Boils

Also known as furuncles, boils are bacterial skin infections that arise when a sebaceous (oil) gland is blocked or a hair becomes ingrown in its follicle—the channel along which it grows from its root to the surface of the skin. The boil may feel itchy or painful, and the child may be tired and feverish.

Boils begin as hard, painful red lumps; they grow bigger and more painful as white blood cells are drawn to the site to fight the infection. The white blood cells form a capsule or "head" around the infection, resulting in an abscess. This pus-filled head usually takes two to three days to burst or drain. By that time, the pain should be alleviated, and the boil should completely heal within another week.

Because infections spread easily from one hair follicle to another, boils sometimes appear in clusters called carbuncles. These clusters are more painful than single boils, and they tend to heal more slowly. If a child has been ill or has lowered resistance to infection for some other reason, boils are more likely to develop into carbuncles.

WHAT CAUSES BOILS?
Boils and carbuncles are caused by bacteria, many of which normally colonize on the surface of the skin. The strain of bacteria most commonly responsible is Staphylococcus. Because bacteria are everywhere in the environment, almost everyone may develop a boil at some point. However, boils and carbuncles are more likely to occur in conditions of poor hygiene or when illness lowers resistance to infection.

The bacteria in boils can sometimes spread from one child to another through ordinary rough-and-tumble play.

COPING WITH BOILS
Clean the skin around a boil with alcohol to help prevent the infection from spreading. To reduce the chance of irritating a boil, cover it with an adhesive dressing made of clean, dry gauze.

Never squeeze a boil; you may spread the infection by pushing the pus downward. Apply warm, moist compresses to the boil to encourage early draining. Antiseptics and ointments are of little value. Follow the pediatrician's directions for home care.

IS MEDICAL ATTENTION NECESSARY?
Yes, usually. Since boils will make children very uncomfortable, and since effective therapy is available, a doctor should be consulted.

WHAT TREATMENTS ARE AVAILABLE?
The pediatrician may prescribe a course of antibiotics to eliminate the boil or carbuncle. Follow her orders about the timing and size of antibiotic doses, and continue the medication for as many days as the doctor has prescribed, even if the symptoms have disappeared.

A pediatrician may also lance a boil (cut it open to drain the pus). Incision and drainage usually bring complete healing. If a child suffers from recurrent boils, a sample of the pus may be taken to determine the underlying cause of the infection. It may also be appropriate to do tests for some underlying cause, such as diabetes or an immune deficiency.

PREVENTING BOILS
The bacteria that cause boils are present throughout the environment, so prevention is often difficult. Helpful measures include:

• Encouraging frequent hand washing

• Making sure a child bathes regularly

• Cautioning a child not to touch another child's boil

• Covering a boil with an adhesive dressing to prevent spreading the causative bacteria

GETTING HELP
Call your doctor if your child:

• Has swollen and tender glands in the same area as the boil

• Has red streaks under the skin radiating out from the boil

• Has a boil in an awkward place—near the eyes, mouth, ear, under the armpit or in the diaper area of a baby

• Has a boil that has not come to a head in five days

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.