Boils Causes, Symptoms, Diagnosis and Treatment

• Conditions
• Boils

Yanelquis Torres, MD

Family Medicine

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Ayesha Aslam Mughal, MD

Sleep Medicine

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Fabiola Baptiste, NP

Family Medicine

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Raga Mohamed Ali Osman

Family Medicine

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Introduction

Causes

Signs and Symptoms

Diagnosis

CBC (includes Differential and Platelets)

C-Reactive Protein CRP

Erythrocyte Sedimentation rate ESR

White Blood Cell Count WBC Count

White Blood Cell Count WBC and Differential

CBC (HH-RBC-WBC-PLT)

Medications

Treatment

Prognosis

Prevention

References

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NHS 111 Wales – Health A-Z : Boils

Overview

Boils and carbuncles are red, painful lumps on the skin that are usually caused by a bacterial infection.

Boils

Boils can develop anywhere on your skin, but you’re most likely to get one in an area where there’s a combination of hair, sweat and friction, such as the neck, face or thighs.

Over time, pus forms inside the boil, making it bigger and more painful. Most boils eventually burst and the pus drains away without leaving a scar. This can take two days to three weeks to happen.

It can sometimes be difficult to tell the difference between a boil and a spot, but boils tend to grow bigger and become more painful. Your GP should be able to diagnose a boil from its appearance.

Carbuncles

A carbuncle is a dome-shaped cluster of boils that usually develops over a few days. The areas most commonly affected are the back, thighs, or back of the neck.

A carbuncle can grow to a size of 3-10cm and will leak pus from a number of points.

You may also:

• have a high temperature of 38C (100.4F) or above
• feel generally unwell
• feel weak and exhausted

Carbuncles are less common than boils and tend to mostly affect middle-aged or older men in poor health or with a weakened immune system.

When to see your GP

See your GP if you think you have a carbuncle.

With boils, you don’t usually need to see a doctor as most boils burst and heal by themselves. But see your GP if you have a boil:

• on your face, nose or spine – this can sometimes cause serious complications
• that gets bigger and feels soft and spongy to touch – it may not burst and heal by itself
• that doesn’t heal within two weeks
• and you have a temperature and feel generally unwell

Your GP should be able to identify a boil or carbuncle by looking at it.

Further testing

Further testing, such as a blood test or skin swab, may be needed if you have:

• a boil or carbuncle that keeps returning or doesn’t respond to treatment
• multiple boils or carbuncle
• a weakened immune system caused by a condition such as diabetes, or having a treatment such as chemotherapy

Treating boils and carbuncles

Self care

Most boils get better without the need for medical treatment.

One of the best ways to speed up healing is to apply a warm, moist face cloth to the boil for 10-20 minutes, three or four times a day.

The heat increases the amount of blood circulating around the boil, which send more infection-fighting white blood cells to the area.

When the boil bursts, cover it with sterile gauze or a dressing to prevent the spread of infection. Afterwards, wash your hands thoroughly using hot water and soap.

Never squeeze or pierce a boil because it could spread the infection.

You can use over-the-counter painkillers, such as paracetamol or ibuprofen, to help relieve any pain caused by the boil.

Draining boils

If your boil doesn’t heal, your GP may decide to drain it, or refer you to hospital to have this done. They’ll usually numb the area first and then use a sterile needle or scalpel to pierce the boil.

Antibiotics

Antibiotics are usually recommended:

• for all cases of carbuncles
• if you have a high temperature
• if you develop a secondary infection, such as cellulitis (infection of the deeper layers of the skin)
• if you have a boil on your face – facial boils have a higher risk of causing complications
• if you’re in severe pain and discomfort

It’s very important to finish the course of antibiotics even if the boil goes away, otherwise the infection could return.

Treating recurrent boils and carbuncles

You’re likely to need further treatment if you keep getting boils or carbuncles.

Most people who keep getting boils are carriers of Staphylococcus aureus (staph bacteria). This means they have staph bacteria living on their skin or inside their nose.

