What are the common causes of skin boils. How can you differentiate between boils and other skin conditions. What are the most effective treatments for boil skin infections.

Understanding Skin Boils: Causes and Characteristics

Skin boils, also known as furuncles, are painful, pus-filled bumps that develop under the skin. These infections typically start in hair follicles or oil glands, caused primarily by bacteria such as Staphylococcus aureus or group A Streptococcus. Boils can occur anywhere on the body but are most common in areas where there’s friction or increased sweating.

What are the primary symptoms of a skin boil?

• Swelling and redness around the affected area
• A tender, warm lump that gradually increases in size
• Formation of a white or yellow center (pustule)
• Oozing or weeping of pus or clear fluid
• Pain that may intensify as the boil grows

It’s crucial to recognize these symptoms early to prevent the infection from spreading or developing into a more severe condition.

Differentiating Boils from Other Skin Conditions

Skin boils can sometimes be confused with other skin conditions due to similar appearances. Understanding the differences is essential for proper treatment and management.

Boils vs. Pimples

While boils and pimples may look similar at first glance, they have distinct differences:

• Cause: Boils are bacterial infections, while pimples result from clogged pores
• Size: Boils tend to be larger and deeper than pimples
• Pain: Boils are usually more painful than pimples
• Progression: Boils often worsen over time, while pimples typically resolve on their own

Boils vs. Cysts

Cysts are another skin condition that can be mistaken for boils:

• Origin: Cysts are typically non-infectious, fluid-filled sacs
• Growth: Cysts usually grow slowly, while boils develop more rapidly
• Pain: Cysts are generally less painful than boils
• Multiplicity: Boils may occur in clusters, while cysts are usually solitary

MRSA Infections: A Serious Form of Skin Boil

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria that’s resistant to many common antibiotics. MRSA infections can manifest as skin boils and are particularly concerning due to their resistance to treatment.

What are the key characteristics of MRSA boils?

• Appearance: Red, swollen, and painful bumps that may resemble spider bites
• Location: Often found in hair-covered areas like the back of the neck, groin, buttocks, armpit, and beard area
• Spread: Highly contagious through skin-to-skin contact or contact with contaminated surfaces
• Treatment resistance: Requires specific antibiotics due to resistance to standard treatments

If you suspect an MRSA infection, it’s crucial to seek medical attention promptly to prevent complications and spread.

Cystic Acne: When Pimples Become Severe

Cystic acne is the most severe form of acne, characterized by deep, painful cysts beneath the skin. While not technically a boil, it can sometimes be mistaken for one due to its appearance and symptoms.

Symptoms of Cystic Acne

• Large, red, and tender bumps deep under the skin
• Painful to touch
• May have a whitish-yellow head
• Can leave scars if not treated properly

How does cystic acne differ from regular acne?

Cystic acne is more severe and deeply rooted than regular acne. It occurs when pores become clogged with excess sebum and dead skin cells, leading to bacterial infection and inflammation deep within the skin. This results in larger, more painful lesions that are more likely to leave scars.

Treatment Options for Cystic Acne

Treating cystic acne often requires a combination of approaches:

1. Oral antibiotics to fight bacterial infection
2. Topical treatments like retinoids or benzoyl peroxide
3. Isotretinoin (Accutane) for severe cases
4. Hormonal treatments for women with hormone-related acne
5. Chemical peels or laser therapy to improve skin texture

It’s important to consult a dermatologist for proper diagnosis and treatment of cystic acne, as over-the-counter remedies are often insufficient.

Impetigo: A Highly Contagious Skin Infection

Impetigo is a bacterial skin infection that primarily affects children but can occur in adults as well. It’s caused by Staphylococcus or Streptococcus bacteria and is highly contagious.

Key Features of Impetigo

• Appearance: Red sores that quickly rupture, ooze, and form a honey-colored crust
• Location: Commonly appears around the nose and mouth, but can occur anywhere on the body
• Spread: Highly contagious through direct contact or sharing personal items
• Onset: Symptoms typically appear within 3 days of exposure to the bacteria

How is impetigo different from other skin infections?

Impetigo is distinguished by its rapid spread, the characteristic honey-colored crusts that form over sores, and its high contagiousness. Unlike boils, impetigo typically affects the superficial layers of the skin and doesn’t form deep, pus-filled lumps.

Treatment Options for Skin Boils and Related Infections

The treatment for skin boils and related infections varies depending on the specific condition, severity, and causative agent. However, some general approaches apply to many of these skin issues.

Home Remedies for Mild Boils

• Warm compresses to promote drainage and healing
• Keeping the area clean and dry
• Avoiding picking or squeezing the boil
• Over-the-counter pain relievers for discomfort

Medical Treatments for Severe or Recurrent Boils

1. Incision and drainage by a healthcare professional
2. Oral antibiotics for widespread or severe infections
3. Topical antibiotics to prevent spread and recurrence
4. Culture and sensitivity testing to identify antibiotic-resistant strains

When should you seek medical attention for a skin boil?

While many boils can be managed at home, certain situations warrant professional medical care:

• The boil is on your face or spine
• It’s larger than 2 inches in diameter
• You have a fever or other systemic symptoms
• The boil doesn’t improve after a week of home treatment
• You have recurring boils
• You have a weakened immune system

Prevention Strategies for Skin Boils and Related Infections

Preventing skin boils and related infections involves maintaining good hygiene practices and taking steps to reduce the risk of bacterial colonization on the skin.

