- Boils symptoms and signs include:
- a firm reddened pea-sized bump,
- tender, swollen skin surrounding the bump,
- the bump may increase in size,
- pus-filled head on the bump, which may spontaneously drain, weep, or ooze.
- Antibiotics alone can be inadequate in treating abscesses. The primary treatments for boils include hot packs and draining (“lancing”) the abscess but only when it is soft and ready to drain. Most of these skin conditions resolve on their own or with home remedies.
- If the individual has a fever or chronic disease, such as cancer or diabetes, or is taking medications that suppress the immune system, he or she should contact a health care professional if a boil (abscess) or other skin infection develops.
- There are a number of ways to reduce the likelihood of developing some forms of boils, but boils are not completely preventable even with proper hygiene and skin care regimens.
- The bacteria that cause boils are contagious, and skin infections can be spread from contact with the fluid from a boil.
Picture: What does a boil look like?
Source: “Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology”; Klaus Wolff, Richard Allen Johnson, Dick Suurmond; Copyright 2005, 2001, 1997, 1993 by The McGraw-Hill Companies. All Rights reserved.
What is a boil? What are boil symptoms and signs? (Part 2)
There are several different types of boils:
- Furuncle or carbuncle: This is an abscess in the skin usually caused by and infection with the bacterium Staphylococcus aureus. A furuncle can have one or more openings onto the skin and may be associated with a fever or chills. The term furuncle is used to refer to a typical boil that occurs within a hair follicle. The term carbuncle is typically used to represent a larger abscess that involves a group of hair follicles and involves a larger area than a furuncle. A carbuncle can form a hardened lump that can be felt in the skin. The condition of having chronic, recurrent boils (furuncles or carbuncles) is referred to as furunculosis or carbunculosis, respectively.
What is a boil? What are boil symptoms and signs? (Part 3)
- Cystic acne: This is a type of abscess that is formed when oil ducts become clogged and infected. Cystic acne affects deeper skin tissue than the more superficial inflammation from common acne. Cystic acne is most common on the face and typically occurs in the teenage years.
- Hidradenitis suppurativa: This is a condition in which there are multiple abscesses that form under the armpits and often in the groin area. These areas are a result of local inflammation of the sweat glands. This form of skin infection is difficult to treat with antibiotics alone and typically requires a surgical procedure to remove the involved sweat glands in order to stop the skin inflammation.
- Pilonidal cyst: This is a unique kind of abscess that occurs in the crease of the buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the area of skin from which hair grows (the hair follicle). With irritation from direct pressure, over time the inflamed area enlarges to become a firm, painful, and tender nodule that makes it difficult to sit without discomfort. These abscesses frequently form after long trips that involve prolonged sitting.
What are risk factors for boils?
Anyone can develop a boil. However, people with certain illnesses or who take certain medications that weaken the body’s immune system (the natural defense system against foreign materials or microbes) are more likely to develop boils. Diseases that are associated with impaired immune systems include diabetes
and kidney failure
. Diseases in which there is inadequate antibody production (such as hypogammaglobulinemia) can also increase the risk of developing boils.
How do health care professionals diagnose boils?
The diagnosis of a boil can be made by observation of the typical signs and symptoms. Blood tests or specialized laboratory tests are not required to make the diagnosis of a boil. If the infection within a boil has spread to deeper tissues or is extensive, cultures of the pus may be taken from the wound
area to identify the precise type of bacteria responsible for the infection. This can guide the choice of antibiotics for treatment.
Home treatment is an option for most simple boils. Ideally, treatment should begin as soon as a boil is noticed since early treatment may prevent later complications.
The primary home remedy for most boils is heat application, usually with hot or warm water soaks or warm compresses. It may be necessary to apply them 20 minutes at a time for three to four times daily. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the site of infection.
If a boil occurs as a result of shaving, it is recommended to avoid shaving in that area until the boil has healed to avoid spread of bacteria.
As long as the boil is small and firm, opening the area and draining the boil is not helpful, even if the area is painful. However, once the boil becomes soft or “forms a head” (that is, a small pustule
or area of pus is noted in the boil), it can be ready to drain (lance). Once drained, pain
relief can be dramatic. Most small boils, such as those that form around hairs, drain on their own with hot soaks. On occasion, and especially with larger boils, medical treatment is required. In this situation, the boil will need to be drained or “lanced” by a health care professional. Frequently, these larger boils contain several pockets of pus that must be opened and drained.
Over-the-counter antibiotics are often used to eliminate any accompanying bacterial infection, especially if there is an infection of the surrounding skin. However, antibiotics are not needed in every situation. In fact, antibiotics have difficulty penetrating the outer wall of an abscess well and often will not cure an abscess without additional surgical drainage.
When an antibiotic is used, the choice depends upon the type of infection that is present as well as the results of tests to identify the precise bacteria that infect the area. Examples of drugs
that have been used in the treatment of boils include topical preparations of clindamycin
and others), mupirocin
(Bactroban), and cephalexin
Complications of boils include formation of a larger abscess, a worsening or spreading of infection to adjacent areas of skin or soft tissue (cellulitis
), and very rarely, spread of the infection through the bloodstream to sites elsewhere in the body. Sometimes a boil may be caused by an organism typically associated with more serious infections, such as methicillin-resistant Staphylococcus aureus
), with a risk of spreading this infection to deeper tissues. Recurrence of the infection is another possible complication, which is more likely in certain types of boils. Recurrence is most common in the disease hidradenitis suppurativa and may also occur in situations in which the cause of the boil or abscess is persistent, such as the clogging of oil ducts seen in cystic acne