Is Impetigo Usually Painful?
No, impetigo is typically not painful—it is usually asymptomatic or may present with mild itching, but pain is not a characteristic feature of this superficial bacterial skin infection. 1
Clinical Presentation
Nonbullous impetigo (70% of cases) presents as erythematous papules that evolve into vesicles and pustules, eventually forming the characteristic honey-colored crusts, but these lesions are generally not painful 1, 2
Bullous impetigo (30% of cases) manifests as fragile, thin-roofed vesicopustules and flaccid bullae that rupture, leaving thin brown crusts—again, without significant pain 1, 3
Regional lymphadenitis may occur, but systemic symptoms including pain are usually absent 1
When Pain Suggests Alternative Diagnosis
- If pain is present, consider deeper infections such as:
- Ecthyma, which represents a deeper variant of impetigo with circular erythematous ulcers extending into the dermis—this can be painful 1
- Furuncles (boils), which are deeper infections of hair follicles with suppuration extending into subcutaneous tissue, presenting as painful inflammatory nodules 1
- Cellulitis, which involves acute inflammation of skin and subcutaneous tissue and is typically painful 4
Symptom Management
Acetaminophen or ibuprofen may be used for discomfort, although impetigo is usually not painful 5
The primary symptom requiring management is itching rather than pain—maintaining a cool environment can help minimize itching 5
Warm, soapy water soaks can soften crusts before applying medication, which enhances antibiotic penetration and provides comfort 5