General Prevention Tips

• Wash hands frequently with soap and water
• Keep cuts, scrapes, and other wounds clean and covered
• Avoid sharing personal items like towels, razors, or clothing
• Shower after sweating or participating in contact sports
• Use antibacterial soap if you’re prone to skin infections

Specific Prevention for MRSA

Given the serious nature of MRSA infections, additional precautions may be necessary:

1. Clean and disinfect high-touch surfaces regularly
2. Wash clothing and bedding in hot water if you or someone in your household has MRSA
3. Follow healthcare provider instructions if you’re colonized with MRSA
4. Inform healthcare providers of your MRSA history when seeking medical care

How can you prevent the spread of skin infections in communal settings?

In settings like gyms, schools, or workplaces, preventing the spread of skin infections requires collective effort:

• Encourage proper hand hygiene
• Provide access to hand sanitizers
• Regularly clean and disinfect shared equipment
• Implement policies for covering open wounds
• Educate community members about recognizing and reporting potential skin infections

Long-term Management of Recurrent Skin Boils

For individuals prone to recurring skin boils, long-term management strategies are essential to prevent future outbreaks and improve overall skin health.

Lifestyle Modifications

• Maintain a healthy diet rich in vitamins and minerals
• Stay hydrated to support skin health
• Manage underlying conditions like diabetes or immune disorders
• Reduce stress through relaxation techniques or exercise
• Avoid tight clothing that may cause friction or irritation

Medical Interventions for Chronic Cases

In cases of frequent recurrence, healthcare providers may recommend:

1. Long-term, low-dose antibiotic therapy
2. Regular use of antibacterial body washes
3. Nasal decolonization with mupirocin ointment
4. Investigation for underlying causes, such as immune deficiencies
5. Referral to a dermatologist or infectious disease specialist

What role does genetics play in susceptibility to recurrent skin boils?

Research suggests that genetic factors may influence an individual’s susceptibility to recurrent skin boils. Some genetic variations can affect the immune system’s ability to fight off certain bacteria, particularly Staphylococcus aureus. Understanding these genetic predispositions can help healthcare providers develop more targeted treatment and prevention strategies for individuals prone to chronic skin infections.

The Psychological Impact of Skin Boils and Related Conditions

While skin boils and related infections are primarily physical conditions, they can have significant psychological effects on those who experience them, especially in cases of severe or recurrent infections.

Common Psychological Challenges

• Embarrassment or self-consciousness about appearance
• Anxiety about potential spread or recurrence
• Depression related to chronic pain or discomfort
• Social isolation due to fear of contagion or appearance concerns
• Frustration with ongoing treatment regimens

Coping Strategies and Support

To address the psychological impact of skin boils and related conditions, consider the following approaches:

1. Seek support from friends, family, or support groups
2. Practice stress-reduction techniques like meditation or yoga
3. Consult a mental health professional if experiencing significant distress
4. Educate yourself about your condition to feel more in control
5. Focus on overall health and well-being, not just the skin condition

How can healthcare providers address the psychological aspects of skin infections?

Healthcare providers play a crucial role in addressing both the physical and psychological aspects of skin infections. They can:

• Provide clear, compassionate communication about the condition and treatment options
• Offer reassurance and education about prognosis and management
• Screen for signs of anxiety or depression related to the skin condition
• Refer patients to mental health professionals when necessary
• Collaborate with dermatologists and mental health providers for comprehensive care

By addressing both the physical and psychological aspects of skin boils and related infections, healthcare providers can offer more holistic and effective care, improving both the physical health and quality of life for their patients.

Boil Healing Stages Pictures – TSMP Medical Blog

Nemours Foundation: “Staph Infections.”

Causes of Skin Boils with Pictures

Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

Updated on October 22, 2022

Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.

Skin boils are infections caused by bacteria or fungi. They commonly develop as a lump around a hair follicle or oil gland. Looking at pictures of boils and understanding the conditions that cause them can help you recognize them if they appear on your body. This can help guide you in seeking treatment.

This article explains boil symptoms, how boils differ from similar skin conditions, and conditions that result in boils.

Boil Symptoms

Skin boils are often caused by an infection with Staphylococcus bacteria. They may also develop from other infectious agents, like group A Streptococcus.

Skin boils can have a pinkish, red, or whitish-yellow color with symptoms that include:

• Swelling
• Oozing of pus or clear fluid
• Pain

Boil vs. Pimple

Skin boils and pimples can look similar, but there are differences. For example, unlike boils, pimples aren’t caused by an infection. Instead, they are caused by blocked pores. This blockage causes pimples, blackheads, and whiteheads to form a bump on the skin. Pimples are the main symptom of acne, a common skin condition.

Sometimes, with acne, bacteria can infect clogged pores, leading to redness and inflammation. This type of acne is known as inflammatory acne.

Boil vs. Cyst

Boils also differ from cysts, which are fluid-filled sacs that are typically non-infectious and non-contagious. However, cysts can become infected if bacteria get in broken skin. In addition, boils usually multiply and can be painful, while cysts typically grow slowly and aren’t painful.

Many people also misidentify a boil for a bug or spider bite. Unless you catch a spider in the act of biting, an infection likely is what’s causing a boil.

