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Panorama Pediatrics

Boil

Definition

  • Staph skin infection causing a painful red lump in the skin

Call or Return If

  • Fever occurs
  • Redness spreads beyond the boil
  • Boil becomes over 2 inches (5 cm) across
  • Boil comes to a head (soft pus-colored center)
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Bright red lump (swelling) in the skin.
  • Painful, even when not being touched.
  • Usually 1/2 to 1 inch across (1 to 2 cm).
  • After about a week, the center of the boil becomes filled with pus. The center becomes soft and mushy.
  • The skin over the boil then develops a large pimple. This is known as "coming to a head".

Cause

  • A boil is an infection of a hair follicle (skin pore).
  • Boils are caused by the Staph bacteria.
  • Friction from tight clothing is a risk factor. Examples are the groin, armpit, buttock, thigh or waist.
  • Shaving is another risk factor. Examples are shaving the face, legs, armpits or pubic hair.

Prevention of Boils

  • Handwashing is the key to prevention of Staph infections. Have everyone in the home wash their hands often with an antibacterial soap or alcohol-based hand sanitizer.
  • Have everyone shower daily with an antibacterial soap. Showers are best because baths still leave many Staph bacteria on the skin.
  • Discourage nose picking. 30% of people have Staph bacteria present in their nose.
  • When shaving anywhere on the body, never try to shave too close. Reason: It causes small cuts that allow Staph bacteria to enter the skin.

Prevention- Bleach Baths for Recurrent Boils

  • Some doctors recommend bleach baths to prevent boils from coming back.
  • Use 1/2 cup (120 ml) of regular bleach per 1 full bathtub of water.
  • Soak for 10 minutes twice weekly.
  • This concentration of bleach is similar to a swimming pool.

After Care Advice

Overview:
  • A boil is a Staph infection of a hair follicle.
  • It can become a recurrent problem.
  • It is not a serious infection, but it needs a doctor for treatment.
  • Here is some care advice that should help.
Moist Heat:
  • Heat can help bring the boil "to a head" so it can be drained.
  • Apply a warm, wet washcloth to the boil for 15 minutes 3 times a day.
Pain Medicine:
  • Until it drains, all boils are painful.
  • To help with the pain, give acetaminophen (such as Tylenol) OR ibuprofen. Use as needed.
Opening the Boil - Done Only By A Doctor:
  • The main treatment of boils is to open them and drain the pus.
  • Then, boils will usually heal on their own.
  • Draining the boil must always be done in a medical setting.
Caution - Do Not Squeeze:
  • Do not squeeze a boil or try to open a boil yourself.
  • Reason: These can force bacteria into the bloodstream or cause more boils.
  • Squeezing a boil on the face can be very dangerous.
Antibiotics By Mouth:
  • Antibiotics may or may not be helpful. Your doctor will decide.
  • If prescribed, take the antibiotic as directed.
Small Red Lump:
  • A small red lump is most often a minor infection of a hair follicle.
  • It may or may not become a boil.
  • Use an antibiotic ointment to keep it from becoming larger. No prescription is needed.
  • Apply it to the red lump 3 times per day.
  • Call Back If: The small red lump becomes larger.
Pus Precautions:
  • Pus or other drainage from an open boil contains lots of Staph bacteria.
  • Once a boil is opened it will drain pus for 3 to 4 days. Then it will slowly heal up.
  • Cover all draining boils with a clean, dry bandage. Usually, a 4 by 4 inch gauze pad and tape is used.
  • Change the bandage twice daily.
  • Clean the skin around the boil with an antibacterial soap each time.
  • Carefully dispose of the bandage into the regular trash.
What to Expect:
  • Without treatment, the body will gradually wall off the Staph infection.
  • After about a week, the center of the boil will fill with pus. It will become soft.
  • The skin over the boil then develops a large pimple. This is known as "coming to a head".
  • The boil is now ready for draining by your doctor.
  • Without draining, it will open and drain by itself in 3 or 4 days.
Return to School or Child Care:
  • Closed boils cannot spread to others.
  • Children with a closed boil can attend school or child care.
  • The pus or drainage in open boils can spread infection to others.
  • For open boils, the drainage needs to be covered completely with a dry bandage. If not, stay home until it heals up (usually 1 week).
Return to Sports:
  • Children with a closed boil may be able to play sports.
  • Children with an open boil cannot return to contact sports until drainage has stopped.
  • Check with the team's trainer if there is one.

Author: Barton Schmitt MD, FAAP Copyright

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.

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