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Boil

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(Carbuncle; Furuncle; Cutaneous Abscess; Skin Abscess; Abscess, Cutaneous; Abscess, Skin)

Definition

A boil is a red, swollen, painful bump under the skin that is caused by an infection. Boils often start in an infected hair follicle. Bacteria form an abscess or pocket of pus. With time, the pus may come to a head and drain out through the skin. Boils can occur anywhere, but common sites include the face, neck, armpits, buttocks, groin, and thighs.
There are several types of boils:
  • Furuncle or carbuncle—an abscess caused by the bacteria Staphylococcus aureus or Streptococcus pyogenes, sometimes occurs as several boils in a group
  • Pilonidal cyst—an abscess that occurs in the crease of the buttocks and almost always requires medical treatment
  • Cystic acne—an abscess that occurs when oil ducts become clogged and infected, more common in the teenage years
  • Hidradenitis suppurativa—an uncommon disorder where multiple abscesses occur in the armpit and groin area
Pilonidal Cyst
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Causes

Causes of boils may include:
  • Bacteria, including Staphylococcus aureus
  • Ingrown hair
  • Splinter or foreign object lodged in the skin
  • Blocked sweat gland or oil duct

Risk Factors

Factors that increase your risk of getting a boil include:
  • Diabetes
  • Poor nutrition
  • Poor hygiene
  • Weakened immune system
  • Exposure to harsh chemicals

Symptoms

Symptoms may include:
  • Skin lump or bump that is red, swollen, and tender
  • Lump that becomes larger, more painful, and softer over time
  • A pocket of pus that may form on top of the boil

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. A bacterial culture of the boil may be taken.
Some boils do not need medical attention and may drain on their own. More serious symptoms from boils may require treatment. These include:
  • The boil worsens, continues, or becomes large or severe
  • You have a fever
  • The skin around the boil turns red or red streaks appear
  • The boil does not drain
  • An additional boil or boils appear
  • The boil limits your normal activities
  • The boil is on your face, near your spine, or in the anal area
  • You have diabetes
  • You develop many boils over several months

Treatment

Your doctor can drain the boil if needed and treat the infection with antibiotics.
Home treatment may include:

Warm Compresses

Apply warm compresses to the boil for 20 minutes, 3-4 times a day. Depending on the area of the body affected, you may be able to soak the boil in warm water. These measures can ease the pain and help bring the pus to the surface. Repeated soaking will help the boil begin to drain.

Lancing the Boil

Do not pop or lance the boil yourself. This can spread the infection and make it worse. If the boil does not drain on its own or it is very large, you may need to have it drained or lanced by your doctor.

Cleaning and Bandaging

Whether the boil drains on its own or was lanced by a doctor, you must keep it clean. Wash it with antibacterial soap and apply a medicated ointment and bandage. Clean the affected area 2-3 times a day until the wound heals completely.

Prevention

To help prevent boils:
  • Practice good hygiene. Wash boil-prone areas with soap and water or an antibacterial soap. Dry thoroughly.
  • Clean and treat any minor skin wounds.
  • Avoid clothing that is too tight.

RESOURCES

American Academy of Dermatology http://www.aad.org

Familydoctor.org http://familydoctor.org

CANADIAN RESOURCES

The College of Family Physicians of Canada http://www.cfpc.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Boils. DermNet NZ website. Available at: http://www.dermnetnz.org/bacterial/boils.html. Accessed January 14, 2013.

Skin abscess. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 27, 2012. Accessed September 14, 2012.

Revision Information

  • Reviewer: Peter Lucas, MD
  • Review Date: 10/2012 -
  • Update Date: 01/14/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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