MRSA Blister

A blister caused by methicillin-resistant Staphylococcus aureus (MRSA) infection is also called a staph infection. But even though it’s common for MRSA to show up as blisters or boils, not all blisters or boils are from MRSA.

Other forms of MRSA and group A Streptococcus bacteria cause skin infections that look very similar.

Symptoms

MRSA can colonize (live) on the skin and cause no harm. However, when you have a cut or scrape, the bacterium can enter the body and cause infection. When this occurs, symptoms may include:

MRSA can spread by touching someone’s skin colonized with MRSA or touching contaminated surfaces.

MRSA blisters commonly form on areas covered by hair, such as the back of the neck, groin, buttocks, armpit, and beard areas.

Treatment

Due to this bacterium’s resistance to many standard antibiotics, treating it requires specific types of medication and dosages. Usually, treatment involves a seven to 10-day course of oral antibiotics such as:

• Trimethoprim-sulfamethoxazole
• Clindamycin
• Minocycline
• Linezolid
• Doxycycline

Cutting an MRSA boil open to drain it should only be done by a healthcare professional using a sterile technique to avoid spreading the MRSA or introducing another infection.

Cystic Acne

Cystic acne is the most severe type of acne. It causes acne cysts that form deep under the skin.

It occurs when pores become clogged with excess sebum (an oily substance found in glands) and dead skin cells. When bacteria infect these clogged pores, the immune system reacts to fight the threat. This reaction causes deep swelling in the skin’s middle layer (the dermis).

Symptoms

An acne cyst is usually red and may have a whitish-yellow head. A cyst can be crusty, painful, or tender to touch, and either large or small in size.

Since the face has an abundance of oil glands, acne cysts tend to appear there. However, they can also appear on the back, butt, chest, neck, shoulders, and upper arms.

Treatment

Treating cystic acne typically includes taking oral antibiotics and applying certain topical gels or creams (often prescription-strength) to the affected area. Some treatments include the use of:

• Azelaic acid
• Benzoyl peroxide
• Retinoids
• Salicylic acid
• Accutane (isotretinoin)

Impetigo

Impetigo is a bacterial skin infection that is pretty common in kids (in fact, some incorrectly pronounce it infantigo). It comes from either Staphylococcus or Streptococcus bacteria.

Impetigo is highly contagious and spreads through contact with an infected person’s sores or the fluid from these sores. It can also spread by sharing towels or clothing with an infected person.

Symptoms

Symptoms of impetigo typically occur within three days after infection. They can include:

• Skin lesions on the lips, nose, arms, and legs
• Pus-filled blisters that easily burst
• Reddish skin with blisters that contain tan or yellowish fluid
• Rash

Treatment

Impetigo is treatable and doesn’t cause a fever. Healthcare providers will most likely be able to identify it just by looking at it. However, if they aren’t sure, they may take a biopsy of the affected skin.

Treating impetigo typically involves applying prescribed topical antibiotics such as mupirocin. Oral antibiotics such as cephalosporins, clindamycin, and sulfamethoxazole may also be used.

Hidradenitis Suppurativa

Hidradenitis suppurativa , sometimes referred to as acne inversa, is a chronic skin disease that affects the sweat glands and hair follicles. This condition causes bumps on the skin that can turn into painful boils. After they heal, scarring occurs.

The reason some people develop this condition is unknown. However, it’s thought that sex hormones and lifestyle factors like smoking may play roles.

Experts believe that hidradenitis suppurativa occurs when an abnormal growth of cells clogs hair follicles. This debris buildup eventually causes the follicle to rupture, leading to inflammation and scarring. Inflammation is an immune system response to aid in the healing process.

Symptoms

Symptoms of hidradenitis suppurativa include:

• Pain
• Swelling
• Pimple-like, pus-filled lesions
• Scarring

The condition typically affects areas where skin touches skin, such as the underarms, groin, buttocks, and breasts.

Treatment

For mild cases, treatment usually involves taking anti-inflammatory medications. In addition, applying topical cleansing agents, such as acne washes and antibacterial soaps, can help.

Treatment for more severe cases may include:

• Corticosteroids
• Antibiotics such as tetracycline and erythromycin
• Humira (adalimumab)
• Acne surgical procedures

Stye

A stye ( hordeolum ) is a painful, red bump that develops on the eyelid. It’s usually caused by a blockage of oil-producing glands in the eyelash follicle and Staphylococcus bacterial infection.

A stye can form either on the outer or inner eyelid. A stye isn’t usually contagious, but it can release small amounts of bacteria. This bacteria can spread through physical touch or contact with items such as pillows.

Symptoms

Symptoms of a stye can include:

• Eyelid crusting
• Teary or scratchy eyes
• A painful swelling on the eyelid
• Light sensitivity

Treatment

Styes typically clear without medical treatment in one to two weeks. Self-care methods may speed healing. A common way to clear a stye is to place warm compresses on the eyelid for 10 to 15 minutes at a time, three to five times a day.

Seeing an ophthalmologist may be wise if your stye doesn’t improve with at-home care. They may prescribe topical or oral antibiotics and ensure there’s no underlying problem. Also, a healthcare provider may surgically drain a stye if it blocks vision or does not clear with antibiotics.

