What are boils and carbuncles. How do they form. What are the common symptoms of these skin infections. Which treatments are most effective for managing boils and carbuncles. When should you seek medical attention for a boil.

Understanding Boils: Common Skin Infections

Boils are painful, pus-filled bumps that develop beneath the skin when hair follicles become infected. These common skin infections, also known as skin abscesses, typically start as small, red lumps and gradually increase in size as they fill with pus. While often manageable with proper home care, some cases may require medical attention.

The primary culprit behind most boils is Staphylococcus aureus, a type of bacteria that many people carry on their skin or in their nasal passages without experiencing any issues. However, when these bacteria enter the body through small breaks in the skin, such as cuts, scrapes, or even clogged pores, they can trigger an infection.

Common Locations for Boils

• Face and neck
• Armpits
• Shoulders and back
• Buttocks
• Inner thighs
• Areas around the ears or nose

Boils tend to develop in areas that are hairy, sweaty, or subject to friction. This explains why they frequently appear in the locations mentioned above.

Recognizing the Symptoms of Boils

Identifying a boil early can help in managing the infection more effectively. What are the telltale signs of a boil? Here are the primary symptoms to watch for:

• A small, red bump that gradually enlarges
• Increasing pain and tenderness in the affected area
• Swelling and redness around the bump
• Development of a white or yellow center as pus accumulates
• Eventual rupture and drainage of the boil

In some cases, individuals may experience additional symptoms such as fatigue, general malaise, or a low-grade fever. These systemic symptoms warrant prompt medical attention, as they may indicate a more severe infection.

Carbuncles: When Boils Cluster Together

While individual boils are common, sometimes multiple boils can develop in close proximity and merge beneath the skin. This cluster of boils is known as a carbuncle. Carbuncles are typically larger, more painful, and take longer to heal than single boils.

Who is at higher risk for developing carbuncles? Men are more prone to carbuncles than women, and they often appear on the back or neck. However, carbuncles can form anywhere on the body and may require more aggressive treatment than individual boils.

The MRSA Connection: A Concerning Variant

While most boils are caused by common staph bacteria, some may be the result of methicillin-resistant Staphylococcus aureus (MRSA). MRSA infections can closely resemble ordinary boils, presenting as red, swollen, and tender skin lesions filled with pus. However, MRSA is resistant to many common antibiotics, making it potentially more dangerous if left untreated.

How can you differentiate between a standard boil and a MRSA infection? The key lies in the response to treatment. If a skin infection doesn’t improve after 2-3 days of antibiotic treatment or continues to spread, your healthcare provider may suspect MRSA. Prompt and appropriate treatment is crucial for managing MRSA infections and preventing more serious complications.

Risk Factors and Prevention Strategies

While anyone can develop a boil, certain factors may increase the risk. Understanding these risk factors can help in implementing preventive measures:

• Close contact with infected individuals
• Presence of skin conditions like acne or eczema
• Diabetes
• Weakened immune system

How can you reduce your risk of developing boils? Here are some effective prevention strategies:

1. Practice good hygiene, including regular handwashing
2. Keep cuts, scrapes, and other skin injuries clean and covered
3. Avoid sharing personal items like towels, razors, or clothing
4. Maintain a healthy lifestyle to support your immune system
5. Manage underlying health conditions effectively

Home Care for Boils: Promoting Healing

Most boils can be effectively managed at home with proper care. What are the key steps in treating a boil at home? Follow these guidelines:

1. Apply warm, moist compresses to the affected area several times a day. This helps draw the pus to the surface and encourage drainage.
2. Once the boil begins to drain, keep the area clean and continue applying warm compresses. Use a fresh, clean compress each time.
3. Cover the draining boil with a sterile bandage, changing it frequently to maintain cleanliness.
4. Wash your hands thoroughly before and after caring for the boil to prevent spreading the infection.
5. Avoid squeezing or attempting to pop the boil, as this can lead to further infection or scarring.

