Staphylococcal Scalded Skin Syndrome (SSSS)

Important information about staphylococcal scalded skin syndrome:

Staphylococcal scalded skin syndrome is a skin condition that can happen after a bacterial infection. The bacteria make a harmful substance called a toxin that gets into the blood. This toxin can make the skin turn red, form blisters, and peel. The skin may look like it has been burned or “scalded”. This condition most commonly happens in children 5 years old and younger. Rarely, it can affect older children and adults, especially if they have kidney disease or a weak immune system.

 

Symptoms include:

  • Fever or chills

  • Fussiness or irritability

  • A painful red rash that often starts in skin folds (neck, armpit, and/or buttock)

  • Fluid-filled blisters that may break open

  • Peeling of the skin, especially when rubbed

  • Crusting skin, often around nose and mouth

  • Dry or scaly skin

Staphylococcal scalded skin syndrome diagnosed is typically diagnosed by reviewing symptoms, health history, and performing a physical exam.

 

Treatment

Treatment includes antibiotics to treat the infection, medicine to control pain, IV fluids to keep your child hydrated, and gentle skin care to help the skin heal.

Fever, fussiness, pain and redness of the skin improves after starting antibiotics. It is normal for skin to continue to peel even after starting antibiotics. Patients generally recover within about 2 weeks.

Patient instructions: Home care 

  • Make sure to give the full course of antibiotics, even if your child looks or feels much better.

  • Give oral acetaminophen or ibuprofen for pain control, if needed.

  • Encourage your child to drink fluids.

  • Be gentle with your child’s skin.

  • Skin care tips:

    • Keep baths short (less than 10 minutes) with lukewarm water.

    • Use gentle, unscented soaps.

    • Do not scrub the skin or use a washcloth, sponges, loofahs, or baby wipes.

    • Moisturize with a bland cream or ointment after baths and at least twice a day.

    • Avoid scented soaps, moisturizers, fragrances/perfumes and scented laundry detergents.

    • Dress your child in loose, soft clothing with minimal elastics. Avoid rough fabrics like wool or nylon.

 Contact your CHOP healthcare team with questions, concerns or if:

  • Your child’s fever (101° F/38.3° C) comes back after starting antibiotics.

  • Your child cannot take the antibiotics or is vomiting preventing them from keeping antibiotics down.

  • The skin has yellow or green discharge.

  • Your child is not drinking enough fluids or urinating much less than usual.

 

Reviewed March 2026 by Amanda Johnson, MD; Mary Larijani, MD