Carbuncle

A single boil is called a furuncle. A carbuncle is a cluster of boils that form on a particular body area. Like a boil, a carbuncle results from a bacterial infection, usually by Staphylococcus aureus.

Research reveals that carbuncles are commonly associated with diabetes.

Symptoms

Because a carbuncle affects deeper layers under the skin, symptoms are more severe than a single boil.

Typically, the affected area is red and inflamed with multiple pus-filled boils. Carbuncles can develop anywhere on the body, but they commonly occur on the back and neck. A carbuncle may also include symptoms like:

Treatment

Although warm compresses may help it drain, it’s not uncommon for a carbuncle to need to be surgically drained by a healthcare provider. A healthcare provider may also prescribe antibiotics like trimethoprim-sulfamethoxazole and doxycycline, especially if it returns.

When to See a Doctor

Skin boils usually heal on their own, especially with proper self-boil treatment. However, some things may indicate an infection is brewing. If you notice any of the following, contact a healthcare provider:

• Fever
• Boils that last longer than one week
• Multiple boils or carbuncles
• Boils that return

A healthcare provider can give proper treatment and ensure there isn’t an underlying problem.

See a healthcare provider if you develop a boil and have diabetes or a condition that affects the immune system.

Summary

Many things may cause boils, including MRSA, cystic acne, impetigo, hidradenitis suppurativa, styes, and carbuncles. Symptoms vary depending on the condition but usually include sensitive pus-filled lesions.

Treatment varies depending on the cause. If you have any signs of infection or the boil isn’t responding to at-home treatment, you should contact a healthcare provider.

Frequently Asked Questions

What is the best antibiotic for skin boils?

There isn’t a clear-cut best antibiotic for skin boils. Some antibiotics may work better than others in clearing a particular bacterium that causes a skin boil. For example, trimethoprim-sulfamethoxazole, clindamycin, and minocycline are more successful in treating an MRSA infection. But skin boils caused by non-MRSA conditions can usually be treated with antibiotics like amoxicillin, cephalosporins, and dicloxacillin.

How do you prevent boils?

Practicing proper hygiene can help prevent boils. For example, washing your hands frequently and bathing regularly can help prevent the spread of bacteria. Also, try avoiding physical contact and sharing items like washcloths and towels with those who have a staph infection or boil, as the bacteria can spread through contact.

How long do boils last?

Without treatment, a boil may take up to two weeks or more to heal. However, with treatment, boils may clear much faster.

Slideshow: A Visual Guide to Boils

A boil is a common, painful infection of a hair follicle and the surrounding skin. It begins as a red lump, then fills with pus as white blood cells rush in to fight the infection. Good home care can often clear up a single boil, also known as a skin abscess. A doctor’s care is needed when a boil resists treatment or develops in certain vulnerable areas of the body.

Boil Symptoms

2/19

Boils are usually pea-sized, but can grow as large as a golf ball. Symptoms can include:

• Swelling, redness, and pain
• A white or yellow center or tip
• Weeping, oozing, or crusting

You may also have a general feeling of ill health, fatigue, or a fever, which is reason to call a doctor.

Where Do Boils Form?

3/19

Boils can form anywhere on the body, but they’re most common on the face, neck, armpits, shoulders, back, and buttocks. Hairy, sweaty areas are typical sites, as well as areas of friction, such as the inner thighs. Boils can also develop around the ear or near the nose. The pain often worsens as pus collects under the skin, then eases as fluids begin to drain.

What Causes Boils?

4/19

Most boils are caused by staph bacteria (Staphylococcus aureus), which many healthy people carry on their skin or in their noses without a problem. When a scrape, cut, or splinter breaks the skin, the bacteria can enter a hair follicle and start an infection. Others boils, such as those associated with acne, develop from clogged pores that become infected.

Ordinary Boil or MRSA Infection?

5/19

MRSA can look exactly like an ordinary boil: red, swollen, pus-filled, and tender. But MRSA infections are caused by one particular type of staph that is resistant to many antibiotics. If a skin infection spreads or doesn’t improve after 2-3 days of antibiotics, your doctor may suspect MRSA. The right treatment given promptly is important to heal a MRSA infection and prevent a deeper, more dangerous infection.

Are Boils Contagious?

6/19

Not exactly, but the germs that cause boils (staph) are easily spread through skin-to-skin contact and contaminated objects. These bacteria usually do no harm unless they find a break in the skin. To avoid spreading staph, don’t share towels, bedding, clothes, or sports gear while you have a boil. Avoid touching the boil, and keep it covered. Frequent hand washing can also help prevent spreading the bacteria.

Early Warning: Folliculitis

7/19

Folliculitis is an inflammation or infection of the hair follicles that can develop into a boil. Tiny pimples with whiteheads appear around individual hairs, sometimes surrounded by red skin. It can be itchy, tender, and uncomfortable, but is typically not as painful or deep as a boil. Shaving or friction from tight clothing can let staph bacteria slip under the skin — the most common cause of both folliculitis and boils.

Boil Type: Carbuncle

8/19

When several boils form close together and join beneath the skin, it’s called a carbuncle. They are most commonly found on the back and the neck but can develop anywhere. Men are more likely to develop carbuncles than women. A carbuncle tends to lie deeper beneath the skin than a boil and can take longer to heal.