Is it safe to use over-the-counter treatments for boils? While some topical antiseptics or antibiotic ointments may be helpful, it’s best to consult with a healthcare provider before applying any medications to a boil. They can provide guidance on the most appropriate treatment based on the severity and location of the infection.

When to Seek Medical Attention

While many boils resolve with home care, some situations require professional medical intervention. When should you consult a doctor for a boil? Seek medical attention if:

• The boil is extremely painful or large
• It doesn’t improve after a week of home treatment
• You develop a fever or other systemic symptoms
• The boil is located on your face, near your spine, or in the anal area
• You have a medical condition that compromises your immune system
• The skin around the boil becomes red, warm, and swollen, indicating potential cellulitis

In these cases, a healthcare provider may need to drain the boil professionally or prescribe antibiotics to manage the infection effectively.

Related Skin Conditions: Beyond Boils

While boils are a common skin infection, several related conditions can present similar symptoms or develop from similar causes. Understanding these conditions can help in distinguishing them from boils and seeking appropriate treatment:

Folliculitis

Folliculitis is an inflammation or infection of hair follicles that can sometimes progress to become a boil. It appears as tiny pimples with whiteheads around individual hairs, often accompanied by redness. While typically less painful and superficial than boils, folliculitis can be itchy and uncomfortable.

What causes folliculitis? Like boils, it’s often triggered by staph bacteria entering the skin through small cuts or abrasions. Shaving and friction from tight clothing are common culprits in introducing bacteria beneath the skin surface.

Cystic Acne

Cystic acne is a severe form of acne that leads to the formation of deep, painful cysts beneath the skin. These cysts develop when oil and dead skin cells clog hair follicles, creating an environment where bacteria can thrive. Unlike regular acne, cystic acne affects deeper layers of skin tissue.

Where does cystic acne typically appear? It’s most commonly found on the face and shoulders, and often occurs during the teenage years. However, it can persist into adulthood for some individuals.

Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic condition characterized by recurring lumps and pus-filled abscesses in certain areas of the body. It typically affects areas where skin rubs against skin, such as the armpits, groin, and under the breasts.

What causes hidradenitis suppurativa? The condition starts when sweat glands and hair follicles become blocked. While mild cases may respond to home care, more severe or recurring instances often require medical intervention. Several treatments are available to manage this challenging condition.

Pilonidal Abscess

A pilonidal abscess is a specific type of boil that forms in the skin just above the buttocks crease. These abscesses are believed to be related to ingrown hairs, and factors such as prolonged sitting, friction, and pressure may contribute to their development.

Some individuals are born with a “pilonidal dimple,” a small pit in the skin that can be prone to infection. If a pilonidal cyst becomes inflamed and infected, it transforms into an abscess. Any signs of infection in this area warrant medical attention due to the risk of complications.

Styes

A stye, often referred to as a “stye on the eye,” is essentially a boil that develops on the eyelid. Like other boils, styes are typically caused by staph bacteria infecting an eyelash follicle. They present as red, warm, and swollen bumps on the eyelid, often causing discomfort.

How can you differentiate a stye from a chalazion? While both appear as lumps on the eyelid, a chalazion is usually painless and results from a blocked oil gland rather than an infection. Proper identification is crucial for determining the appropriate treatment approach.

Understanding these related conditions can help individuals recognize when they’re dealing with a simple boil versus a potentially more complex skin issue. When in doubt, consulting with a healthcare provider can ensure accurate diagnosis and appropriate treatment.

Advanced Treatment Options for Persistent Boils

While most boils respond well to home care or basic medical interventions, some cases may require more advanced treatment approaches. What options are available for managing persistent or recurrent boils?

Incision and Drainage

For large or deep boils that don’t drain on their own, a healthcare provider may perform an incision and drainage procedure. This involves making a small cut in the boil to allow the pus to drain out. While this can be uncomfortable, it often provides immediate relief and promotes faster healing.

