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

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

Contact 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

Contact 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 cm) 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.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.