Overview
Boils and carbuncles are types of skin infections caused by bacteria, typically Staphylococcus aureus. Boils appear as painful, pus-filled bumps that form under the skin when hair follicles become infected. They usually occur on the face, back of the neck, armpits, thighs, and buttocks. A carbuncle is a cluster of interconnected boils that form a larger area of infection under the skin. Carbuncles are more severe than individual boils and may cause fever, chills, and general illness. Boils and carbuncles can be treated at home for some cases, but it's important to see a doctor if you have multiple boils, a boil on your face or affecting your vision, a boil that worsens rapidly, becomes extremely painful, grows larger despite self-care, doesn't heal in two weeks, or recurs frequently.
Understanding the disease
Symptoms
The symptoms of boils and carbuncles include: Boils:
- A painful, red bump that starts out small and can enlarge to more than 2 inches (5 centimeters)
- Reddish or purplish, swollen skin around the bump
- An increase in the size of the bump over a few days as it fills with pus
- Development of a yellow-white tip that eventually ruptures and allows the pus to drain out Carbuncles:
- A cluster of boils that form a connected area of infection
- Compared with single boils, carbuncles cause a deeper and more severe infection and are more likely to leave a scar
- People who have a carbuncle often feel unwell in general and may experience a fever and chills It's important to see a doctor if you have more than one boil at a time, if a boil occurs on your face or affects your vision, if the boil worsens rapidly or is extremely painful, if it causes a fever, gets bigger despite self-care, hasn't healed in two weeks, or recurs.
Development
Boils and carbuncles develop as a result of infection by the bacterium Staphylococcus aureus, commonly found on the skin and inside the nose. A boil starts as a reddish or purplish, tender bump that fills with pus, becoming larger and more painful until it ruptures and drains. A carbuncle is a cluster of boils that form a connected area of infection under the skin. The bacteria typically enter through small injuries or breaks in the skin, such as those caused by friction, sweat, or insect bites. Risk factors for boils and carbuncles include close contact with someone who has a staph infection, diabetes, and weakened immunity. It is essential to seek medical attention if you have multiple boils, a large boil, a boil that worsens rapidly, a fever, or a boil that hasn't healed within two weeks.
Assessment and Diagnosis
Triage
You should see a doctor if boils and carbuncles are suspected when you have more than one boil at a time, if a boil occurs on your face or affects your vision, if a boil worsens rapidly or is extremely painful, if a boil causes a fever, if a boil gets bigger despite self-care, or if a boil hasn't healed in two weeks or recurs.
Diagnosis
To diagnose boils and carbuncles, your doctor will likely examine the affected area and may perform additional tests, such as sending a sample of the pus for lab testing. This may be helpful if you have recurring infections or an infection that hasn't responded to standard treatment. Lab testing can help determine the best type of antibiotic for your specific infection.
Management and Treatment
Complications
Complications of boils and carbuncles can include the spread of infection (sepsis) which can lead to deeper infections in the body, such as endocarditis (infection of the heart) or osteomyelitis (infection of the bone). Rarely, bacteria from a boil or carbuncle can enter the bloodstream and travel to other parts of the body. It's important to seek medical attention if you have a boil that is large, painful, growing rapidly, or not improving with self-care.
Treatment
To treat boils and carbuncles, you can generally follow these steps:
- Warm Compresses: Apply a warm washcloth or compress to the affected area several times a day, for about 10 minutes each time. This helps the boil rupture and drain more quickly.
- Incision and Drainage: For larger boils and carbuncles, your doctor may drain the infection by making an incision or using a needle to release the pus.
- Antibiotics: In some cases, your doctor may prescribe antibiotics to help heal severe or recurrent infections.
- Prevent Contamination: Always wash your hands thoroughly after treating a boil, and launder clothing, towels, or compresses that have touched the infected area, especially if you have recurrent infections. Remember not to squeeze or lance a boil yourself, as this can spread the infection. Follow your doctor's instructions for treatment and self-care, and seek medical attention if the infection worsens, spreads, or does not improve with treatment.
Preparing for medical consultation
To prepare for an appointment for boils and carbuncles, you should:
- List all your signs and symptoms and when they first occurred.
- Record how long the bumps lasted and if any recurred.
- Make a list of all medications - including vitamins, herbs, and over-the-counter drugs - that you are taking, and bring the original bottles and a list of doses and directions.
- Prepare a list of questions to ask your doctor, such as:
- Are tests needed to confirm the diagnosis?
- What is the best course of action?
- Is there a generic alternative to the medicine you're prescribing?
- Can I wait to see if the condition goes away on its own? Remember to share your key medical and personal information, including any major stressors, recent life changes, or vacations to places with weather that differs from where you live. This information will help your doctor understand your overall health and provide appropriate treatment recommendations.