Antibiotic Therapy

In cases where boils are severe, recurring, or potentially caused by MRSA, oral antibiotics may be prescribed. The choice of antibiotic will depend on the suspected bacteria and any known antibiotic resistances. It’s crucial to complete the full course of antibiotics as prescribed, even if symptoms improve quickly.

Culture and Sensitivity Testing

For recurrent or treatment-resistant boils, your healthcare provider may take a sample of the pus for culture and sensitivity testing. This helps identify the specific bacteria causing the infection and determines which antibiotics will be most effective in treating it.

Addressing Underlying Conditions

If boils are a recurring problem, it may be necessary to investigate and address any underlying health conditions. This could include managing diabetes more effectively, addressing skin conditions that increase infection risk, or evaluating for potential immune system disorders.

Decolonization Protocols

For individuals who frequently develop boils or carry antibiotic-resistant bacteria, healthcare providers may recommend a decolonization protocol. This typically involves using special antiseptic washes or ointments to reduce the bacterial load on the skin and in the nasal passages.

By understanding these advanced treatment options, individuals dealing with persistent or severe boils can work with their healthcare providers to develop an effective management plan. Remember, early intervention and proper care are key to preventing complications and promoting quick healing of boils and related skin infections.

Pictures on Skin, Causes, and Treatment

Medically Reviewed by Dany Paul Baby, MD on June 26, 2022

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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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REFERENCES:

Nemours Foundation: “Staph Infections.”

Skinsight.com: “MRSA.”

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?”

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Pictures of What They Look Like

Medically Reviewed by Stephanie S. Gardner, MD on November 22, 2022

It’s a lump of fluid, air, or something else. Cysts are very common, and most aren’t cancer. You may need tests (like a CT scan, ultrasound, or biopsy) to confirm that it’s a cyst. They do not go away, but often, cysts don’t need treatment. Your doctor can let you know if yours does. You can get cysts in many different parts of your body, and you may not even know that they’re there.

You get acne when oil and dead skin block a pore. This often causes a small growth, or “pimple,” that goes away on its own or with over-the-counter drugs. If it’s more serious or a pimple gets very irritated, you might get a larger squishy growth called a cyst. (Hard growths are called nodules.) Talk to your doctor about treatment including antibiotics and other medications for your cysts.

A soft, fluid-filled lump can form at the back of your knee if you injure the joint because of arthritis, inflammation, a torn ligament, or other causes. You might mistake it for a blood clot. Rest with your leg raised up and ice the area for 15 minutes at a time. Anti-inflammatory drugs could also help. In some cases your doctor may suggest surgery or use a needle to drain it or inject steroids to lessen swelling.

The tiny Bartholin glands are deep under the skin on either side of the vagina opening. Their job seems to be to make fluids for sex. If something blocks a duct in one of these glands, it fills with mucus and gets bigger. It could even get infected and form a sore called an abscess. Tub soaks can help. In serious cases, your doctor might do surgery to create a permanent drain or remove the cyst.

You might notice one or more smooth lumps with clear edges on your breast, but you can’t always feel them. They may hurt in the days just before your period starts or when you have lots of caffeine. They’re very common and more likely right before menopause, or afterward, if you take replacement hormones. You don’t usually need to treat them, but see your doctor about any breast lump because it may be something more serious than a cyst.

In the womb, a baby’s bladder connects to its belly button through a channel called the urachus in the abdominal wall gut. If it doesn’t close by the time you’re born, a small lump of tissue and fluid (a cyst) can grow there. If it gets infected, you could have belly button pain, fever, and bloody urine. Your doctor may give you antibiotics, drain or remove the cyst, and possibly repair the area with surgery.

Here, something blocks a gland around a hair or irritates the opening (follicle) that holds it, often on your face, ear, head, trunk, or groin. That causes a bump to grow slowly under the skin. It’s usually soft enough to move when you touch it.  Usually, it doesn’t hurt, but you might notice a bad smell. Smaller ones usually go away on their own, but your doctor may need to drain or remove larger, swollen, or painful cysts.

