Skin boils are caused by bacteria. Whether from infection or from a clogged hair follicle, they can occur anywhere on the body and are usually painful, not to mention unsightly. If your body is busy fighting infection, it may produce the boil. Fortunately, they can be treated, either at home or, in serious cases, with medical assistance.
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, possibly 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 smells foul.
Boils can appear almost anywhere on the skin. They occur more often on hairy parts of the body, where the infection may begin in a hair follicle.
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, though, and allow 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.
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. Sometimes, though, 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
- You have diabetes and develop a boil
- 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.
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 help is a warm compress. Warm compresses may help the boil rupture more quickly. To make a compress, soak a washcloth in warm (not boiling) water and place it over the boil. Use the compress for about half an hour at a time, every few hours.
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.
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 called necrotizing fasciitis. Necrotizing fasciitis can cause severe skin damage and lead 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 healthcare 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.
Prevention and Diagnosis
While most boils are simple skin conditions that follow an infection, other causes should be ruled out should you continue to develop them. Underlying skin or health concerns may be causing a suppressed immune system. Proper evaluation from your physician will help determine the cause of boils and make it easier to implement a treatment and prevention plan that works to keep these skin nuisances at bay. Whether it be an antibiotic or a better hygiene plan, you can hopefully remedy and prevent boil recurrence.