Boils

Causes

Boils are very common. They are most often caused by the bacteria Staphylococcus aureus. They can also be caused by other types bacteria or fungi found on the skin's surface. Damage to the hair follicle allows the infection to grow deeper into the follicle and the tissues under it.

Boils may occur in the hair follicles anywhere on the body. They are most common on the face, neck, armpit, buttocks, and thighs. There can be one or many boils.

Symptoms

A boil may begin as a tender, pinkish-red, swollen, firm area in the skin. Over time, it will feel like a water-filled balloon or cyst.

Pain gets worse as it fills with pus and dead tissue. Pain lessens when the boil drains. A boil may drain on its own. More often, the boil needs to be opened to drain. 

The main symptoms of a boil include:

• A bump about the size of a pea but may be as large as a golf ball
• White or yellow centers (pustules)
• Spreading to other skin areas or joining with other boils
• Quick growth
• Weeping, oozing, or crusting

Other symptoms may include:

• Fatigue
• Fever
• General ill-feeling
• Itching before the boil develops
• Skin redness around the boil

Exams and Tests

The health care provider can usually diagnose a boil based on how it looks. A sample of cells from the boil may be sent to the lab for a culture to look for staphylococcus or other bacteria.

Treatment

Boils may heal on their own after a period of itching and mild pain. More often, they become more painful as pus builds up.

Boils usually need to open and drain in order to heal. This most often happens within 2 weeks.

• Put warm, moist compresses on the boil several times a day to speed draining and healing. 
• Never squeeze a boil or try to cut it open at home. This can spread the infection.
• Continue to put warm, wet compresses on the area after the boil opens.

You may need to have surgery to drain deep or large boils. Get treatment from you health care provider if:

• A boil lasts longer than 2 weeks.
• A boil comes back.
• You have a boil on your spine or the middle of the face.
• You have a fever or other symptoms with the boil
• The boil causes pain.

It is important keep a boil clean:

• Clean and change dressings on boils often.
• Wash your hands very well after touching a boil.
• Do not re-use or share washcloths or towels. Wash clothing, washcloths, towels, and sheets or other items that contact infected areas in very hot water.
• Throw out used dressings in a sealed bag so that fluid from the boil does not touch anything else. 

Your doctor may give you antibiotics you take by mouth or a shot if the boil is very bad or comes back.

Antibacterial soaps and creams cannot help much once a boil has formed. 

Outlook (Prognosis)

Some people have repeated infections and are unable to prevent them.

Boils  in areas like the ear canal or nose can be very painful. A health care provider should treat boils of the nose.

Boils that form close together may expand and join, causing a condition called carbunculosis.

Possible Complications

• Abscess of the skin, spinal cord, brain, kidneys, or other organ
• Brain infection
• Endocarditis
• Osteomyelitis
• Permanent scarring
• Sepsis
• Spinal cord infection
• Spread of infection to other parts of the body or skin surfaces

When to Contact a Medical Professional

Call your health care provider if boils:

• Appear on the face or spine
• Come back
• Do not heal with home treatment within 1 week
• Occur along with a fever, red streaks coming out from the sore, large build up of fluid in the area, or other symptoms of infection

Prevention

The following may help prevent the spread of infection:

• Antibacterial soaps
• Antiseptic (germ-killing) washes
• Keeping clean (such as thorough handwashing)

Alternative Names

Furuncle

References

Habif TM. Bacterial infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 9.

Millett CR, Halpern AV, Reboli AC, et al. Bacterial Diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa:Mosby Elsevier; 2012:chap 74.

Update Date: 11/20/2012

Updated by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.