A loose hair gets pushed back into the skin. Your body sees it as a threat and builds a pocket around it that holds dead skin and fluid. You might notice irritation at the base of your spine in the crease where your buttocks start.  If it gets infected, it can become very painful and may need to be drained or removed. Younger men get it more often, as do people who sit a lot, aren’t active, or are obese.

It’s a lump filled with liquid, most often near joints or tendons on your wrist or fingers. Tendon or joint stress might cause it, but it’s not clear. It may hurt and sometimes changes in size or goes away on its own. Anti-inflammatory meds or splints might curb pain. In more serious cases, your doctor may drain it with a needle or remove it completely.

Oil from the meibomian glands around the eyelids gets too thick or the opening clogs. Either way, it builds up and inflames the gland and forms a lump. The cause is often unclear, but certain skin types get it more. You may have no pain unless it gets fairly large. Really big ones can press on your eye and blur your vision. It usually goes away on its own, and warm compresses can help. Talk to your doctor if it sticks around.

Eggs from a pork tapeworm, a parasite, can pass into your food or drink contaminated with poop. They hatch in your gut and send small round “oncospheres” through your blood to the brain, muscles, liver, and other organs where they form cysts. You doctor will probably only treat them if they’re in your brain where they could cause headaches, seizures, confusion, or other problems. You’d likely take steroids to ease inflammation.

This cyst forms inside the epididymis, a coiled tube inside a man’s scrotum that connects to their testicles and helps move sperm. It seems to happen when sperm build up at the end of the tube. It’s not cancerous and doesn’t usually hurt, but your doctor should check to be sure. It usually goes away on its own. About a third of all men will get a spermatocele in their lifetime.

It happens before you’re born if the layers of your skin don’t grow together properly, usually on the head, neck, or face. That causes a pocket that traps skin, hair follicles, sweat glands, blood, fat, nails, teeth, and other structures. It might not be noticeable until fluid builds up and makes it bigger, sometimes years after birth. Then it looks like a small lump with skin on top that’s easy to move. Your doctor will likely remove the cyst with surgery.

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12) PIXOLOGICSTUDIO / Science Source

13) SPL / Science Source

American Academy of Dermatology: “Different kinds of pimples,” “What can clear severe acne?”

American Association for Pediatric Ophthalmology and Strabismus: “Chalazion.”

American Pediatric Surgical Association: “Urachal Cysts.”

American Society for Surgery of The Hand: “Ganglion Cysts.”

Cleveland Clinic: “Spermatocele,” “Sebaceous Cysts,” “Breast Cysts,” “What is a Baker’s cyst?”

Johns Hopkins Medicine: “Sebaceous Cysts. ”

Mayo Clinic: “Pilonidal cyst.”

Merck Manual: “Tapeworm Infection,” “Bartholin Gland Cysts.”

Michigan Medicine Kellogg Eye Center: “Chalazion and Stye.”

National Center for Advancing Translational Sciences: “Urachal cyst.”

St. Louis Children’s Hospital: “Dermoid Cyst in Children.”

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Furuncle (boil) – symptoms, causes, signs and methods of treatment in adults in “SM-Clinic”

This disease is treated by a Dermatologist
, Surgeon

• About the disease
• Types of boils
• Symptoms of a boil
• Causes of boil development
• Diagnostics
• Expert opinion
• Treatment of furunculosis
• Prevention
• Rehabilitation
• Questions and answers
• Doctors

About the disease

A furuncle is also called a boil. It occurs more often in adulthood. Men are affected somewhat more often than women. The main peak of incidence falls on the autumn and spring periods, when the body’s defenses weaken.

Unlike ostiofolliculitis and folliculitis, the formation of a furuncle is accompanied by the involvement of the surrounding tissue in the inflammatory process. This is due to the severe course of the disease.

On places devoid of hair (palms and palmar surface of the fingers, soles) boils do not develop. Most often they occur on areas of the skin that are subject to contamination (forearms, back of the hand) and friction (back of the neck, lower back, gluteal region, thighs).