Treatment will depend on where the bacteria are found on your body. An antiseptic soap can be used to kill the bacteria on the skin. Bacteria in the nose will need to be treated with a prescribed antiseptic cream for up to 10 days.

Causes of boils and carbuncles

Boils and carbuncles are often caused by a type of bacteria called Staphylococcus aureus (staph bacteria) that infects one or more hair follicles. Staph bacteria usually live harmlessly on the surface of the skin or in the lining of the nose.

You can get a boil when bacteria enter the skin through cuts and grazes. Your immune system responds by sending infection-fighting white blood cells to kill the bacteria.

Over time, a mixture of dead bacteria, dead white blood cells and dead skin cells build up inside the boil to form pus.

A carbuncle develops when the infection spread further beneath the skin to create a cluster of boils.

Complications of boils and carbuncles

Although most boils and carbuncles don’t cause further problems, some people develop a secondary infection.

This can range from a relatively minor (though often very painful) infection of the deeper layer of the skin, such as cellulitis, to rarer and more serious complications, such as sepsis.

Larger boils and carbuncles can also lead to scarring.

Preventing boils and carbuncles

You can’t always avoid getting a boil or carbuncle, but these simple steps can reduce your risk:

• wash your skin regularly using a mild antibacterial soap
• carefully clean any cuts, wounds or grazes (even small ones)
• cover cuts, wounds and grazes with a sterile bandage until they heal
• eat healthily and exercise regularly to boost your immune system

Can I catch a boil or carbuncle?

Yes, you can. Unlike acne, boils and carbuncles can spread to another part of the body or to another person.

To prevent boils and carbuncles spreading, take simple precautions such as:

• washing your hands after touching affected areas
• using a separate face cloth and towel
• washing underwear, bed linen and towels at a high temperature
• covering wounds with a dressing until they heal
• carefully disposing of used dressings

The information on this page has been adapted by NHS Wales from original content supplied by NHS website nhs.uk

Last Updated:
02/07/2021 11:06:37

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Furunculosis: causes, symptoms and recommendations for the treatment of the disease. Dr. Peter

Many people get acne from time to time, we all know that. Everyone must have encountered the so-called inflammation of the hair follicle (furuncle). However, if it happens frequently and regularly, it is called furunculosis.

Causes

The most common causes of inflammation of the follicles are bacterial infections, such as those caused by staphylococci. But metabolic disorders, general problems in the secretory tracts of the hair follicles, immune deficiencies, and poor personal hygiene can also contribute to furunculosis.

Skin diseases favor furunculosis. People with acne are also more likely to suffer from acne. The reasons may be the initial purulent pimples, the inflammation of which deepens as it progresses. This is often facilitated by scratching and squeezing the pimple. Not only does this further irritate the tissues, it also allows additional bacteria to enter already damaged skin through the hands and fingers.

First of all, the appearance of boils on the face contributes to the appearance of furunculosis. The skin layers here are especially sensitive and penetrated by numerous vessels. Easy game for bacteria, which can very quickly invade other areas of the head and spread the infection. If this is not treated immediately, serious secondary illnesses such as meningitis can occur.

Metabolic disorders or chronic metabolic diseases can also provoke furunculosis due to increased secretion of sebum. As a result, the skin becomes very oily, the hair follicles become congested due to the rapid emptying of the sebaceous glands and the follicles become clogged.

Bacteria, which find ideal conditions for reproduction here, receive a nutrient medium for growth. Metabolic disorders can also contribute to furunculosis due to the consumption of very fatty or sugary foods, as the body fails to remove the ingredients during the day. Metabolic disturbances can also have hormonal causes, as seen in adolescents with furunculosis.

Furunculosis is also associated with a widespread disease – diabetes mellitus. Because the body lacks the insulin needed for internal metabolism, diabetics suffer from metabolic changes that disrupt the skin. The result can be blockage of the follicles and, in chronic cases, furunculosis.

Anyone with both acne and excessive sweating (hyperhidrosis) is also susceptible to furunculosis, as sweat further clogs follicles and increases the risk of inflammation. Hyperhidrosis can also be caused by hormonal and metabolic problems. These include conditions such as thyroid dysfunction, menopausal symptoms, diabetes, and obesity.

