Treat Impetigo With
Hydrogen Peroxide

Hydrogen peroxide 1% cream (branded as Crystacide) is a topical antiseptic used as a first-line treatment for localised, non-bullous impetigo. Unlike fusidic acid, hydrogen peroxide is not an antibiotic and does not contribute to antibiotic resistance, making it an increasingly preferred first-choice option per NICE guidance. It works by releasing oxygen radicals that kill bacteria on the skin surface. Through Pharmacy First, a pharmacist can supply hydrogen peroxide cream for impetigo without a GP appointment.

Apply hydrogen peroxide 1% cream to the affected area two to three times daily for 5–7 days. Gently clean the affected skin with soap and water and pat dry before application. Apply a thin layer to the impetigo lesions. Wash your hands before and after each application. The cream may cause mild tingling or effervescence on the skin — this is normal and indicates it is working.

NICE guidelines increasingly recommend hydrogen peroxide 1% cream as a first-line topical treatment for localised, non-bullous impetigo because it does not contribute to antibiotic resistance. Antibiotic resistance (particularly to fusidic acid) is a growing concern in the UK, and using non-antibiotic alternatives where effective helps preserve antibiotics for when they are most needed. Hydrogen peroxide cream has been shown to be as effective as topical fusidic acid for mild impetigo.

Yes, the NHS Pharmacy First service allows pharmacists to supply hydrogen peroxide 1% cream for impetigo. It is often the first-choice topical treatment offered due to its effectiveness without contributing to antibiotic resistance. This is a free NHS service.

Side effects are generally mild. Common effects include temporary stinging, tingling, or mild irritation at the application site. The cream may cause a temporary whitening or bleaching effect on treated skin. Allergic reactions are rare. Hydrogen peroxide may bleach hair and fabrics, so avoid contact with eyebrows, hairline, and clothing. If significant irritation occurs, reduce to twice daily application or consult your pharmacist.

Hydrogen peroxide cream is suitable for localised, mild impetigo. You may need oral antibiotics instead if the impetigo is widespread, bullous (fluid-filled blisters), not improving after 2–3 days of topical treatment, or if you are systemically unwell. Return to the pharmacy for review if the infection is not improving, as the pharmacist may then supply oral antibiotics such as flucloxacillin or clarithromycin.

NHS Pharmacy First is a free service that lets you get a remote video consultation and treatment for six common conditions without visiting your GP. It is available through NowPatient to NHS patients aged 18 and over in England.

The service covers six conditions: sinusitis, sore throats, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections (UTIs) in women. Each condition is subject to an eligibility screening before you can book a consultation.

Yes, the video consultation is completely free. If your clinician prescribes medication and you are not exempt from NHS prescription charges, you will pay a single NHS prescription charge. If you are exempt (for example, you are over 60 or on Income Support), there is no charge at all.

No. The service is commissioned by NHS England and is only available to patients registered with a GP in England. It is not available in Scotland, Wales, Northern Ireland, or outside the UK.

You are eligible if you are aged 18 or over and registered with the NHS in England. You must also pass a condition-specific eligibility screening, which is carried out by an assessment tool before you can book your consultation.

If you do not qualify for the service, NowPatient will signpost you to the right NHS care provider or service so you can still get the help you need. You can also download a referral note, explaining why you failed the assessment.

No. NHS Pharmacy First through NowPatient currently covers only the six listed conditions. For other conditions, please contact your GP or visit an NHS walk-in centre.

Log in to your NowPatient account and go to the NHS Pharmacy First Service Card in the NHS Hub. Select your condition, complete the eligibility screening, and if you qualify, follow the prompts to choose your preferred date, time, and clinician.

Yes. During booking, you can browse available clinicians and filter by gender and spoken languages. You can view each clinician’s name, licence number, and credentials before making your choice.

After booking, you will see a ‘Pre-consultation Requirements’ section with tips on how to prepare. You will also be asked to provide your consultation address and emergency contact details. You can opt in to receive an SMS reminder 30 minutes before your appointment.

The clinician will ask you questions to assess your condition and explore treatment options. If treatment is appropriate, you and the clinician will agree on the best option together. Medication is not guaranteed — it is provided only at the clinician’s discretion.

