What are the recommended first-line topical treatments for a child diagnosed with impetigo?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended first-line topical treatments for a child diagnosed with impetigo:

  • For localized non-bullous impetigo in children who are not systemically unwell or at high risk of complications, hydrogen peroxide 1% cream applied two to three times daily for 5 days is recommended as the first-line treatment.
  • If hydrogen peroxide 1% cream is unsuitable (for example, if the impetigo is around the eyes), topical fusidic acid 2% cream applied three times daily for 5 days should be offered.
  • If fusidic acid resistance is suspected or confirmed, topical mupirocin 2% cream applied three times daily for 5 days is recommended as an alternative.

Reassessment is advised if symptoms worsen rapidly or do not improve after completing the treatment course.

Educational content only. Always verify information and use clinical judgement.