Is Your Child Sick? TM


Boil

Is this your child's symptom?

  • Painful red lump in the skin
  • Hair follicle infection caused by the Staph bacteria
  • Most boils need to be seen by a doctor

Symptoms of a Boil

  • Bright red lump (swelling) in the skin.
  • Painful, even when not being touched.
  • Most often ½ 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."

Causes of Boils

  • 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. Common sites are the groin, armpit, buttock, thigh or waist.
  • Shaving is also a risk factor. Common sites are the face, legs, armpits or pubic area.

Prevention of Boils

  • Washing hands is key to preventing Staph skin infections. Have everyone in the home wash their hands often. Use a liquid antibacterial soap or alcohol hand sanitizer. Have everyone shower daily. Showers are best, because baths still leave many Staph bacteria on the skin.
  • Avoid nose picking. 30% of people have Staph bacteria 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 Boils that Come Back.

  • Some doctors suggest bleach baths to prevent boils from coming back. Talk with your doctor about this treatment.
  • Use ½ cup (120 mL) of regular bleach per 1 full bathtub of water.
  • Soak for 10 minutes twice weekly.
  • This mix of bleach and water is like a swimming pool.

When to Call for Boil

When to Call for Boil

Call Doctor or Seek Care Now

  • Widespread red rash
  • Fever
  • Boil on the face
  • Age less than 1 month old (newborn) with a boil
  • Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Age less than 1 year old with a boil
  • Spreading redness around the boil
  • There are 2 or more boils
  • Size is larger than 2 inches (5 cm) across
  • Center of the boil is soft or pus-colored. Exception: a common pimple.
  • Boil is draining pus
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Boil suspected (red lump larger than ½ inch or 12 mm across). Reason: confirm your child does have a boil. Note: see home care advice for boil treatment.
  • Using antibiotic ointment more than 3 days for small red lump, but not improved
  • Boils keep coming back in your family
  • You have other questions or concerns

Self Care at Home

  • Boil diagnosed by a doctor
  • Possible boil not yet seen by a doctor: painful red lump larger than ½ inch (12 mm) across
  • Possible early boil or minor skin infection: tender red lump smaller than ½ inch (12 mm) across. Note: see home care advice for small red lump.

Call Doctor or Seek Care Now

  • Widespread red rash
  • Fever
  • Boil on the face
  • Age less than 1 month old (newborn) with a boil
  • Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Age less than 1 year old with a boil
  • Spreading redness around the boil
  • There are 2 or more boils
  • Size is larger than 2 inches (5 cm) across
  • Center of the boil is soft or pus-colored. Exception: a common pimple.
  • Boil is draining pus
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Boil suspected (red lump larger than ½ inch or 12 mm across). Reason: confirm your child does have a boil. Note: see home care advice for boil treatment.
  • Using antibiotic ointment more than 3 days for small red lump, but not improved
  • Boils keep coming back in your family
  • You have other questions or concerns

Self Care at Home

  • Boil diagnosed by a doctor
  • Possible boil not yet seen by a doctor: painful red lump larger than ½ inch (12 mm) across
  • Possible early boil or minor skin infection: tender red lump smaller than ½ inch (12 mm) across. Note: see home care advice for small red lump.

Care Advice

Treatment for a Boil (painful red lump larger than ½ inch or 12 mm across)

  1. What You Should Know About Boils:
    • A boil is a Staph infection of a hair follicle.
    • It is not a serious infection.
    • Boils should be seen by a doctor for treatment.
    • The doctor can tell if it needs to be drained and when to do it.
    • Here is some care advice that should help.
  2. Moist Heat:
    • Heat can help bring the boil "to a head," so it can be drained.
    • Apply a warm, wet washcloth to the boil. Do this for 15 minutes 3 times a day.
  3. Pain Medicine:
    • Until it drains, all boils are painful.
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  4. 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.
  5. Caution - Do Not Squeeze:
    • Do not squeeze a boil or try to open a boil yourself.
    • Reason: this can force bacteria into the bloodstream or cause more boils.
    • Squeezing a boil on the face can be very harmful.
  6. Antibiotics By Mouth:
    • Antibiotics may or may not be helpful. Your doctor will decide.
    • If prescribed, take the antibiotic as directed.
  7. 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. A gauze pad and tape work well.
    • Change the bandage twice daily.
    • Clean the skin around the boil with an antibacterial soap each time.
    • Carefully throw the bandage away in the regular trash.
    • Wash your hands well after any contact with the boil, drainage or the bandage.
  8. What to Expect:
    • Without treatment, the body will slowly 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.
  9. Return to School or Child Care:
    • Closed boils cannot spread to others.
    • Children with a closed boil can go to school or child care.
    • The pus or drainage in open boils can spread infection to others.
    • For open boils, the drainage needs to be fully covered with a dry bandage. If not, stay home until it heals up (most often 1 week).
  10. 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.
  11. Call Your Doctor If:
    • Fever occurs
    • Redness spreads beyond the boil
    • Boil becomes larger than 2 inches (5 ml) across
    • Boil comes to a head (soft pus-colored center)
    • You think your child needs to be seen
    • Your child becomes worse

Treatment for a Small Tender Red Lump (less than ½ inch or 12 mm across)

  1. What You Should Know About a Small Tender Red Lump:
    • A small red lump most often is a minor infection of a hair follicle.
    • It may or may not become a boil.
    • Use an antibiotic ointment to keep it from getting worse. No prescription is needed.
    • Apply it to the red lump 3 times per day.
  2. Pain Medicine:
    • If painful, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  3. Caution - Do Not Squeeze:
    • Do not squeeze skin lump. Reason: squeezing it can force bacteria into the skin.
  4. Call Your Doctor If:
    • Red lump becomes larger or bigger than ½ inch (12 mm)
    • Not improved after using antibiotic ointment for 3 days
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

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

Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

Boil

Boil. A boil is an infection of a hair follicle. It starts as a red lump and quickly fills with pus. As it grows, it becomes more painful. This photo shows the pus-filled center of the boil. A doctor can tell if it needs to be drained and when to do so.

Is Your Child Sick?TM

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