Boil Type: Cystic Acne

9/19

Cystic acne is a type of skin abscess that forms when oil and dead skin cells clog a hair follicle, creating a place where bacteria grow and thrive. It affects deeper skin tissue than regular acne, leading to firm, painful cysts. It’s most commonly on the face and shoulders and typically occurs in the teenage years.

Boil Type: Armpit and Groin

10/19

When lumps and pus-filled abscesses repeatedly develop in these areas of the body, it may be a chronic condition called hidradenitis suppurativa. Infection starts in sweat glands and hair follicles that become blocked. Mild cases heal with home care. Several drugs and treatments are available for more serious and recurring cases.

Boil Type: Pilonidal Abscess

11/19

When a boil forms in the skin just above the buttocks crease, it may be a pilonidal abscess. Hair is believed to play a role, and irritation, pressure, and prolonged sitting may also contribute to the development of a cyst here. If a cyst becomes inflamed and infected, it becomes an abscess. Some children are born with a “pilonidal dimple” where infections can crop up. Signs of infection require a doctor’s attention.

Boil Type: Stye

12/19

The familiar “stye on the eye” is a boil, usually caused by staph bacteria. It starts in the follicle of an eyelash and may be red, warm, swollen, and uncomfortable. A stye is sometimes confused with a chalazion, which is also a lump on the eyelid, but a chalazion is usually painless and is caused by a blocked oil gland, not an infection.

Who Gets Boils?

13/19

Anyone can develop a boil. The risk increases with:

• Close contact with an infected person
• Acne, eczema, or other causes of breaks in the skin
• Diabetes
• A weakened immune system

Treatment: Home Care

14/19

You can take care of most boils at home. Apply warm, moist compresses several times a day to help a boil open and drain. After it starts draining, keep it clean, and continue using warm compresses — a clean one every time. Change the bandage often and wash hands well. Resist the urge to squeeze or pop the boil. This can make the infection worse.

When to Call the Doctor

15/19

If a boil doesn’t heal after a week of home care, call your doctor. Other reasons to call include:

• A boil on the face or spine
• A fever or red streaks coming from the sore
• A very large or painful boil
• A boil that keeps coming back

Treatment: Procedures

16/19

If the fluid inside a boil doesn’t drain by itself, your doctor may prick the top of the sore with a sterile instrument to be sure it drains completely. A deep infection may be packed with sterile gauze so it continues to drain. Antibiotics and steroid shots are sometimes given to help with healing.

Treatment: Recurrent Boils

17/19

For some people, boils are a recurring problem. In addition to standard treatment, your doctor may try to eliminate or reduce staph bacteria throughout the body. This can include any or all of the following treatments: washing up with a special antiseptic soap, using an antibiotic ointment inside the nose, or, if necessary, 1-2 months of antibiotics taken by mouth.

Boil Complications

18/19

Most boils heal with home treatment or a doctor’s visit. Sores on the face may require antibiotics because they’re so close to the eyes and brain. Rarely, the staph bacteria from a boil or carbuncle can get into the bloodstream, which can then affect the heart and other internal organs.

How to Prevent Boils

19/19

Since bacteria are everywhere in our environments and on many people’s skin, the best defense against boils includes:

• Hand washing or use of alcohol-based hand sanitizer
• Careful cleaning of cuts, scrapes, and other wounds
• Keeping wounds covered
• Not sharing towels, sheets, razors, etc.

Wash towels, sheets, and anything else in contact with an infected area in very hot water. Throw away any wound dressings in a tightly sealed bag.

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IMAGES PROVIDED BY:

1) Peggy Firth and Susan Gilbert for WebMD
2) Dr. P. Marazzi / Photo Researchers, Inc, Watney Collection / Phototake, ISM / Phototake
3) Watney Collection / Phototake, ISM / Phototake, Biophoto Associates / Photo Researchers, Inc, Interactive Medical Media LLC
4) David Mack / Photo Researchers, Inc
5) Interactive Medical Media LLC
6) Stockbyte
7) Interactive Medical Media LLC
8) Peggy Firth and Susan Gilbert for WebMD
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10) Interactive Medical Media LLC
11) Peggy Firth and Susan Gilbert for WebMD
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15) Dr. Harout Tanielian / Photo Researchers, Inc.
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17) Stockbyte, iStock
18) Medioimages/Photodisc
19) Sean Justice/Digital Vision

Nemours Foundation: “Staph Infections. ”

University of Chicago Medical Center: “MRSA FAQ.”

Merck Manual of Medical Information, 2nd Home Edition: “Folliculitis and Skin Abscesses.”

NIH Genetics Home Reference: “Hidradenitis Suppurativa.”

Hidradenitis Suppurativa Foundation: “What is Hidradenitis Suppurativa?”

American Academy of Ophthalmology: “What Are Chalazia and Styes?”

Diagnosis, Causes, and Treatments of Carbuncles

Diagnosis, Causes, and Treatments of Carbuncles

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Medically reviewed by Debra Sullivan, Ph. D., MSN, R.N., CNE, COI — By Chitra Badii — Updated on May 22, 2023

A carbuncle is a type of staph infection that appears as a collection of boils or infected bumps. They are often swollen, red, and painful. Treatment may involve antibiotics, antibacterial soaps, or surgery.

Boils are bacterial infections that form under your skin at a hair follicle. A carbuncle is a cluster of boils that have multiple pus “heads.” They’re tender and painful, and cause a severe infection which could leave a scar. A carbuncle is also called a staph skin infection.

