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Boils and carbuncles

Definition


Disease: Boils and carbuncles Boils and carbuncles
Category: Dermatological diseases

Disease Definition:

When painful pus-filled bumps form under the skin due to infection from bacteria or inflammation of one or more of hair follicles, it is called boils and carbuncles.

Boils, which are also called furuncles, usually begin as red, raw lumps. Pus quickly fills the lumps, growing larger and more painful until they burst and drain.

A carbuncle is a set of boils forming a merged infected area under the skin.

A boil shouldn’t be cut or squeezed, because it may spread the infection. In case a boil is extremely painful, lasts more than 15 days or occurs along with a fever, the person should see a doctor. However, in most cases, a single boil could be treated at home.
 

Work Group:


Symptoms, Causes

Symptoms:

BOILS:

A painful pink or red bump appears on the skin that is between 1 to 2 centimeters (between about half an inch to three quarters of an inch) in diameter. The surrounding skin might be red and swollen.
The bump will be filled with pus in the span of a few days. It will grow larger and painful, reaching the size of a golf ball in some cases. Then, it will develop to a yellow-white tipped bump, which will eventually burst and drain. Although sometimes it may take up to a month or more, but usually, a boil clears in a couple of weeks. Additionally, a large boil may leave a scar, while small boils usually heal without leaving a sign.


Any place on the skin is a probable area for boils. Yet, they usually occur on the hair-bearing areas that are more apt to sweat or experience friction, such as a person’s thighs, armpits, buttocks, neck or face. 

Inflamed and painful lumps caused by cystic acne resemble boils a lot. But compared with cystic acne, boils are redder, more painful and more inflamed around the border.

CARBUNCLES:

Carbuncles are a cluster of boils, which usually occur on the back of the neck, shoulders or thighs. The infection that is caused by carbuncles is deeper and graver than that caused by a single boil.  Fever, chills and tiredness are some of the conditions that usually accompany carbuncles. Additionally, carbuncles are probable to leave a scar and they develop and heal more slowly.

As mentioned before, a single small boil can be treated with self-care measures. However, if the boils are big or if they are on a person’s face or spine, the person should see a doctor. Additionally, the doctor should be visited in case a person has:

 

  • Frequent boils
  • An organ transplant, HIV infection, or some other condition that suppresses the immune system
  • A boil that rapidly aggravates and hurts a lot
  • Red lines radiating from a boil. This may be a sign that the infection has entered the person’s lymphatic system
  • Large boils that are accompanied by a fever or that haven’t healed in two weeks.


Children and older adults should receive medical care if they develop one or more boils.
 

Causes:

Hair follicles are the tube-shaped shafts from which hair grows. When one or more hair follicles become infected with staph bacteria, namely the Staphylococcus aureus, boils occur.
These bacteria normally live in a person’s skin, throat or nasal passage. They are responsible for food-borne illnesses, hospital-acquired infections, as well as for serious diseases such as pneumonia, meningitis, urinary tract infections and endocarditis, which is the infection of the lining of the heart.

Boil-causing staph bacteria pores in through a cut, scratch or break in the skin. Specialized white blood cells called neutrophils hurry in to fight the infection as soon as this occurs. This will cause inflammation and the formation of pus, which is the mixture of bacteria, dead skin cells and old white blood cells.
 

Complications

Complications:

Some of the complications that boils and carbuncles may cause include:

MRSA:

Methicillin-resistant Staphylococcus aureus is a drug-resistant strain of Staphylococcus aureus. This condition is highly contagious and spreads rapidly in crowded or unhealthy situations or where gymnastic equipment or towels are shared.
MRSA responds well to several antibiotics, but is resistant to penicillin and its treatment is very difficult.

Blood poisoning:

The bacteria from a boil can travel through a person’s bloodstream and spread the infection to other parts of the body. This is a life- threatening situation called sepsis or blood poisoning.

At first, blood poisoning causes symptoms like chills, spiking fever, heart palpitations, and feeling extremely ill. The situation could develop to a shock marked by low blood pressure and body temperature, confusion, clotting abnormalities and bleeding into the skin. If sepsis is left untreated, it may be fatal, making it a medical emergency. 
 

Treatments:

A boil or carbuncle can be treated by making a small incision in its tip.  This procedure eases the pain, speeds recovery and lessens scarring. Because deep infections can’t be totally drained, they are covered with gauze so that the pus can continue to drain. In the case of severe or recurrent infections, antibiotics can be prescribed.
 

Prognosis:

Not available

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Consultants Corner

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist
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