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Health Issues

Boils, Abscess & Cellulitis

​Boils, abscess, and cellulitis are bacterial infections of the skin that usually begin from a scratch or bug bite and progress to a red nodule that fills with pus.
  • Boils are superficial infections with a thin layer of skin over fluid.
  • Abscesses are generally larger and deeper than boils with redness and painful swelling over an area filled with pus.
  • Cellulitis is an infection within the skin and the area just beneath it; the skin is red and tender. The area of cellulitis can spread quickly.

What are the signs or symptoms?

Boils are usually small areas (penny or nickel size) with a thin covering of skin, while abscesses are larger raised areas on the skin that are tender to touch and filled with pus in the deeper tissue. Abscesses and boils may drain when the skin over the infected area opens and lets the fluid or pus out. Signs of cellulitis include areas of redness, skin tenderness, and fever. All of these skin infections are usually warmer than the surrounding normal areas of skin because of the body’s reaction to the infection.

What are the incubation and contagious periods?

The incubation period (the time between being exposed to the disease and when the symptoms start) is unknown. Common skin bacteria (staph and strep) are the cause of boils, abscesses, and cellulitis. These bacteria are present on the skin of most children and usually do not cause a problem. However, staph and strep may cause infection when there is a break in the skin or when the bacterial infection becomes more aggressive and overpowers normal defenses against infection.

In recent years, a certain type of staph called methicillin-resistant Staphylococcus aureus, or MRSA has become a more likely cause of more serious infections. These skin infections are contagious when the infected area is open and drainage is present. People who carry the bacteria in their noses and throats and on their skin may pass the bacteria on to others. However, for an infection to occur, the bacteria must get through a break in the skin.

How is it spread?

Person-to-person contact with pus and skin bacteria and to a lesser extent, contaminated environmental surfaces and objects.

How do you control it?

  • Use good hand-hygiene.
  • Eczema is a risk factor for MRSA. Those with eczema on their hands should practice good eczema control.
  • Cover lesions if they are draining.
  • Infected children may need antibiotic treatment for tissue infections. Surgical drainage without antibiotics may be used for an abscess. If antibiotics are prescribed, they should be given according to the instructions on the prescription label.
Occasionally, multiple people within a family or child care setting may become recurrently infected with boils and abscesses. This may be due to MRSA. In some cases, the infected person never spreads the bacteria to others.
No effective and long-lasting way to eliminate MRSA from child care settings and families is known because it commonly lives on the skin and in the noses of those not infected.

Additional Resources:

Last Updated
Managing Infectious Diseases in Child Care and Schools, 3rd Edition (Copyright © 2013 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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