The most obvious first symptom of a carbuncle is a red, irritated lump under your skin. Touching it may be painful. It can range from the size of a lentil to a medium-sized mushroom.

The size of the lump increases over a few days as it quickly becomes filled with pus. It eventually develops a yellow-white tip or “head” that will rupture and drain the pus. Nearby areas may also experience swelling.

Other symptoms may include:

• itching before the lump appears
• bodily aches
• fatigue
• fever and chills
• skin crustiness or oozing

Pus usually appears within one day of carbuncle formation.

A carbuncle usually develops when Staphylococcus aureus bacteria enter your hair follicles. These bacteria are also referred to as “staph.” Scrapes and other broken skin make it easy for bacteria to enter your body and cause an infection. This can result in boils or carbuncles (a cluster of boils) filled with fluid and pus.

The moist parts of your body are particularly susceptible to this infection because bacteria thrive in these areas. Carbuncles are usually found on the back of the neck, shoulders, or thigh. They can also appear on your face, neck, armpits, or buttocks; or any area you sweat or experience friction.

Being in close contact with someone who has a carbuncle increases your chances of developing one. The following factors also increase the risk of developing a carbuncle:

• poor hygiene
• diabetes
• a weak immune system
• dermatitis
• kidney disease
• liver disease
• shaving and other activities that break the skin

Your doctor can usually diagnose a carbuncle by looking at your skin. A pus sample may also be taken for lab analysis.

It’s important to keep track of how long you’ve had the carbuncle. Tell your doctor if it’s lasted longer than two weeks. You should also mention if you’ve had the same symptoms before.

If you keep developing carbuncles, it may be a sign of other health issues, such as diabetes. Your doctor may want to run urine or blood tests to check your overall health.

There are several possible treatments for a carbuncle. First, it’s important to assess your carbuncle:

• Is it bigger than two inches?
• Is it on your face — close to your nose or eyes?
• Is it close to your spine?
• Has it worsened rapidly?
• Has it remained unhealed for two weeks?

If you answered yes to any of these questions, you should see a doctor. Your infection could lead to more serious problems.

Medical treatment

Your doctor will use one or more of the following medical treatments to heal your carbuncle:

• Antibiotics. These are taken orally or applied to your skin.
• Pain relievers. Over-the-counter medications are typically sufficient.
• Antibacterial soaps. These may be suggested as part of your daily cleaning regimen.
• Surgery. Your doctor may drain deep or large carbuncles with a scalpel or needle.

You should never try to drain a carbuncle yourself. There’s a risk that you’ll spread the infection. You could also end up infecting your bloodstream.

Home care

To soothe your pain, speed healing, and lower the risk of spreading the infection:

• Place a clean, warm, moist cloth on your carbuncle several times a day. Leave it on for 15 minutes. This will help it drain faster.
• Keep your skin clean with antibacterial soap.
• Change your bandages often if you’ve had surgery.
• Wash your hands after touching your carbuncle.

Carbuncles typically respond well to medical treatment. In some cases, they may heal without medical intervention.

Your first infection may result in repeated infections in the future. See your doctor if this happens. It could be a sign of a more serious health problem.

Proper hygiene reduces your risk of developing a carbuncle. Follow these prevention tips:

• Wash your hands before eating and after using the bathroom.
• Shower often to keep your skin free of bacteria.
• Avoid squeezing boils or rubbing any broken skin.
• Wash clothes, sheets, and towels regularly in hot water.

See your doctor if you think you have a chronic illness or other skin issues that may be causing breaks in your skin.

Last medically reviewed on June 28, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Boils and carbuncles. (2016).
  my.clevelandclinic.org/health/diseases/15153-boils–carbuncles
• Dhar DA. (n.d.). Folliculitis and skin abscesses.
  merckmanuals.com/home/skin-disorders/bacterial-skin-infections/folliculitis-and-skin-abscesses
• Mayo Clinic Staff. (2018). Boils and carbuncles.
  mayoclinic.org/diseases-conditions/boils-and-carbuncles/symptoms-causes/syc-20353770

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

May 22, 2023

Written By

Chitra Badii

Edited By

Debbie Nurmi

Jun 28, 2018

Medically Reviewed By

Debra Sullivan, PhD, MSN, RN, CNE, COI

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Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Chitra Badii — Updated on May 22, 2023

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90,000 photos, in the ear, on the face, on the pope; treatment

What is a boil

Furuncle (in everyday life “boil”) is an acute purulent inflammation of the hair follicle, sebaceous gland and surrounding subcutaneous fat and skin. Most often, a boil occurs on the neck, back of the head, face, back, buttocks (“on the pope”) and thighs. A condition in which several boils form on the body at the same time (in one place and / or in different places) is called “furunculosis”.

Hair consists of shaft and root; the latter is located in the hair follicle. The ducts of the sebaceous and sweat glands flow into the hair follicle. In turn, the hair follicle is immersed in the skin and subcutaneous fat. Infection from contaminated and / or injured skin enters the hair follicle, where bacteria multiply. Then the infection penetrates into the sebaceous glands, clogging their ducts, and spreads to the subcutaneous fat. A purulent focus is formed with a hair follicle in the center.

