What are boils?
Boils (a type of skin abscess) are inflamed and pus-filled areas under the skin that look like oversized pimples. The medical name for a boil is a furuncle. Carbuncle is the term given to a cluster of boils. Boils are usually caused by Staphylococcus aureus bacteria infecting one or more hair follicles and they may be accompanied by fever or chills.
A boil generally starts as a reddened, tender area that becomes firm and hard over time. Eventually, the centre of the boil softens and becomes filled with pus that finally ‘forms a head’ and drains out through the skin. Boils are painful and can develop anywhere on the body, but often in areas like the armpits, buttocks, face, genitals, and neck.
Other types of skin abscesses
- Cystic acne — this type of abscess forms when the oil ducts in the skin become clogged, causing infection. This is commonly seen in adolescents.
- Hidradenitis suppurativa — this is a condition where multiple abscesses form under the armpits or groin area and is generally caused by an inflammation of the sweat glands.
- Pilonidal cyst — this is a specific type of abscess that develops in the crease of the buttocks often resulting from an ingrowing hair that continues to grow, or from long periods of sitting, for example in people who drive long distances for a living. This type of abscess usually needs to be treated surgically.
- A red lump on the skin that grows and becomes filled with pus.
- Tenderness and pain, which is sometimes severe.
- Fever, occasionally, which can be a sign of septicaemia - a complication of boils.
What causes boils?
The Staphylococcus bacteria which cause boils may enter your skin via a cut or any break in the skin, including tiny grazes.
Boils can affect anyone, but there are some people who are more susceptible, including people with diabetes and kidney problems. Also, if a person suffers from immune system deficiencies, they may be more susceptible to boils. Sometimes adolescents go through a phase of experiencing boils.
How is a boil treated?
One form of treatment is the application of some type of hot pack. The heat increases the circulation to the area and increases the body’s ability to fight infection. Once the head of the boil forms it can rupture and drain, which will give considerable pain relief. Larger boils may need to be lanced and drained by your doctor who may also prescribe antibiotics.
What you can do
- Consult a doctor if the boil is on the face, shows signs of worsening, if there is fever, if it recurs in one or 2 days, or if it has not healed after one or 2 weeks.
- Do not burst a boil, as the infection may spread. Let it rupture on its own.
- Apply a hot, moist compress 3 times a day, for about 10 minutes at a time to help ‘ripen’ the boil.
- Take simple painkillers.
- After the boil has burst, wash the area thoroughly with soap and water, or an antiseptic solution, and cover it with a dry dressing. Repeat the procedure daily until the area is completely healed.
- Shower instead of bathing, as this decreases the chances of spreading the infection.
- Don't share towels or soap with people in your household.
In children, recommendations include a week of antibiotics; the whole household should wash daily for 5 days using an antiseptic wash such as 1 per cent triclosan and a nasal antiseptic, since that’s where the staphylococci reside.
What your doctor can do for you
- Lance the boil with a sterile needle or scalpel, drain the pus, and cover the area with a dry dressing. A large boil may need to be re-dressed daily until it heals.
- Prescribe antibiotics.
- Check if the boil is a symptom of any other underlying condition and investigate further if needed.
- Avoid scratching an itch, as infection may set in if the skin breaks.
- Apply antiseptics such as chlorhexidine plus cetrimide cream or liquid (e.g. Savlon) or acriflavine lotion to broken skin to prevent infection.
- Wash your hands or any other part of the body with soap and water if it comes into contact with an oozing boil.
2. Sukumaran V and Senanayake S. Bacterial skin and soft tissue infections. Aust Prescriber 2016; 39: 159-63.