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Expert Q&A:
What causes recurrent boils on my 3-year-old's bottom?

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Answered by Anthony Mancini M.D.
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Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.



Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.



Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.
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Question


What causes recurrent boils on my 3-year-old's bottom?

Answer


Toddlers and school-aged children not uncommonly get bacterial infection in the hair follicles on the buttocks or posterior thighs. Small lesions (red bumps with pustules on the surface) are termed "folliculitis," and when these lesions get larger they are called "furuncles" or, when very large, "carbuncles." The latter two are commonly known as boils.

While some children with recurrent disease may have predisposing conditions (like obesity, diabetes, or immune problems), most are otherwise completely healthy. Some may actually carry the bacterium that causes these problems ( Staphylococcus aureus) in the diaper area, which accounts for the common occurrence on the buttocks. Treatments include antibacterial soaps, topical antibiotics, and, for severe cases, oral antibiotics. Your son's pediatrician or dermatologist can give you further guidance.
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