Boils And Carbuncles

1 What are Boils and Carbuncles?

Boils and carbuncles are red, painful lumps that develop under your skin when bacteria infects and causes inflammation to one or more of your hair follicles.

Furuncles

Boils are also called furuncles and these usually appear as red lumps that quickly get filled with pus.

These lumps become larger and more painful until it bursts open to drain away the pus.

It takes about 2 days-3 weeks for the boil to rupture. Boils most commonly occur on the skin in areas such as the face, neck, or thighs, where there is a combination of excess sweat, hair, and friction.

Boils develop most commonly among the teens and young adults, particularly in males.

Carbuncles

A carbuncle is a collection of boils that form a connected area of infection below the skin.

They often occurs on the back, thighs, or the back of the neck.

Carbuncles develop less commonly than boils, and occur most often in middle-aged or in elderly men with a weak immune system.

Usually, a single boil may taken care of at home, but do not try to prick or squeeze it out as it may cause spreading of the infection.

If a boil or carbuncle becomes very painful and lasts for more than 2 weeks with fever, you should consult your doctor for professional care.

2 Symptoms

The signs and symptoms of a boil include:

  • A red, painful bump that is about the size of a pea
  • Inflammation of skin surrounding the bump
  • The size of the bump increases over time as pus forms inside it (it can sometimes develop as big as a baseball)
  • Development of a yellow-white colored tip that may gradually burst and allow the pus to drain out

Carbuncles

A carbuncle is a group of boils that result in a deeper and more severe infection, often leaving behind a scar.

It can be more than 10 cm in size, and may drain pus from several points.

You may have other symptoms such as:

  • A high temperature of 38°C or above accompanied by chills
  • A general feeling of illness or being unwell
  • Feeling weak and exhausted

You can take care of a single, small boil that bursts and heals by itself.

However, you should visit your doctor if you have multiple boils at a time or if a boil:

  • Occurs on your face, nose or spine as it can lead to serious complications
  • Becomes bigger in size and feels soft to touch, as it may not rupture and heal by itself
  • Is more than 2 inches (5 centimeters) in diameter
  • Worsens rapidly or is extremely painful
  • Causes a fever
  • Has lasted for more than 2 weeks without healing
  • Occurs repeatedly
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3 Causes

Most often, boils and carbuncles are caused by a type of bacteria called Staphylococcus aureus that infects one or more hair follicles.

These bacteria live on the skin surface or in the lining of the nose and do not cause any harm.

Boils may develop when the bacteria gain entry into your skin through small cuts or an insect bite.

Your immune system responds to this by recruiting white blood cells to fight against the bacteria.

A substance containing dead bacteria, white blood cells and skin cells accumulate inside the lump called pus.

If the infection spreads deep into the skin and creates a cluster of several boils, it is called a carbuncle.

4 Making a Diagnosis

Boils and carbuncles can be diagnosed by their appearance, but if you tend to get recurrent infections or if an infection is not responding well to standard treatment, your doctor may order testing for a sample of the pus collected from the boil or carbuncle.

You may consult your family doctor or a general practitioner first but you may be referred to a dermatologist or infectious disease specialist if required after evaluation of your condition.

Before your appointment:

  • Make a comprehensive list of all your signs and symptoms and the time these were first discovered.
  • Record for how long each lesion lasted and if any have recurred.
  • Make a list of all current medications you are taking including vitamins, herbal supplements, and over-the-counter drugs.

For boils and carbuncles, some basic questions to ask your doctor include:

  • Do you order any tests to confirm the diagnosis?
  • What is the best available course of action?
  • What should be done to prevent the spread of infection?
  • What skin care measures should be followed while the condition heals?

Your doctor is likely to ask you a number of questions, such as:

  • How did the boil appear when it first started?
  • Are your lesions painful?
  • Have you ever developed a boil or carbuncle before?
  • Did you have a fever with chills?
  • Have you undergone replacement of heart valves, joints or are there any other prosthetic devices in your body?

A vast majority of the bacteria that usually cause boils have turned resistant to certain types of antibiotics.

Therefore, this test would help to decide the type of antibiotic suitable for your situation.

5 Treatment

Generally, small single boils can be treated at home by applying warm compresses that can relieve your pain as well as facilitate natural drainage of the pus.

For larger boils and carbuncles, the treatment may include:

  • Incision and drainage: A large boil or carbuncle will be drained by making a small incision on its upper surface. Deeper infections that cannot be drained completely may be packed with a sterile gauze that soaks up the additional pus
  • Antibiotics: When the boils occur repeatedly or when they are very severe, your doctor will advise antibiotics that can help in healing recurrent infections.

6 Prevention

Prevention of boils and carbuncles is not always achievable, particularly in immunocompromised individuals.

However, these measures may help in avoiding staphylococcal infections:
Keep your hands clean by washing them frequently with a mild soap or an alcohol-based hand rub.

Careful hand-washing provides the best defense against disease causing germs.

  • Keep the wounds covered: Cover skin breaches or abrasions. Keep them clean and covered with a sterile, dry bandage until they heal completely.
  • Avoid sharing your personal things such as towels, clothes, and razors with others.

Staphylococcal infections may spread through objects, and from one person to another.

If you have a cut or a sore, wash the clothes you have used with detergent, hot water and added bleach. Dry them in a hot dryer.

7 Alternative and Homeopathic Remedies

Several alternative and homeopathic remedies are used for boils and carbuncles.

Tea tree oil, obtained from the leaves of the Australian tea tree (Melaleuca alternifolia) is an antiseptic, antibiotic and antifungal agent and is an age-old remedy for boils.

Although it is not scientifically proven to be beneficial, it has been used topically to treat boils.

Be sure to consult your doctor before using such alternative medicine treatments as tea tree oil can lead to allergic reactions in some people.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with boils and carbuncles.

For small boils, this self-care advice may help the infection to heal quickly and prevent its spread to other areas:

  • Warm compresses: Apply a warm washcloth or compress over the boil several times in a day. This relieves your pain and helps the boil burst and drain away the pus more quickly.
  • Never squeeze or try piercing a boil on your own as this can spread the infection.
  • Maintain cleanliness and prevent cross-contamination: Wash your hands thoroughly after treating a boil. Also, thoroughly wash the clothing, towels or compresses that have been in contact with the infected area, particularly if you have been getting recurrent boils or carbuncles.

9 Risks and Complications

The following factors may increase the risk of developing boils and carbuncles:

  • Being in close contact with an individual who has a staphylococcal infection: You are more likely to develop a boil if you are living or in close contact with someone who has a similar infection.
  • Diabetes: Diabetic conditions make it more difficult for your body to fight against infection, including bacterial skin infections.
  • Other skin conditions: As skin problems such as eczema and acne damage your skin's protective layer, these make you more susceptible to boils and carbuncles.
  • Compromised state of immunity: Immunocompromised people are more susceptible to boils and carbuncles. In rare cases, bacteria from a boil or more commonly, a carbuncle may gain entry into your bloodstream and reach other parts of your body. This spread of infection, commonly called blood poisoning or sepsis can lead to infections in the deeper organs of your body such as your heart (endocarditis) and bone (osteomyelitis).

Boils and carbuncles may affect any person, including the otherwise healthy individual.

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