crusts. This is the type covered by the NHS Pharmacy First clinical pathway.
Bullous impetigo causes larger fluid-filled blisters, often affecting the body or skin folds. These can rupture and leave moist, sore areas.
Bullous impetigo is excluded from the Pharmacy First treatment pathway and requires assessment through an appropriate healthcare service.
Not every crusted rash is impetigo. Eczema, cold sores and other skin conditions can sometimes look similar. An assessment helps identify the most appropriate treatment.
What treatment can Pharmacy First provide?
Treatment depends on the number of affected areas, the severity of symptoms and your medical history. The pharmacist will recommend the most suitable option following the assessment.
- Antiseptic cream: Hydrogen peroxide 1% cream may be recommended for small, localised areas of non-bullous impetigo. It helps reduce bacteria on the skin without using an antibiotic.
- Antibiotic cream: Fusidic acid 2% cream may be supplied when hydrogen peroxide is unsuitable or has not worked and the infection remains localised.
- Oral antibiotics: For more widespread non-bullous impetigo, the pharmacist may supply flucloxacillin or a suitable alternative when the NHS clinical criteria are met.
- Further medical care: If the infection is recurring, unusually severe or outside the Pharmacy First pathway, the pharmacist will recommend an appropriate healthcare service.
How are treatments chosen?
Under the NHS Pharmacy First pathway, localised impetigo generally means up to 3 affected sores or clusters. Hydrogen peroxide 1% cream is usually considered first when suitable.
If the infection involves 4 or more sores or clusters, oral antibiotic treatment may be appropriate.
The pharmacist will also check whether treatment is suitable for your age, allergies, pregnancy status, other medicines and medical conditions.
How long does treatment take?
Treatment supplied through Pharmacy First is generally used for 5 days, whether this involves an antiseptic cream, antibiotic cream or oral antibiotics.
Symptoms often begin improving during treatment, although complete healing may take longer.
Follow the instructions carefully and finish the prescribed treatment, even if the skin starts looking better.
Prescription treatment is not automatic. The pharmacist will confirm whether your symptoms match non-bullous impetigo and whether treatment can be supplied safely under the NHS pathway.
How to care for impetigo at home
Alongside appropriate treatment, good skin care and hygiene can help reduce irritation and prevent impetigo from spreading.
- Keep the affected skin clean. Gently wash the sores with soap and water, then dry carefully using a clean towel. Avoid rubbing or scrubbing the skin.
- Avoid touching or scratching. Scratching can spread bacteria to other areas of the body and damage healing skin. Keep fingernails clean and short.
- Wash your hands regularly. Use soap and water, especially before and after touching the sores or applying treatment.
- Use medicines as directed. Apply prescribed creams or take antibiotics exactly as instructed by the pharmacist. Do not share treatment with anyone else.
- Keep personal items separate. Avoid sharing towels, flannels, pillowcases, bedding or clothing while the infection is contagious.
- Protect affected areas. Cover sores loosely with clothing or a suitable dressing when practical, particularly if they are likely to be touched.
How long does impetigo take to clear?
With appropriate treatment, impetigo often begins improving within a few days.
The sores gradually dry and heal as the infection clears. Some temporary skin discolouration may remain after the crusts disappear.
Without treatment, the infection can take longer to settle and may continue spreading to other areas or people.
If symptoms worsen rapidly or significantly, or have not improved after completing the treatment course, seek further medical assessment.
How to stop impetigo spreading
Impetigo is highly contagious. It can spread through direct skin contact or by touching items contaminated with bacteria from infected sores.
Simple precautions can help protect family members, classmates and others.
- Wash towels, bedding and clothing regularly at a high temperature where suitable
- Clean frequently touched surfaces and washable children’s toys
- Avoid close skin-to-skin contact while the infection is contagious
- Do not share personal items such as towels or flannels
- Avoid contact sports, swimming and gym activities until no longer contagious
- Avoid preparing food for other people while infectious
When can children return to school or nursery?
