Definition

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

Health Information

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.

Care Advice

1. 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.
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 for 15 minutes 3 times a day.
3. Pain Medicine:
   • Until it drains, all boils are painful.
   • To help with the pain, give acetaminophen (such as Tylenol) OR ibuprofen. 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: These can force bacteria into the bloodstream or cause more boils.
   • Squeezing a boil on the face can be very dangerous.
6. Antibiotics By Mouth:
   • Antibiotics may or may not be helpful. Your doctor will decide.
   • If prescribed, take the antibiotic as directed.
7. 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.
8. 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.
9. 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.
10. 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).
11. 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 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

Author: Barton Schmitt MD, FAAP

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