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Boils and Carbuncles

A painful, deep, bacterial infection of a hair follicle. The infection-usually from staphylococcus bacteria-begins in the hair follicle and penetrates the skin's deeper layers. Boils are common and contagious.

If there are multiple heads, the lesion is called a 'carbuncle'. Large boils form abscesses, defined as an accumulation of pus within a cavity. Cellulitis may also occur, i.e. infection of the surrounding tissues, and this may cause fever and illness.

Causes

Boils are easily transmitted under crowded, unsanitary conditions. Athletic teams who work out with each other daily may have an outbreak of boils among members. Health clubs that do not keep showers clean or put adequate amounts of chemicals in pools or whirlpool hot tubs are particularly likely to harbor germs that cause boils. The following factors make a person more susceptible to boils:

• Poor nutrition.
• Illness that has lowered resistance.
• Diabetes mellitus.
• Use of immunosuppressive drugs.

Signs and symptoms

• A domed nodule that is painful, tender, red and has pus at the surface. Boils appear suddenly and ripen in 24 hours. They are usually 1-1/2cm to 3cm in diameter; some are larger.
• Fever.
• Swelling of the closest lymph glands.

Diagnosis

Doctors usually diagnose a boil simply by looking at your skin, but sometimes they take a sample of pus to check for the type of bacteria it contains. If you have recurring infections, you may be tested for diabetes or other illnesses that weaken your immune system.

Treatment

Most simple boils can be treated at home. Ideally, the treatment should begin as soon as a boil is noticed since early treatment may prevent later complications.

Home Treatment

• Relieve pain with gentle heat from warm-water compresses, a heating pad, hot-water bottle or heat lamp. Use heat 3 or 4 times daily for 20 minutes.
• Prevent the spread of boils by using clean towels only once or using paper towels and discarding them.

Medication

• Your doctor may prescribe a penicillin drug, such as oxacillin, dicloxacillin or nafcillin, or erythromycin antibiotics to fight infection.
• Don't use non-prescription antibiotic creams or ointments on the boil's surface. They are ineffective.

However, antibiotics are not needed in every situation. In fact, antibiotics have difficult penetrating the outer wall of an abscess well and often will not cure an abscess without additional surgical drainage.

Prevention

Keep the skin clean. Use only locker rooms, showers, tubs and steam rooms that are maintained according to hygienic regulations.