Boil

When To Call

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 1/2 inch (12 mm) across
• Possible early boil or minor skin infection: tender red lump smaller than 1/2 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)

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.

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.

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.

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: this can force bacteria into the bloodstream or cause more boils.
• Squeezing a boil on the face can be very harmful.

Antibiotics By Mouth:

• Antibiotics may or may not be helpful. Your doctor will decide.
• If prescribed, take the antibiotic as directed.

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.

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.

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).

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.

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)

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.

Pain Medicine:

• If painful, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.

Caution - Do Not Squeeze:

• Do not squeeze skin lump. Reason: squeezing it can force bacteria into the skin.

Call Your Doctor If:

• Red lump becomes larger or bigger than 1/2 inch (12 mm)
• Not improved after using antibiotic ointment for 3 days
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Photos

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.

Source: Self Care Decisions LLC
From the Dr. William Weston Collection of Pediatric Dermatology. Used with permission.