781.344.3791
fax: 781.341.3614
907 Sumner St., Suite M-102, Stoughton, MA 02072

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.

What's New?
On July 1, 2019, Dr. Philip Hourigan will retire from the practice of pediatric primary care.  Dr. Hourigan has been caring for infants and children for over 35 years.  His practice consists of three generations of families.  He will be greatly missed by his patients and colleagues.  We all join in wishing him a happy and healthy retirement.
See More >
Is Your Child Sick?
What's Going Around?