Types of boils

Depending on the number of formations, single and multiple boils are distinguished. In the latter case, the disease is called furunculosis.

In the process of development, pathology passes through three successive stages:

• infiltrative: accompanied by tissue infiltration;
• purulent-necrotic: characterized by purulent fusion of the central part of the boil and the formation of a purulent-necrotic rod;
• healing stage: begins from the moment of spontaneous or artificial opening of the abscess and lasts until the formation of a scar.

Symptoms of a boil

At the initial stage of the development of the disease, the patient feels slight itching and tingling. On the 1st-2nd day, a formation appears that protrudes conically above the skin. The tissues turn red and become painful when touched. As the boil matures, a head appears on its top – a small accumulation of pus with a black dot in the center.

On the 3-7th day in the form of a rod, together with the remnants of the hair, they are excreted with pus. The resulting wound is cleaned, filled with granulation tissue and healed. The swelling around it gradually decreases, the pain disappears. A small, whitish, somewhat retracted scar remains at the site of inflammation.

Multiple lesions of boils that appear simultaneously or sequentially one after another in different parts of the body – called furunculosis. A disease that lasts with small remissions for several years is considered chronic, relapsing.

Furuncle usually does not cause significant disturbances in well-being. With the defeat of a significant amount of tissue, symptoms of intoxication appear: weakness, headaches, fever. The intensity of pain depends on the location of the formation. In the face area (lips, forehead), as well as on the scrotum, the formation of a boil is accompanied by swelling of the surrounding tissues, which is explained by the looseness of the subcutaneous tissue.

Causes of the development of a boil

The main cause of the development of a furuncle is the defeat of the hair follicle or its surrounding tissues by Staphylococcus aureus, rarely white. An important factor is also a decrease in general or local immunity against the background of chronic diseases, metabolic disorders, and infections. Pathology occurs especially often in patients with diabetes mellitus, obesity, chronic liver and kidney damage, oncological diseases, etc. Infection of tissues often occurs against the background of skin damage: scratches, cuts, abrasions, constant exposure to sweat or purulent discharge (from the nose, ears).

The causes of localized furunculosis are most often incorrect methods of therapy and ignoring the doctor’s recommendations (use of compresses, undertreatment of residual compaction, washing the place where the elements appear).

Get advice

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by phone:

+7 (495) 292-39-72

Request a call back
Book online

Why SM-Clinic?

1

Treatment is carried out in accordance with clinical guidelines

2

Comprehensive assessment of the nature of the disease and treatment prognosis

3

Modern diagnostic equipment and own laboratory

9000 2 4

High level of service and balanced pricing policy

Diagnosis

Diagnosis of boils is not difficult. During a visual examination of the patient, a dermatologist discovers a characteristic formation. Its appearance allows you to assess the stage of development of the disease. During the conversation, the doctor determines the possible cause of the development of boils, identifies risk factors. For an accurate diagnosis and determination of the pathogen, bakposev of the discharge is prescribed. In case of multiple lesions, additional diagnostics is carried out:

• general and biochemical blood test;
• immunogram;
• assessment of hormone levels;
• examination by ENT, endocrinologist and other specialists;
• examination of internal organs, paranasal sinuses, lungs, etc. depending on the specific clinical situation.

Expert opinion

Furuncle is a rather serious disease, which should be treated with great care. In no case should you self-medicate: you should not make compresses, use various ointments – in most cases this leads to the spread of the inflammatory process.

A complication of a boil can be lymphadenitis and lymphangitis (damage to the lymphatic vessels and nodes). Of particular danger are rapidly progressing acute thrombophlebitis and sepsis.

Acute thrombophlebitis usually develops with boils located near the large saphenous veins, and sepsis – with boils of the face. They are often the result of attempts to squeeze out the contents of the boil, cutting it off during shaving, trauma during massage. The prognosis for these complications is very serious.

Omarova Andzhelika Mutaevna

Coloproctologist, surgeon, Ph.D.

