Boils (Furuncles or Furunculosis)
Furunculosis is a common skin condition or infection that causes boils or deep skin sores. It is usually caused by the bacteria staphylococcus aureus.
Furuncles are bacterial infections of hair follicles. The bacteria invades the skin through a hair follicle then goes into deeper layers of the skin. The furuncle or boil starts as a deep, firm, tender red papule or swelling, then becomes a larger, deep-seated nodule. This can be quite painful. Also pus oozing out of the skin once the nodule becomes deep-seated is not an unusual occurrence.
Infections may vary from individual to individual, ranging from a tiny pimple to a large carbuncle. The boils seem to appear in areas where friction occurs such as:
- neck
- buttocks
- thighs
It is not known where the bacteria comes from. But transmission from person to person is possible when direct contact is made with drainage of the pus.
Boils usually appear in young adults or adults and rarely in children. They are more likely to be diagnosed in those with diabetes or in those who are obese.
Symptoms
Boils can appear "from nowhere" quite suddenly and unexpectedly. They usually range from ½" to 1" in diameter. They can often be very painful. Sometimes they stay deep and reabsorb or sometimes they rupture to the skin surface -- in that case they heal, but with scarring.
Diagnosis/Treatment
Diagnosing a boil can be done by your health care provider in an office setting. The health care provider will want to differentiate between boils and other bacterial and fungal infections as well as inflamed cysts.
It is important to treat furunculosis. Left untreated there is the possibility that if the boil ruptures, the infection could spread into the bloodstream and into other areas of the body.
In early stages, penicillin or another antibiotic may be prescribed and antibiotics usually are affective in healing. Antibiotics will help stop the spread of the infection. However if pus has formed your health care provider may open or incise the boil and drain it. This is done especially when the boil is not too thick and the mass underneath is not too hard.
The conventional treatment for boils has been gentle heat from a heating pad, or even a lamp held close to the boil for 20 minutes 4 times per day. Warm compresses also are effective applied 3 or 4 times per day for about 20 minutes each.
But some boils do not respond to gentle or moist heat so antibiotics may be recommended, in most cases because with the difficult or aggressive boils that do not respond to gentle heat use of an antibiotic at a later stage will not be effective.
Applying medication directly on the boil doesn't penetrate the affected area so it is of little use.
You can actually help the boil heal by keeping your movements to a minimum. Moving will slow the healing process. Avoid activities where you sweat heavily such as sports or heavy manual labor.
Covering the draining boil with a bandage is recommended, especially since there is the possibility of contagion. Workers in restaurants or health care settings may be advised to stay at home until the boil has healed.
It is important to keep the skin clean and use your own towels, washcloths and bedding. Don't share them with other household members or guests because of the possibility of contagion.
Recurring boils can be problematic. If there is an instance of recurrence the patient should be checked for diabetes. Antibiotics are usually effective in stopping new boils from occurring, but as with acne, antibiotics have no long term effectiveness in preventing the disorder from recurring once use is discontinued.Remember, if pus is present surgical drainage is usually indicated. But the pus may cause new boils by contaminating nearby skin. Follow-up with your health care provider is necessary after surgery.
If, after treatment, the boil does not improve, a new therapy or antibiotic might be required.
If you have a boil or furuncle, or have questions regarding them, please see your health care provider.
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