Ayomide's teacher spotted the golden-crusted sores at school and sent him home. His mother brought him to Mascot Healthcare the same afternoon. The diagnosis was made on sight and he was back at school — no longer contagious — within 48 hours.
Ayomide is a 6-year-old primary school pupil, Gbagada. Presented by his mother with 4-day history of honey-coloured crusted sores on the nose, upper lip, and chin — spreading to the cheek. His school had called his mother on day 3 to collect him.
Impetigo Contagiosa (Bullous)Mama Ayo had noticed the first small sore on Ayomide's nose on a Monday and assumed it was a mosquito bite he had scratched. By Wednesday there were four — and they had a distinctive golden-yellow crust she had not seen before. On Thursday morning, Ayomide's class teacher called: "Please come and collect Ayomide. He has sores on his face and we cannot have him in the classroom."
She brought him to Mascot Healthcare that afternoon. The doctor looked at Ayomide's face for ten seconds. "This is impetigo," she said. "Very common, very contagious, very treatable. He'll be back at school in 48 hours."
The relief on Mama Ayo's face was visible.
Impetigo is a highly contagious superficial bacterial skin infection. The golden-honey crust is its most recognisable feature. In children, it spreads rapidly by touch and through shared items.
Classic golden-brown crusts on the nose, upper lip, and chin — the hallmark of non-bullous impetigo.
New lesions appeared on the cheek by day 3 — autoinoculation through touching and scratching.
Moderate itch — Ayomide was scratching, spreading the bacteria to new sites.
A single fragile clear/cloudy blister on the chin — suggesting a bullous component.
Ayomide was otherwise well — eating, playing, and afebrile.
Dettol antiseptic applied to the sores — appropriate hygienic measure; insufficient to clear bacterial infection.
Mosquito bite cream — applied on day 1; no antibacterial effect.
Told to leave the sores alone — appropriate if crusts are left to dry naturally; touching and scratching caused spread.
The doctor prescribed a medicated cream — applied to each sore after gently soaking off the crusts with warm saline. Ayomide was instructed not to scratch; fingernails were trimmed. He was also given oral medication given the blistering and extent of the spread.
Key hygiene instructions: Ayomide's face towel washed daily in hot water; no sharing towels or face cloths; hands washed after any contact with the sores; school notified he could return after 48 hours of antibiotic treatment.
Mama Ayo was also told to watch for any signs of periorbital cellulitis (redness spreading toward the eye) — which would require urgent reassessment.
Impetigo Contagiosa (non-bullous dominant, bullous component) — Staphylococcus aureus (clinical diagnosis)
Medicated cream to the sores; a course of oral medication; soaking crusts with warm saline; hygiene precautions; school return after 48 hours
At 48 hours: dramatic improvement in all lesions; crust separating; no new lesions. Returned to school day 3.
All lesions healed within 7 days of starting treatment. Ayomide returned to school on day 3 with no further spread. No sibling developed the infection.
Impetigo is extremely common in Nigerian school-age children and is easily recognised by the honey-coloured crust. Antibiotic treatment produces rapid improvement — most children can return to school within 48 hours of starting treatment.
The key is prompt treatment and strict hygiene during the infectious period — particularly no sharing of towels and daily washing of the child's bedding.
Golden-crusted facial sores in a child are impetigo — 48 hours of antibiotic treatment and they're back at school.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.