Treatment of furunculosis

Treatment of furuncle is only surgical, because no other therapy will be successful if the focus of purulent inflammation is not removed or opened and drained in a timely manner.

The opening of the boil is usually performed under local anesthesia and is painless for the patient. At the same time, antibiotic therapy, means for correcting immunity and eliminating background pathologies, if any, are prescribed.

Simple (uncomplicated) lesions can be treated on an outpatient basis and do not require hospitalization. But in case of a severe course, if the patient develops swelling of the soft tissues of the cheek, lip or eye, urgent hospitalization is necessary in the surgical department to constantly monitor the development of the process and prevent complications.

Strict bed rest and appropriate therapy are prescribed for high fever.

Prevention

To minimize the risk of developing boils, it is necessary to regularly cleanse the skin of impurities and fully treat any tissue damage. People with hyperhidrosis and/or excess sebum need to pay special attention to hygiene. General measures are also important: proper nutrition, a healthy lifestyle, timely treatment of acute and chronic diseases.

Rehabilitation

After opening an uncomplicated boil, the patient goes home after 1-2. In the next 2 weeks, he needs to regularly visit a doctor for dressings, take prescribed medications. It is strictly forbidden to play sports, swim in open water or pools, overheat.

Questions and Answers

No. Self-medication and the use of folk remedies can cause complications.

Yes, when a purulent focus is located on the face, the infection can go to the meninges.

Gostishchev Victor Kuzmich. Clinical operative purulent surgery. Guide for doctors. GEOTAR-Media, 2016

Rodionov Anatoly Nikolaevich, Sydikov Akmal Abdikaharovich, Zaslavsky Denis Vladimirovich. Clinical dermatology. Illustrated guide for doctors. GEOTAR-Media, 2022

Nikolsky V. Yu., Imbryakov K. V. Furuncles and carbuncles of the face // Russian Dental Journal. 2013. No. 5.

Okulich V.K., Fedyanin S.D. RATIONAL USE OF ANTIBACTERIAL DRUGS IN PATIENTS WITH PURULENT WOUNDS, FURUNCULOSIS, BOILS AND CARBUNCULES // Bulletin of the Voronezh State Medical University. 2003. No. 4.

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Diseases referred by the Surgeon

Soft tissue abscess
liver abscess
Appendicitis
Ascites
Atheroma
femoral hernia
Crohn’s disease
Gangrene
soft tissue hematoma
Giant cell tumor of bone
Hygroma
festering wounds
Hernia
Hernia of the white line of the abdomen
hiatal hernia
Diastasis rectus abdominis
Intestinal diverticulosis
Cholelithiasis
Keratoma
liver cyst
pancreatic cyst
salivary gland cyst
Neck cyst
stab wound
stab wound
Lipoma
Mechanical jaundice
Bowel obstruction
burns
Oleogranuloma
kidney tumor
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treatment, opening, removal, treatment and ointments

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3. Boil: treatment / ointment / cream / remedies0006

What is a boil?

Furuncle is an infection of the hair follicle leading to the formation of a cavity with accumulation of pus and dead tissue ^{1. 8} .

Both a single furuncle and furunculosis may appear – many boils at different stages of development.

According to the international classification of diseases (ICD-10) , diseases accompanied by the appearance of a boil are indicated by the name “Skin abscess, furuncle and carbuncle” and have the code L02 .

Formation of a boil

What symptoms may accompany the appearance of a boil?

• The appearance of nodules (papules) of various sizes, sometimes with an abscess
• Localization of lesions in the face, neck, thighs, buttocks
• Infection of neighboring follicles and the formation of a larger abscess, known as a carbuncle
• Scar formation after healing of lesions defeat

Causes of a boil

• Staphylococcus aureus (S. aureus) is the most common causative agent, but other bacteria can also cause infections.
• For example, with boils in the genital area, as well as the buttocks, intestinal bacteria such as enterobacteria (Enterobacteriaceae) and enterococci (Enterococci) become frequent pathogens ^{1. 7} .
• In addition, corynebacteria (Corynebacterium), epidermal staphylococcus (S. epidermidis) and beta-hemolytic streptococcus group A (S. pyogenes) can be the causative agents of infection in a boil.
• Recurrent boils are most often caused by methicillin-resistant Staphylococcus aureus (S. Aureus) ¹ .

