NHS treatment for impetigo
Impetigo is a contagious skin infection that mostly affects children. Our pharmacist can assess you or your child and supply the right treatment free under NHS Pharmacy First.
What is impetigo?
Impetigo is a common bacterial skin infection. The most familiar form — "non-bullous" impetigo — causes red sores that ooze, burst, and dry into yellow-brown crusts. It's most common in children but adults can get it too. It usually clears with treatment in 7-10 days.
Typical features:
- Sores or blisters that quickly burst
- Yellow-brown ("golden") crusts forming over the broken skin
- Usually appears on the face — around the mouth and nose — but can be anywhere
- Sometimes itchy or mildly sore but rarely painful
- Spreads easily through scratching, towels, bedding
The two types
- Non-bullous impetigo (most common) — small sores that crust over. This is what the Pharmacy First pathway treats.
- Bullous impetigo (less common) — larger fluid-filled blisters, often on the trunk. This type is not covered by Pharmacy First — the pharmacist will refer you to your GP or, if you are unwell, to urgent care.
Who can use this service?
- Adults and children aged 1 and over
- Clinical features consistent with non-bullous impetigo
- If you are pregnant or breastfeeding, let the pharmacist know — topical hydrogen peroxide and topical fusidic acid are suitable, and we have antibiotic options safe in pregnancy if needed (erythromycin is used for penicillin-allergic pregnant patients aged 16+). Pregnant patients under 16 are referred to a GP.
- No widespread or systemic infection
If the rash is very widespread, you have signs of being unwell systemically (fever, lethargy), or there's any uncertainty about the diagnosis, the pharmacist will refer you to your GP.
What treatment can be supplied?
The NHS Pharmacy First impetigo pathway follows current NICE guidance. The recommendations shifted in recent updates to reduce antibiotic use for localised cases.
- Hydrogen peroxide 1% cream (first-line for localised non-bullous impetigo in patients who are not systemically unwell) — applied 2-3 times a day for 5 days
- Topical fusidic acid (second-line, if hydrogen peroxide isn't suitable or hasn't worked) — applied 3 times a day for 5 days
- Oral flucloxacillin — for more widespread non-bullous impetigo or if topical treatment isn't appropriate
- Oral clarithromycin or erythromycin — alternatives for penicillin-allergic patients
The pharmacist also gives infection-control advice — handwashing, separate towels, keeping the affected area clean and dry, staying off school or nursery until the sores have crusted over and healed, or 48 hours after starting treatment (hydrogen peroxide cream or antibiotics).
How it works — fully online from your phone
- Start the online assessment via the Digital Gateway link above — eligibility, location and spread of the rash, history, allergies, current medicines. You'll upload a photo of the affected area so the pharmacist can confirm the diagnosis.
- Pharmacist reviews your record in our PharmOutcomes system — usually within 1-2 hours during opening hours.
- Pharmacist phones or video-calls you to confirm the plan and answer questions. If the photo needs follow-up, we may send a secure accuRx video link.
- Clinical decision — hydrogen peroxide cream (first-line for localised non-bullous impetigo), topical fusidic acid, or oral antibiotic for more widespread cases.
- Medicine delivered or collected — free delivery via Royal Mail Tracked anywhere in England, same-day in Leeds LS postcodes. Or collect from us if you're nearby.
- Infection-control advice sent to you in writing — handwashing, separate towels, when children can return to school/nursery.
- GP notified automatically via NHS GP Connect.
Start your impetigo assessment online
Open our NHS-assured Digital Gateway on your phone, upload a photo of the affected area, and the pharmacist will review and decide on treatment. Free for adults and children aged 1+.
Start online assessment → Or call 0113 244 1551Frequently asked questions
- How long is impetigo contagious?
- Until the sores have crusted over and healed, or for 48 hours after starting treatment (hydrogen peroxide cream or antibiotics). Children should stay off school/nursery during this time.
- Will my child definitely get antibiotics?
- Not necessarily. For localised non-bullous impetigo, NICE now recommends hydrogen peroxide cream first — this works for most cases and reduces antibiotic resistance pressure. Antibiotics are used for more widespread cases or when first-line fails. Trials show hydrogen peroxide 1% cream is as effective as a topical antibiotic for localised cases — it is a real treatment, not a placebo or compromise.
- Can adults get impetigo too?
- Yes — though it's most common in children. The pathway covers everyone aged 1+.
- Can I just buy fucidin cream over the counter?
- Topical fusidic acid is prescription-only. Through Pharmacy First we can supply it free if it's clinically appropriate — no need to go to a GP.
- Is it really free?
- Yes — consultation and any medicine supplied through Pharmacy First are free, even for items you'd normally pay an NHS prescription charge for.
- Should I cover the sores?
- Loose covering reduces spread to other parts of the body and to other people. Avoid sharing towels, flannels, or bedding. Wash hands often.
About this service at Hyde Park Pharmacy
Hyde Park Pharmacy is a community pharmacy in central Leeds (premises 9011727, regulated by the General Pharmaceutical Council). Our superintendent pharmacist is Shoyab Umarji (GPhC #2065619, Independent Prescriber). The impetigo pathway follows v1.1 NHS England Pharmacy First service spec (October 2025).
For the full list of Pharmacy First conditions, see our main Pharmacy First page. For a step-by-step explanation of the post-submission flow, see what happens next.