Pediatric Folliculitis, Furuncles (Boils) and Carbuncles

Bacteria on the skin can cause an infection of one or more hair follicles. A hair follicle is the base or root of a hair. There are three different kinds of infections:

• Folliculitis. This is inflammation of a hair follicle.
• Furuncle. This is an infection of the hair follicle that goes into the deeper layers of skin. A small pocket of pus (abscess) forms. It’s also known as a boil.
• Carbuncle. This is a group of infected hair follicles with pus. A carbuncle is larger and deeper than a furuncle.

These can occur anywhere on the skin where there is hair. They happen most often where there may be rubbing and sweating. This includes the back of the neck, face, armpits, waist, groin, thighs or buttocks.

Bacteria called Staphylococcus aureus (staph) are the most common cause of these infections. But other kinds of bacteria can also cause them.

Anybody can develop folliculitis, furuncles or carbuncles. A child may be more at risk if he or she:

• Has diabetes or a weak immune system
• Has other skin infections
• Has close contact with someone with a skin abscess, furuncle or carbuncle
• Has skin injuries, such as scrapes, cuts or insect bites
• Is getting IV medicine
• Has been in hot tub or spa water that is not properly treated

Symptoms can occur a bit differently in each child. They can include:

• A single lump or bump (skin lesion)
• Groups of skin lesions

The lesions may be:

• Red
• Warm
• Swollen
• Painful
• Leaking fluid (pus)

Symptoms that affect the whole body can include:

• Fever and chills
• Fast heart beat
• Low blood pressure

The symptoms of folliculitis, furuncles and carbuncles can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam.

Your child may need to see a specialist to treat a moderate to severe furuncle or carbuncle. A sample of the pus from the infection may be sent to a lab. This is called a culture. It’s done to see what type of bacteria caused the infection. It can help the doctor decide the best antibiotic for treatment.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Folliculitis and mild furuncles may go away with no treatment. Warm cloths (compresses) may help easy symptoms and speed healing.

Moderate to severe furuncles and carbuncles are often treated by draining. A healthcare provider cuts into the lesion and drains the fluid (pus) inside. This is called incision and drainage. Your child may also need to take antibiotic medicine by mouth (oral) or in a vein (IV). You may also need to apply antibiotic ointment or cream on your child.

To help to prevent these infections:

• Make sure you clean and protect any skin injuries.
• Make sure your child washes his or her hands often.
• Keep your child's nails cut short.
• Encourage older children and teens to keep their faces clean, use clean razors, don't share razors and bathe often.
• Use only well-maintained spas or hot tubs.
• Try to have your child stay away from others with these infections.

Possible complications may include:

• Infection spreading to other parts of the body
• Return of the infection
• Scarring

Call the healthcare provider if your child has:

• Symptoms that affect a large area
• Symptoms that get worse
• Fever
• New symptoms