Factors that provoke the appearance of a boil

In addition to the direct effect of the pathogen, various provoking factors can contribute to the onset of the disease:

• Physical contact with infected people
• Anemia

9000 5 Prior antibiotic therapy

• Diabetes mellitus
• Poor personal hygiene
• Decreased immunity
• Skin diseases (atopic dermatitis, chronic wounds or ulcers on the legs)
• Obesity and hematological disorders

How does a boil occur?

Maturation stage:

• Formation of edematous and painful thickening (infiltrate) of bright red color.
• Accumulation of fluid in a closed cavity, as indicated by the appearance of a symptom of fluctuation (fluctuation) in the central part of the seal.
• Formation of a purulent-necrotic shaft (hair base surrounded by pus and dead tissue).
• Opening of a boil with separation of purulent-necrotic masses.

Healing stage:

• Filling the formed “capacity” with young connective tissue (granulation).
• Scar formation (scar, rough connective tissue) ⁸ .

Diagnosis

The diagnosis is made on the basis of a visual examination and data from various research methods that a doctor can choose:

During visual inspection of , attention should be paid to the presence of a seal (infiltrate), in which 1 purulent core is located.

Culture of swabs from lesions is performed to identify the pathogen and determine its sensitivity to antibiotics.

Blood chemistry – to detect diabetes (glucose or glycated hemoglobin (HbA1c)).

Complete blood count – to exclude systemic infection and diseases of internal organs (an increased number of leukocytes, an increased erythrocyte sedimentation rate indicate severe inflammation).

Enzyme-linked immunosorbent assay (ELISA) – detection of HIV infection in relapses of the disease ¹ .

How is a boil treated?

Several approaches are used in the treatment of a boil.

Surgical treatment

It is important to note that surgical treatment is carried out at the stage when a closed cavity filled with pus has formed in the boil.

• An abscess (accumulation of purulent contents) is opened.
• After an incision, cotton and gauze swabs may need to be inserted into the wound to remove liquid content (drainage).

Treatment directed at the pathogen (etiotropic treatment)

Etiotropic treatment consists in the appointment of systemic antimicrobial drugs that act on the pathogen. It is carried out in the presence of symptoms of acute inflammation: high body temperature, headache, general weakness, lethargy, as well as in the presence of a boil on the face and multiple boils – furunculosis ^1.8 .

Please note that squeezing out the contents of the boil and doing massage near it is strictly prohibited!

Topical treatment of a boil depending on the stage of development

Stage of induration (infiltration) development

At the stage of formation of a painful edematous induration, the skin is treated with 70% alcohol or a solution based on povidone-iodine (Betadine ^® ) . Antibiotics, electrophoresis with antiseptics can also be used.

In order to accelerate the maturation of the boil, it is recommended to apply warm compresses with 20–30% ethyl alcohol or 5–10% aqueous solution of ichthyol for 1–3 days. It is also possible to use ointments containing the following medicines ¹⁰ :

• Povidone-iodine (Betadine ^® ) has an antiseptic effect, thanks to the macrogol in its composition, it helps to “pull out” pus. Promotes the destruction of harmful microorganisms and reduces the inflammatory process.
• Kalanchoe (phytopreparation) has an anti-inflammatory and regenerating effect.
• Dimethyl sulfoxide has anti-inflammatory, antiseptic and analgesic effects.
• Tar and xeroform have an antimicrobial and regenerating effect.
• Pine oleoresin , which has an antimicrobial and regenerating effect.
• Ichthyol has antimicrobial, anti-inflammatory, keratoplastic (accelerates the formation of the stratum corneum) and analgesic effect.
• Salicylic acid which softens the stratum corneum and has an antimicrobial effect.