According to NHS guidance, impetigo generally stops being contagious:
- 48 hours after starting prescribed hydrogen peroxide cream or antibiotic treatment
- When all the sores have healed, dried out and crusted over if no treatment has been used
Children should stay away from school or nursery until they are no longer contagious. Adults should follow the same precautions before returning to work.
Can impetigo come back?
Yes. Some people develop repeated infections, particularly when bacteria remain on the skin or inside the nose.
If you experience 2 or more episodes within the same year, this is considered recurrent impetigo under the NHS Pharmacy First pathway.
Recurrent impetigo is excluded from this pathway and should be assessed by a GP, who may recommend swabs or other preventative treatment.
When should you contact a GP?
Although Pharmacy First can treat many cases of non-bullous impetigo, some infections need further investigation.
Arrange a GP assessment if:
- Your child is under 1 year old
- You have had impetigo before and it has returned within the same year
- You are breastfeeding and have impetigo sores on your breasts
- You have a weakened immune system
- The infection has not improved after completing treatment
- You develop large blisters or symptoms suggesting bullous impetigo
What if impetigo is getting worse?
Sometimes a bacterial skin infection can spread into deeper layers of the skin, causing cellulitis.
Symptoms can include increasing warmth, redness, swelling, tenderness and spreading skin discolouration.
If you develop these symptoms, particularly alongside a fever or feeling unwell, seek urgent medical advice.
Do not wait until treatment is finished if symptoms are rapidly worsening. Follow the urgent-care guidance above whenever concerning symptoms develop.
Impetigo treatment FAQs
Find quick answers to common questions about impetigo and the NHS Pharmacy First service.
Who can use Pharmacy First for impetigo?
The NHS Pharmacy First impetigo pathway is available for eligible adults and children aged 1 and over with suspected non-bullous impetigo. No GP referral is needed. Bullous impetigo, recurrent infections and pregnancy under 16 are excluded. The pharmacist will confirm eligibility during the assessment.
Can I get antibiotics for impetigo without seeing a GP?
Yes. An authorised pharmacist can supply certain antibiotic creams or oral antibiotics when the NHS clinical criteria are met. Small, localised infections are usually treated with hydrogen peroxide 1% cream first when suitable. More widespread infections may require oral antibiotics.
Is impetigo contagious, and when can my child return to school?
Yes. Impetigo spreads easily through skin contact and shared items. Children should stay away from school or nursery until 48 hours after starting prescribed hydrogen peroxide or antibiotic treatment, or until the sores have healed, dried out and crusted over if untreated.
Can adults get impetigo?
Yes. Although impetigo is most common in young children, adults can develop it too. The bacteria can enter through small cuts, insect bites or irritated skin. Adults with suspected non-bullous impetigo can use Pharmacy First if they meet the service criteria.
Is the NHS Pharmacy First consultation free?
Yes. Eligible NHS Pharmacy First consultations are free. Normal NHS prescription charges apply to medicines supplied unless you qualify for an exemption. Over-the-counter products purchased separately are paid for. Where you are registered with a GP, information about the consultation is sent to the practice to update your medical record.
Get help with impetigo at Lemonpill
If you or your child have developed crusted sores, blisters or a spreading skin infection, Lemonpill is here to help.
Our pharmacist can assess the affected skin, recommend appropriate treatment and explain how to prevent impetigo from spreading to others.
Concerned about a possible impetigo infection? An NHS Pharmacy First consultation can help identify the most appropriate treatment without needing a GP referral.
Book your Pharmacy First impetigo consultation
For assistance with appointments or service eligibility, contact Lemonpill, based in Islington, London.
This information is for general guidance and does not replace an individual clinical assessment. NHS Pharmacy First treatment for non-bullous impetigo is available to eligible patients aged 1 and over. Treatment depends on symptoms, medical history and NHS clinical criteria. Bullous impetigo, recurrent infections and certain medical circumstances are excluded. Seek urgent medical advice for rapidly spreading infection, severe symptoms or signs of a more serious illness.