The cause of infection in a boil in 80% of cases is a staphylococcal infection. The development of the disease is facilitated by a decrease in immunity, diabetes mellitus, purulent discharge in rhinitis, pharyngitis, frequent skin contamination, trauma, skin scratches, etc.

boil). When maturing, the boil, as a rule, opens on its own; while the “rod” comes out, the signs of inflammation (soreness, swelling, redness) decrease. In place of the “rod” of the boil, a scar is formed.

A boil (furunculosis) is diagnosed by a therapist, family doctor, pediatrician, dermatologist, surgeon using an external examination.

Treatment of boils is conservative with antiseptic treatment of the skin and resolving, anti-inflammatory ointments, such as ichthyol. UHF and dry heat are also used.

Without treatment, a boil is complicated by an abscess, phlegmon, inflammation of a nearby vein (phlebitis), lymphatic vessels (lymphangitis), arthritis, pyelonephritis, encephalitis, and even sepsis. With the threat of complications, the surgeon performs an operative opening of the boil and the installation of drainage to improve the outflow of pus. The procedure is performed under local anesthesia.

Prevention of boils and furunculosis comes down to personal hygiene, prevention and timely treatment of skin microtraumas, avoidance of contact with irritating chemical compounds, strengthening of immunity, etc. ie skin;

chronic diseases: diabetes mellitus, HIV infection, otitis media, rhinitis, sinusitis, pharyngitis, frequent acute respiratory viral infections, etc. ;

Symptoms and types of boils

In its development, the furuncle goes through 3 successive stages.

At the stage of infiltration (“boiling”), there is redness, swelling of the skin around the infected hair follicle; pain and fever in that area.

After 2-4 days, a purulent-necrotic “rod” is formed around the hair with an infected hair follicle, which breaks through a thin tissue cover and comes out (“boil breakthrough”). Relief comes immediately: pain, swelling and local redness decrease.

After rejection of the “core” of the furuncle, a skin defect similar to an ulcer is formed in its place, which heals within a week – is replaced by connective tissue with the formation of a scar (scar).

Let’s consider the common types of boils.

Furuncle in the ear – occurs, as a rule, in children with infection from dirty hands when scratching the skin; with improper hygienic care of the ears. The development of the disease contributes to hypothermia, otitis media, SARS. Initially manifested by itching and discomfort; later, redness, swelling of the skin, sometimes strong “shooting” pain, radiating to the head and upper jaw, is formed. The pain is aggravated by touch. At the site of redness, a tubercle with a purulent center is formed. At this stage, a local increase in temperature can develop into a general fever – an increase in body temperature up to 38 degrees.

Conservative treatment includes treatment with antibacterial and anti-inflammatory sprays, creams, ointments, ear drops. If the abscess does not resolve on its own, the surgeon opens it with a small incision and installation of drainage. Untimely or incorrect opening of the abscess can provoke purulent otitis media, meningitis, osteomyelitis and sepsis.

Furuncle on the face in most cases is localized near the upper lip, nose and eyes. More often suffer people with a tendency to acne and pimples. The symptoms are similar to those of a furuncle in the ear, but the pain is less pronounced. A boil on the face cannot be opened on its own, especially squeezed out, as this can lead to serious complications: phlebitis and thrombosis of the veins of the face, meningitis, sepsis.

The furuncle on the buttock is very painful, it interferes with walking, lying down and sitting. As the “rod” of the boil matures, a dense painful tubercle forms on the skin, on the surface of which a white dot appears. The skin around the tubercle swells and turns red. There is a local increase in temperature. The “ripening” of a boil on the buttock lasts up to 4 days. After opening the abscess and getting pus with bacteria on the skin, an antibiotic ointment should be used to prevent new boils.

Carbuncle

Carbuncle is an acute purulent inflammation of the skin, subcutaneous fat and sebaceous glands, which begins with infection and inflammation of several hair follicles at once. This distinguishes a carbuncle from a furuncle, in which only one hair follicle becomes infected. The carbuncle is usually localized on the back of the neck, face, back and buttocks. In ⅘ of cases, the cause of infection in carbuncle is staphylococcus aureus.

Damage to several hair follicles at the same time determines the more severe course of the carbuncle in comparison with the furuncle. As a rule, not only a local increase in temperature is noted, but also a general fever, chills, nausea and vomiting as a manifestation of intoxication of the body. The skin over the carbuncle first turns red, then turns blue and even blackens. After opening the abscess, several funnel-shaped sores are formed, which merge into one wound with a dirty gray bottom and undermined edges. In addition to local treatment for carbuncle, it may be necessary to prescribe antibiotics and remove intoxication with intravenous infusions of saline and colloidal solutions.

Diagnosis of a boil

It is not difficult for a therapist, family doctor, pediatrician, dermatologist, surgeon, because the boil has a characteristic appearance.

In case of furunculosis, it is necessary to establish the cause of the disease (diabetes mellitus, HIV infection, etc.), which may require consultation of an endocrinologist, infectious disease specialist and other specialists.

Furuncle treatment

Immediately after infection, an abscess can be prevented with UV and UHF therapy. But this rarely succeeds.

The maturation of an abscess can be accelerated with alcohol, warm compresses and dry heat.

After opening the abscess, apply a bandage with hypertonic solution to improve the discharge of pus, as well as bandages with antiseptics to prevent re-infection.

