Abscess, Incision and Drainage (Child)

An abscess is an infected area of skin where bacteria have caused fluid (pus) to form. Bacteria normally live on the skin and don’t cause harm. But sometimes bacteria enter the skin through a hair root, or cut or scrape in the skin. If bacteria become trapped under the skin, an abscess can form. An abscess can be caused by an ingrown hair, puncture wound, or insect bite. It can also be caused by a blocked oil gland, pimple, or cyst. Abscesses often occur on skin that is hairy or exposed to friction and sweat. An abscess near a hair root is called a boil.

At first, an abscess is red, raised, firm, and sore to the touch. The area can also feel warm. Then the area will then collect pus.

In some cases, an abscess will be cut and the pus drained out. This is known as incision and drainage. It's also sometimes called lancing. A baby may need to stay in the hospital overnight for this procedure. After the procedure, your child may be given antibiotics to help cure the infection. The abscess will likely drain for several days before it dries up. It can take several weeks to heal.

Home care

Your healthcare provider may prescribe an oral or topical antibiotic for your child. Pain medicine may also be prescribed. Follow all instructions. Report any side effects or possible reactions to your child's healthcare provider.

General care

For babies

  • Apply a warm, moist compress to the abscess for 20 minutes up to 3 times a day, or as advised by your baby's healthcare provider. This may help the abscess come to a head, soften, and drain on its own.

  • Don't soak the abscess in bath water. This can spread infection. Instead, gently wash the area with soap and clean running water.

  • Don’t cut, pop, or squeeze the abscess. This can be very painful and spread infection.

  • If the abscess drains pus on its own, cover the area with a nonstick gauze bandage. Use as little tape as possible to prevent irritating the baby’s skin. Call your baby’s healthcare provider for further instructions. Abscesses may drain pus for several days and need to stay covered during this time. Carefully discard all soiled bandages. They can infect others.

  • Change your baby’s clothes daily. Change sheets and blankets if they are soiled by pus. Wash all clothing and linens in hot water, including cloth diapers. If your baby’s abscess is on the buttocks, carefully discard diaper wipes and disposable diapers. Don’t share any linens with other family members.

For children

  • Keep the area covered with a nonstick gauze bandage, as instructed.

  • Be careful to prevent the infection from spreading. Wash your hands before and after caring for your child. Wash in hot water any clothes, bedding, and towels that come into contact with the pus. Don’t let other family members share unwashed clothes, bedding, or towels.

  • Have your child wear clean clothes daily.

  • Change the bandage if you see pus in it. Wash the area gently with soap and warm water or as instructed by the healthcare provider. Carefully discard all soiled bandages.

  • Don’t have your child sit in bath water. This can spread the infection. Have your child take a shower instead of a bath. Or gently wash the area with soap and clean running water.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

Special note to parents

Take care to prevent the infection from spreading. Wash your hands with soap and clean running water before and after caring for the abscess. Make sure your child or other family members don't touch the abscess. Contact your healthcare provider if other family members have symptoms.

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • The abscess gets bigger

  • The abscess comes back

  • Redness and swelling get worse

  • Pain doesn’t go away, or gets worse. In babies, pain may show up as fussing that can’t be soothed.

  • Foul-smelling fluid leaking from the area

  • Red streaks in the skin around the area

  • Reaction to the medicine

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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