After opening the boil, it is advisable to accelerate the separation of purulent-necrotic masses (purulent core). Therefore, therapeutic tactics include the removal of liquid contents (drainage), the application of dressings with hypertonic solution, as well as ointments with proteolytic enzymes (Clostridiopeptidase A + Chloramphenicol), which have antibacterial, wound cleansing and wound healing effects.

Healing stage

It is recommended to apply sterile gauze soaked in a disinfectant, such as povidone-iodine (Betadine 9) to the central part of the lesion.0235 ® ) and ichthyol along the edge. It is possible to carry out physiotherapeutic procedures, for example, surface UHF therapy, infrared radiation.

At any stage of development of a boil, antiseptic treatment is very important, which helps to avoid the spread of infection and destroy the infection in the boil.

Antiseptic treatment of boils with preparations based on povidone-iodine (Betadine®)

Iodophors have proven themselves as a local antiseptic. Iodophors consist of complexes of iodine molecules with a carrier. In aqueous solution, iodophors release iodine molecules. The best known iodophor is Betadine ^® . This drug is an iodine complex with a water-soluble polymer – povidone ¹¹ .
Preparations Betadine ^® have antimicrobial activity, act against gram-positive, gram-negative bacteria. In addition, povidone-iodine is active against fungi, viruses, and protozoa. The drug has a high safety profile ^13-15 .

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• The antimicrobial action of occurs after free iodine is separated from povidone. The release occurs gradually, so the antiseptic effect is prolonged. Free iodine quickly penetrates microbes, destroys their structures, causing the death of harmful microorganisms.
• The virucidal effect of is also achieved due to the destruction of the membranes and intracellular structures of viruses by the released iodine from the povidone-iodine complex ¹² .
• In addition, povidone-iodine, which is part of Betadine ^® , , has activity against biofilms of certain types of microbes and thereby accelerates the healing process. Biofilms are a multitude of microorganisms that stick together and prevent the healing of affected areas ¹⁵ .
• Studies show that povidone-iodine does not cause “addiction” in microbes (development of resistance to it) ¹⁶ .

Betadine ^® is available in a variety of formulations for use as an antiseptic. For the treatment of a boil, it is used in the form of a solution and ointment.

• The undiluted solution is applied to the area of ​​the boil ¹³ .
• Betadine ointment ^® is applied in a thin layer 2-3 times a day, it can be applied under an occlusive (isolating from air and water) dressing ¹⁴ .

Prevention of the occurrence of boils

• Personal hygiene is necessary, especially after touching infected skin or objects that have been in direct contact with the boil.
• Reuse or sharing of personal items (disposable/electric shavers, epilators, bedding, towels that have been in contact with infected skin) should be avoided.
• Increased environmental hygiene measures should be directed to surfaces (i.e. counters, doorknobs, tubs and toilet seats) that may come into contact with bare skin – these should be treated with antiseptics ⁹ .

Frequently asked questions

Which diseases have similar symptoms?

Carbuncle, anthrax, tularemia, acne conglobate, purulent hydradenitis, reaction to a foreign body and other types of abscesses have similar symptoms ^1.8 .

Can complications occur with furunculosis?

The most common complications of furunculosis are scarring and recurrence of the disease. There is also the possibility of developing endocarditis, pneumonia, myositis, osteomyelitis, septic arthritis, meningitis and brain abscess after infection with Staphylococcus aureus ¹ .

Which doctor should I contact?

A dermatologist will make a correct diagnosis and prescribe an effective treatment. If surgery is necessary, the assistance of a surgeon will be required. In addition, in the presence of concomitant diseases, a consultation with a therapist, endocrinologist, immunologist is needed.

Kraskovsky Fedor Yanovich

Surgeon.

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Ointment based on iodine: mechanism of action, scope. Ointment Betadine® based on povidone-iodine for the treatment of various skin diseases.

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References

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2. Winters RD, Mitchell M. Folliculitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2022.
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