Skin Boils

Recognizing Skin Boils

Boils start as small, painful red bumps. There may be one or several. Multiple boils can appear all at once, or develop one at a time. Single boils are also called furuncles. Clusters of boils are called carbuncles.

Within a day or two, the bump or bumps begin to fill with pus. Boils continue to grow over several days or weeks, with more and more pus accumulating inside. They may become very large—several centimeters across—and extremely painful.The area around the boil becomes reddened and inflamed. Gradually, an area of the skin over the boil will thin and then rupture, allowing the pus to drain out. The pus is yellow or green and often foul-smelling.

Boils can appear almost anywhere on the skin. They occur more often on hairy parts of the body, with the infection beginning in a hair follicle.

Causes

Bacteria

Most skin boils are caused a bacteria called Staphylococcus aureus ("staph"). Staph lives on the surface of normal skin and usually doesn't cause any problems. A tiny scratch or cut can let the bacteria in, allowing it to grow more than usual. As the body tries to fight the infection, a combination of dead blood cells, skin cells, and bacteria forms the yellow-white or yellow-green fluid called pus.

Risk Factors

Poor hygiene and poor general health are risk factors for skin boils. People with diabetes, which can interfere with the body's ability to fight infection, or with other immune-suppressing conditions are also at risk. Skin problems like acne or eczema can make it easier for the bacteria to get in.

However, even very healthy people can get skin boils. Sometimes they're caused by strains of staph that are difficult to fight. Sometimes, it's just bad luck.

When to Get Help

In most cases, the body is very good at fighting infection. Boils tend to last for a week or two, then rupture and heal. But sometimes they continue to worsen. Call the doctor if a boil:

• Becomes very large or deep.
• Is extremely painful.
• Is accompanied by illness or a fever.
• Is located over the spine or on the face.
• Does not get better within one week.
• Appears very inflamed, especially if the redness is spreading or if there are red lines radiating from the area.
• Heals and then recurs, or if more boils appear.

Rarely, a boil can lead to a dangerous blood infection. Fever may be a signal that the bacteria have invaded the bloodstream. Redness that spreads very rapidly may be a sign that the body is not able to fight the infection. Immediate antibiotic treatment is needed to prevent severe skin damage. In either of these cases, it's important to get medical help right away.

Treatment

Home Treatment

Never lance (cut open) a boil on your own. Keep the area clean, but don’t scrub or pick at it. Doing so can make the infection worse. A home treatment that may helpis a warm compress. Warm compresses may help the boil rupture more quickly. To make a compress, soak a washcloth in warm—but not boiling—water and place it over the boil. Use the compress for about half an hour at a time, every few hours.

Medical Treatmnent

If the boil continues to grow, fails to rupture after a few days, or shows other signs of failing to heal, a doctor can help. He or she may lance the boil using a sterile scalpel and gently press on the skin to help clear the pus. Many skin boils will clear up completely after they have been lanced. Your doctor may also prescribe antibiotics to help your body get rid of the infection.

MRSA

Recently, an especially virulent strain of staph has been appearing in skin infections. This strain, called Methicillin-Resistant Staphylococcus Aureas (MRSA), is resistant to many antibiotics. MRSA causes diseases including recurrent skin boils, dangerous or deadly blood infections, and the fast-spreading infection necrotizing fasciitis. Necrotizing fasciitis can cause severe skin damage leading to disfigurement and even death.

IV drug abusers may be at particular risk of getting MRSA. Other risk factors include recent hospitalization or regular visits to health-care facilities such as dialysis centers. In the general community, risk factors include:

• Crowded living conditions, such as military barracks
• Poor hygiene
• Contact with contaminated objects, including shared towels
• Close skin-to-skin contact, which can occur among athletes during a game.

Some MRSA infections require IV antibiotics. If you're concerned about a skin boil being caused by MRSA, talk with your doctor.