In order to avoid the spread of infection and, as a result, serious complications, it is impossible to open the boil on your own – ignite the cover of the rod or squeeze out the pus. Only a surgeon can open a boil, who notches the cover of the abscess, removes the “rod” and drains the wound to improve the outflow of pus.

In addition to topical treatment, antibiotics, painkillers, antipyretics may be required; removal of intoxication, stimulation of immunity, etc.

Prevention of boils

To avoid illness, follow the recommendations:

• avoid hypothermia;
• observe the rules of personal hygiene: take a shower daily;
• avoid trauma and microtrauma of the skin; timely treat damaged skin with antiseptics;
• avoid contact with irritants, liquids; with industrial and household dust;
• timely treat infectious diseases: otitis media, rhinitis, sinusitis, SARS;
• maintain normal blood sugar levels;
• take a multivitamin in spring and fall; strengthen immunity.

Which doctor to contact

At the first sign of a boil or carbuncle, consult a general practitioner, family doctor, pediatrician, dermatologist, surgeon. Contact the doctors of the Botkin.pro medical video consultation service. See how our doctors answer patients’ questions. Ask a question to the service doctors for free, without leaving this page, or here. Consult with your favorite doctor.

Questions from patients – answers from doctors Botkin.pro online:

• Wound after a boil

  The wound after a boil on the spine in the area of ​​the coccyx does not heal, although the pus has come out. Bleeding without pus for 4 days. Levomekol does not help

  Perhaps this is not a furuncle, but a coccyx cyst; I need a surgeon to look. Instead of Levomekol, you can put Betadine. Not much time has passed yet.

Removal of a boil in the clinic “Deka” in Moscow

Navigation:

The disease associated with the appearance of boils is called furunculosis. Along with some other inflammations, the furuncle belongs to the group of pyoderma, that is, skin pathologies of a purulent-inflammatory nature. The most common causes of a boil are increased sweating and sebum secretion, pollution, skin microtrauma (for example, shaving cuts), decreased immunity, malnutrition, metabolic disorders, etc. quite right.

The following factors contribute to the appearance of boils:

• excessive sweating, as constant excessive sweating breaks the structure and protective properties of the skin;
• frequent injuries and microtraumas of the skin (abrasions, scratches, abrasions), through which infections can easily penetrate;
• scratching and skin lesions caused by various diseases;
• constant skin contact with discharge from the nose and ears in case of otitis media, rhinitis, etc.;
• poor hygiene;
• decrease in the protective properties of the skin due to the harmfulness of the profession (constant contact with dust, lubricants, aggressive chemicals, etc.)

As a rule, the formation of single boils is associated with any of the above external factors affecting the skin. And if we are talking about the systematic appearance of acute purulent inflammation of the hair follicles and sebaceous glands on the skin, most likely, furunculosis is provoked by hormonal disorders or a decrease in immunity. In such cases, for the successful treatment and prevention of furunculosis, you need to work with the cause – take immunomodulating drugs or conduct hormone therapy.

Complications

A furuncle cannot be called a “harmless pimple”: in addition to severe pain, deterioration of well-being, the lack of treatment leads to serious complications. In this case, we can talk about local and general complications. The local ones include phlegmon, carbuncle, abscess and even erysipelas (a chronic infectious disease). Common complications of a boil can be: lymphangitis, lymphadenitis, sepsis, arthritis, abscesses of internal systems and organs, including the brain. Boils on the face and neck are especially dangerous.

Why is a boil on the face dangerous? An attempt to squeeze a boil on the face can lead to the infection penetrating into the venous bed and causing the development of thrombophlebitis, that is, inflammation of the venous walls with the formation of blood clots. The face in such cases acquires a bluish tint, becomes swollen, any touching it brings pain, often the body temperature rises to 40⁰C. The infection can spread into the cranial cavity and lead to meningitis, meningoencephalitis, sepsis. In purulent surgery, there is such a rule: boils on the face located above the upper lip require great care, and here the patient’s “self-activity” is highly undesirable.

In general, the appearance of a boil anywhere on the face or body should be taken seriously. The furuncle of the abdomen, neck, thigh is “capable” of bringing very painful sensations and disrupting plans for the next week. And its improper treatment will prolong suffering or bring unnecessary complications.

Furuncle: treatment

Treatment will directly depend on the stage of the disease. This can be both therapeutic treatment and surgical removal of the boil.

Infiltration stage. The appearance of an infiltrate is observed on the skin – an area with redness, swelling and induration. The infiltrate is painful, gradually increasing in size (up to 1-3 cm on average). What is characteristic: the formation of an infiltrate always occurs around the hair, because staphylococci primarily affect the hair follicle, multiplying inside it. In everyday life, this stage is simply called “boil ripens”.

The main goal of treating a boil at this stage is to accelerate the maturation of the boil. The doctor recommends applying dry heat, ichthyol compresses to the lesion, lubricating the surface of the boil and the area around it with antibacterial ointment, prescribing physiotherapeutic procedures (UHF, laser).

Purulent-necrotic stage. It occurs 2-4 days after the first symptoms appear: a purulent core forms in the center of the infiltrate, its end is visible above the surface (like an abscess). At a certain point, the thin tissue that covers the rod bursts, after which pus and dead tissue begin to come out. The patient feels a significant relief of all symptoms, swelling and redness, pain decreases.