When it happens · 3 min read
Honey-colored crusts
It started as a small sore near their nose and now there are several, weeping and drying into crusts the color of honey. It looks neglected, which is the part parents find hardest, and it is not.
This one is bacterial, it is genuinely contagious, and it needs a prescription rather than patience.
Last updated August 19, 2026
The crust is the clue
The most common cause is a staph bacterium, Staphylococcus aureus, getting into skin — often through a small break that nobody noticed: a scratch, a cold sore, an eczema patch, a bitten lip.
Sores weep and then dry into yellow or honey-colored crusts and scabs. That color is the identifying feature and the reason it is worth naming — it is unlike almost anything else on a child's face.
It is especially common on the face, around the nose, mouth and ears, and frequently on the arms and legs.
Because it often starts where skin is already broken, children with eczema get it more, and it can be mistaken for the eczema simply getting worse.
It needs antibiotics
Topical antibiotics for less severe cases or a small area of skin; oral antibiotics when a large area is affected. That is a decision for a doctor rather than a judgement to make at home.
Once an antibiotic is started, healing should begin within a few days. If it is not improving in that window, go back rather than waiting it out.
There is no useful home remedy here. Keeping it clean is sensible and is not treatment — the infection is bacterial and needs an antibiotic to clear.
The contagion rule, precisely
Impetigo is highly contagious — particularly good at spreading from person to person.
The return rule: avoid close contact with other children until the rash is clear OR improving after two days of antibiotics. Read that carefully, because it is neither 'two days' on its own nor 'wait until the skin is perfect'. Two days of treatment AND visible improvement.
At home, it spreads by contact with anything that touched it. Separate towels, flannels and bedding, wash them hot, and keep nails short — scratching moves it around the child's own body as efficiently as it moves it to a sibling.
This is also why it runs through nurseries and families: it is on hands and fabric, not in the air.
Common questions
- When can they go back to nursery?
- When the rash is clear, or improving after two days of antibiotics. Both parts matter — two days of treatment with visible improvement, rather than either alone.
- Can I treat it without seeing a doctor?
- No. It is a bacterial infection and needs antibiotics — topical for a small area, oral for a large one. Cleaning it is sensible but is not treatment.
- How did they get it?
- Usually bacteria entering through a small break in the skin — a scratch, a bitten lip, a cold sore, an eczema patch. Children with eczema get it more often, and it can look at first like the eczema simply worsening.
- It isn't getting better after a few days. What now?
- Go back to the doctor. Healing should begin within a few days of starting an antibiotic, so no improvement in that window is a reason to be reassessed rather than to keep waiting.
If it's this, not that
Still not sure
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Where this comes from
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Written from the sources named above, and it is not a substitute for your own doctor. If something feels wrong to you, that instinct is a good enough reason to call — you know yourself and this family better than any page does.