Daily shaving of the beard may contribute to the development of furunculosis in the chin and cheeks. Pathogens migrate into the skin due to lack of sterile razor wound care. People with very oily skin suffer more than others, they need regular skin cleansing and careful hygiene to prevent blockage of hair follicles and furunculosis. This does not mean that general personal hygiene is bad. Simply touching or popping a pimple with unwashed hands can cause a nasty infection.

Another important factor in the development of furunculosis is a weakened immune system, because it is well known that infectious agents are suppressed worse. Particularly problematic is that the bacteria do not remain locally restricted to follicles, but can enter the blood and lymphatic system.

Furunculosis symptoms

All body hair is found in hair follicles, sacs that feed the hair shaft. Anatomically, it is an elongated depression in the skin that contains the hair root. Each hair follicle has different glands. The sebaceous glands produce substances that moisturize the skin and protect it from drying out.

The sweat glands regulate body temperature, and the olfactory glands are responsible for odor signals by releasing pheromones. However, these numerous secretions, which are important to the body, can contribute to inflammation as they are a good basis for microbial growth.

When the entire follicle, including the surrounding tissue, becomes inflamed, it is called a boil. Typical is a plug of pus and dead skin tissue, visible as hard, red, swollen, and irritated tissue. Although boils can cause pain, if they occur sporadically and irregularly and do not exceed a certain size, there is no reason to panic. On the other hand, especially large boils must be removed medically, otherwise they can leave deep scars.

You should also see a doctor if the boils affect several neighboring follicles and the infection spreads deeper.

When boils appear repeatedly on different areas of the skin, doctors speak of furunculosis, “furunculosis disease.” In principle, any part of the body can be affected. However, they most often appear on the face, neck, buttocks, and inner thighs. For recurrent (recurring) furunculosis, antibiotic treatment is recommended to reduce the chance of recurrence.

Possible complications and risks

In addition to fatigue and discomfort, symptoms such as fever and swollen lymph nodes may also occur. In especially severe cases, furunculosis can lead to sepsis (blood poisoning) or meningitis.

Diagnosis

The diagnosis is based on the patient’s complaints, medical history and external examination.

How to treat furunculosis

Treatment of furunculosis, of course, largely depends on the causes and their severity. While for some it is enough to treat with home remedies or topical preparations and adherence to certain rules of hygiene, then in severe cases, drug therapy or even surgery is necessary.

In general, boils should not be squeezed out or scraped off because, in addition to the potential risk of infection, dirty hands can push the bacteria out of the boil into the bloodstream.

If you want to speed up the maturation of the boil, you can do it in many ways: apply local heat (eg red light lamp or wet warm compresses). Over-the-counter ointments or poultices with chamomile, calendula, or arnica may also help. They help heal wounds.

Field mint, fenugreek, nettle, marshmallow, calendula and tea tree can also be used to make a caring cleansing tincture. Harsh cleaning products or cosmetics also stress and irritate the skin. On the other hand, it is recommended to clean the skin with water only, using special natural skin care products.

Avoid fatty and sweet foods, foods with artificial additives are also unfavorable. Opt for skin-healthy foods like berries. They provide the skin with important antioxidants to protect against free radicals, which are responsible for a clear complexion, among other things. You can also improve skin protection with vitamins, minerals and trace elements.

Minerals such as silicon and zinc are important for the skin and are found in cabbage and root vegetables such as kale, Brussels sprouts, broccoli, radishes and radishes. Those who eat carrots, peppers and spinach, as well as currants, sea buckthorn and rose hips, provide their skin with sufficient amounts of vitamin C and vitamin B. emptying of skin pores. Mineral water and unsweetened teas are preferred over sweetened soft drinks and juices. If you like something sweet, you can use sweeteners like stevia or honeysuckle as an alternative to sugar.

If furunculosis requires medical treatment, antibiotic therapy with penicillin may be considered. In case of additional fever and severe pain, painkillers with antipyretic ingredients such as ibuprofen or paracetamol are also used.