Cellulitis and Skin Abscess

What are they? 

Cellulitis is a bacterial infection of the skin. A skin abscess is a collection of pus or discharge underneath the skin. Sometimes a child has just cellulitis or an abscess, and sometimes they have both together. 

What causes them? 

Cellulitis and skin abscesses are caused by an infection. Often, the infection starts when bacteria (a type of germ) get into the skin through a cut, bite, or scrape. The body’s immune system (germ-fighting system) makes special cells to fight the bacteria. It is the body’s germ-fighting cells and the bacteria that make up most of the pus or discharge. 

How can they be prevented? 

Wear protective clothing and equipment (such as shin guards and bike helmets) to prevent bug bites, cuts and scrapes. If your child does get an injury, wash the area well with soap and water, apply an antibiotic ointment, and cover with gauze or a bandage. For diapered infants and children, take care to avoid diaper rash.  Call your doctor if your child is bitten by an animal or human as these injuries may need special attention.

What are the signs & symptoms?  

Cellulitis usually starts as a small area of skin that is red, tender, warm, and swollen. As it gets bigger and spreads to more skin, a child may have a fever or chills. Nearby lymph nodes may also be swollen and tender. Abscesses are usually red, warm, and swollen as well and form painful and tender bumps. They may leak fluid (the discharge or pus). They can develop on top of the skin (they may look like a pimple), under the skin, in a tooth, or deep inside the body. Cellulitis is not usually contagious, but pus/discharge from an abscess can spread infection. 

How are they diagnosed? 

Both cellulitis and skin abscess can often be diagnosed during an exam. Sometimes, imaging, such as an ultrasound, is needed to diagnose a skin abscess. Sometimes the doctor may also take blood samples to check for bacteria in the bloodstream.  

How are they treated? 

Because they are caused by a bacterial infection, most children with cellulitis or abscess will be given antibiotics to help kill the germs. Sometimes these antibiotics must be given in the hospital, especially if they need intravenous (IV) antibiotics.  

If there is an abscess, it is important for the pus/discharge to drain out so it can heal. If your child’s abscess is already draining, your child’s provider might recommend waiting to see if it heals on its own. If it is not draining or is not draining enough, the provider may recommend that you apply a warm compress at home to help it open up. You can make a compress by wetting a washcloth with warm (not hot) water and placing it over the abscess for several minutes, a few times a day. Sometimes, your provider may need to help drain the pus by making a small cut in the abscess. This procedure may require sedation and/or the help of a pediatric surgeon. 

If your child needs surgery

What happens during surgery?

Your child will be asleep for the surgery. To drain the abscess, the surgeon will make a cut over the pus-filled pocket. The pus/discharge will be drained out. The empty pocket might be filled with a clean piece of gauze to help stop the bleeding. The cut will heal on its own. If needed, you will be taught how to care for the cut.

Will my child be in pain?

An abscess can be very painful until it is drained. Most children feel much better after the abscess is drained. Your child might need some mild pain medicine for a few days after the surgery.

What can I expect after the surgery?

• Diet: Most patients are able to eat a normal diet.
• Activity: Your child may return to normal activities as they tolerate. Your child should not go in a pool, lake, or other body of water until the skin has completely healed. Your child can shower and/or bathe as instructed by your surgeon.
• Wound care: Your child’s surgeon will give you specific instructions for wound care following the surgery. Here are some things you and your child can do as well:
  • Prevent the spread of germs from the skin abscess
    • Wear gloves and/or wash your hands before and after caring for the abscess
    • Keep the abscess covered with a bandage so drainage does not get on clothing
    • Don’t let your child share washcloths, sheets, towels, clothing, or razors
    • Wash your child’s clothing, sheets, and towels in a washing machine. Dry completely in a hot dryer.
  • Keep the area clean and dry. Avoid fabrics not made of cotton/wool and tight-fitting underwear.
  • Have your child bathe or shower often. Especially after activities that make them sweat. Use antibacterial or glycerin soap.
• Medicines: Medication for pain such as acetaminophen (Tylenol®), ibuprofen (Motrin® or Advil®), or a narcotic may be needed to help with pain for a few days after surgery. If antibiotics are prescribed, it is very important that your child take all doses as directed, even if they are feeling better. This is the best way to kill the harmful germs. 
• Return to school/daycare: Your child may return to school or daycare when you feel it is appropriate.

When do I call the surgeon?

If your child had surgery, call if your child has:

• Fevers over 101 °F
• Wound redness
• Increasing pain
• Worsening drainage

Follow-up with your child’s surgeon as directed following surgery. You can call 612-813-8000 to schedule an appointment.

When do I call the primary care provider?

If your child did not have surgery, call if your child has:

• Worsening redness, swelling, or pain 
• Has red streaks on the skin near the skin abscess 
• Gets a new fever, has a fever that is getting higher, or has a fever that lasts more than 48 hours (2 days) 

Questions?

This information is not specific to your child but provides general information. If you have any questions, please call your clinic.

Reviewed 2/2024

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