With your consent, the clinician may inform your GP of the treatment prescribed. We recommend agreeing to this, as your GP is responsible for your overall care and should have a record of the consultation.

Yes. You will receive an in-app and push notification summarising the consultation outcome, including any referrals to your GP and advice given by the clinician. You can view this in the ‘Notifications’ section of your homepage.

If your clinician prescribes medication, you will be directed to your Cart to complete the checkout process. This includes confirming your NHS exemption status, choosing a delivery address and method, and submitting payment.

If you are not exempt from NHS prescription charges, you will pay a single prescription charge per item. If you are exempt, you will not be charged. You will be asked to confirm your exemption status during checkout.

Yes. During the consultation, we will ask for your consent to provide the service. This allows us to communicate with your GP and share information with NHS England, NHS Improvement, and the NHS Business Services Authority (NHSBSA) when required.

Our clinicians are board-certified pharmacists registered with the General Pharmaceutical Council (GPhC). All clinicians undergo DBS background checks and a comprehensive licence verification process. The conditions and medications they can prescribe are strictly governed and reviewed in line with NHS guidelines.

Yes. The service is classified as a Class I medical device under UK MDR 2002 regulations. It complies with NHS standards DTAC, DCB 0160, and DCB 0129. Consultations are delivered via live video to ensure clinical safety and appropriate prescribing.

Yes. NowPatient operates from a HIPAA, DTAC, and Cyber Essentials Plus certified platform that ensures the highest levels of information security. Clinicians access systems on a zero-trust basis with single sign-on (SSO) technology.

Yes. As an NHS patient, our clinicians can access your GP record, including your medications, observations, and investigations. This helps them assess your condition safely and accurately.

We deliver to all postcodes in England. Some rural areas may experience slightly longer delivery times.

All orders are shipped in discreet, unmarked packaging. Temperature-sensitive medications are sent in cold chain-validated packaging to ensure product quality and safety.

We offer Royal Mail Standard Tracked & Signed (2–3 days) and Royal Mail Special Delivery (next working day, guaranteed before 1pm). Orders placed before 3pm Monday–Friday are dispatched the same day.

Your first order must be delivered to the address registered with NowPatient. After that, you can choose any delivery address, including your workplace.

Check the tracking details in the ‘Notification Feed’ section of your dashboard. If your delivery has not arrived within 10 days of the dispatch notification, contact us and we will work to resolve the issue.

NowPatient sends status updates by email and in-app notifications at every stage of your order, from placement through to delivery.

Yes. NowPatient’s pharmacists provide medication advice and counselling across all dispensing services. If you have questions about your prescribed medication, our pharmacy team is available to help.

You may receive a short survey about your experience. We encourage you to complete it, as your feedback helps us improve the service. It is especially helpful if you highlight areas for improvement.

You may be entitled to free NHS prescriptions from the NHS Pharmacy Service if you meet specific eligibility criteria. To claim exemption, the appropriate category must be selected on the prescription form and valid evidence may be required. The exemption categories are listed below:

Age-Related Exemptions

• A: Aged 60 or over, or under 16 (unless date of birth is printed on the form)

• B: Aged 16, 17, or 18 and in full-time education

Certificate-Based Exemptions

• D: Maternity exemption certificate

• E: Medical exemption certificate

• F: Prescription prepayment certificate

• W: HRT-only prescription prepayment certificate

• G: Ministry of Defence prescription exemption certificate

• L: HC2 (full help) certificate

Benefit-Related Exemptions

• H: Receiving Income-related Employment and Support Allowance (ESA)

• S: Receiving Pension Credit Guarantee Credit (including partners)

• U: Receiving Universal Credit and meeting eligibility criteria (Earnings ≤ £435, or ≤ £935 [if UC includes child element or limited capability for work)], in most recent assessment period)

Important

You must only claim an exemption if they are entitled to it. Incorrect claims can result in penalty charges. Proof of eligibility should be provided if requested when collecting medication.

Prescription Item Level Exemptions

You may be entitled to certain medication items for free as listed below. Make sure you declare this when you checkout your prescription order.

• For Contraceptive Use

• For STI (Sexually Transmitted Infection) Treatment

• For latent or active Tuberculosis (TB) or to treat adverse effects of TB treatment

Check if you have an exemption from paying NHS costs

You can check your exemption status by clicking below