A spot of bother

Published in Medicinewise Living

Date published: About this date

Wondering what that spot, rash, lump or bump is on your child? Well, they may have just picked up a catchy skin condition from their school mates.

Learn how to recognise and treat impetigo, head lice, ringworm and warts and what can be done to prevent these contagious conditions spreading to others.


Learn how to recognise, treat and prevent the spread of contagious skin conditions. (GekaSkr / Shutterstock.com)

Impetigo, also known as school sores, is a skin infection caused by bacteria from the nose or surface of the skin. It usually occurs when bacteria spread from your hands or fingers into cuts, grazes, insect bites, or other skin injuries.

Impetigo can look nasty and feel painful or itchy, but it's rarely serious and usually heals well. Blisters appear, which burst and weep fluid to form wet-looking golden or brown crusts. These are often found on the skin around the nose or mouth, but they can also arise elsewhere like on the limbs or armpits.

A doctor will prescribe treatment with an antibiotic cream, or an oral antibiotic if impetigo is severe or widespread on the body. It's important to take the antibiotic exactly as prescribed. If an infection is not completely treated, it may become more serious. Bacteria may also build up a resistance to the antibiotic if not taken as directed, meaning it's more likely to spread to others, or become untreatable in future.

Children with impetigo should not return to school or day care, or come into contact with newborns, until they get the right treatment.

Head lice

Lice are harmless insects that can spread to anyone, no matter how clean or short you keep your hair. They can't fly so they spread by crawling from head to head when people are in close contact. You might also catch head lice through contact with objects, like when sharing helmets.

You need to find live lice to know there's an infestation — itching and nits (eggs) attached to hair can be noticed even after lice are dead. Look for live lice by 'wet combing' which involves spreading a generous amount of hair conditioner through wet hair, then combing sections of hair from root to tip using a fine-toothed comb. Lice and nits can be detected by wiping conditioner from the comb onto a paper towel or tissue. Work through the whole head of hair and repeat at least twice to ensure any live lice are found.

If you find live lice, a medicated shampoo, lotion or spray containing an insecticide can help cure an infestation. Get advice when choosing a product: some can smell or irritate the skin, may be easier to apply than others, or may be unsuitable for some people — including children under 2 years of age, people with asthma or skin conditions, and women who are pregnant or breastfeeding.

Alternatively, you can try daily wet combing for 10–14 days: this can treat an infestation by removing lice and eggs, but it does not kill them. An electronic comb is another non-medicine alternative.

Whatever you choose, remember that no single treatment kills all eggs or is assured to work. You must repeat treatment with an insecticide product 7–10 days after the first application — otherwise you won't get rid of head lice effectively.

Also be mindful that lice are becoming more resistant to insecticides like maldison (the active ingredient in brands like HL 7) and permethrin (e.g. Quellada). If the treatment you choose doesn’t work, see a pharmacist as you may need to try a different product or method. Find out more about head lice.

Ringworm (tinea)

Ringworm is a fungal skin infection children generally pick up from pets such as dogs, cats, mice or guinea pigs. But it can be spread by people and objects, such as towels.

A rash usually appears on the scalp, face or body in the shape of a ring, and can be itchy, scaly or cause hair loss. It can look like many non-fungal skin rashes, such as dermatitis and psoriasis, so get your doctor or pharmacist to check it.

The treatment needed depends on where and how severe the infection is. Mild ringworm on the face or body can be treated with an antifungal cream such as Canesten (containing the active ingredient clotrimazole) or Daktarin (containing miconazole). You need to continue most antifungal creams until 2 weeks after symptoms disappear, otherwise the infection may come back.

If an antifungal cream doesn't work, or the ringworm is on the scalp or widespread on the body, your doctor may need to prescribe a different antifungal treatment. Shampoos containing an antifungal, like the brand Selsun, may also be advised for scalp ringworm to help reduce the spread of infection.


Warts are a viral skin infection caused by the human papillomavirus. There are many different types including common warts and plantar warts (also known as verrucas). Warts can all look different — from thin threads to hard lumps — and may affect all parts of the body, but mostly the hands and feet.

Warts spread very easily through direct contact, so you can catch them in communal showers, changing rooms and public swimming pools from other people, or from contaminated objects like towels and floors.

Most warts go away by themselves but treatment may hasten this, and severe or persistent warts are likely to need treatment. There are a range of treatment options, including creams, resins, injections, freezing (e.g. with liquid nitrogen), duct tape occlusion and surgery. No single treatment is assured to work, and each has its risks and benefits. Speak with your doctor or pharmacist to discuss which option is best for your child. You may need to use more than one treatment.

And remember to cover warts to help prevent them spreading to other parts of the body or to other people. For example, use a waterproof bandaid or wear thongs at swimming pools.

For more information about medicines for skin conditions or how to be medicinewise, visit our website or call Medicines Line on 1300 MEDICINE (1300 633 424) Monday to Friday, 9am to 5pm AEST.

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