also referred to as a skin abscess, is a localized skin infection that begins as a reddened, tender area. The area soon becomes firm, hard, and more tender, due to the infection.


The center of the


then softens and fills with infection fighting white blood cells in the bloodstream to eradicate the infection.

The white blood cells, bacteria, and proteins are what forms the pus.

Next, the pus “forms a head,” which can be opened or drained through the surface of the skin. Pus enclosed within the tissue is called an abscess.

A “furuncle or carbuncle” is an abscess in the skin usually caused by the Staphylococcus aureus bacteria. A furuncle can have one or more openings on the skin and may be associated with a fever or chills. The term “furuncle” is used to refer to a typical boil that occurs within a hair follicle.

The term “carbuncle” is used to represent a larger abscess that involves a group of hair follicles and involves a larger area than a furuncle.

A “carbuncle” can form a hardened lump that can be felt in the skin. Having chronic or “recurring boils” is referred to as “furunculosis or carbunculosis.”



are caused by an ingrown hair. Others form as the result of a splinter or foreign material that’s become lodged in the skin, or those of acne, from plugged sweat glands that become infected.

Our skin is an essential part of our immune defense against microbes, germs and bacteria, that are foreign to our body. Any cut or scrape in our skin, can develop into an abscess should it become infected with bacteria.

People with a lowered immune system from taking certain medications are more likely to develop boils. Illnesses that can be associated with impaired immune systems are diabetes and kidney failure. Diseases where there’s inadequate antibody production, that are associated with deficiencies in the immune system can increase the tendency to boils.

Medications like cortisone (prednisone, Deltasone, Liquid Pred and prednisolone Pediapred Oral Liquid, Medrol) and medications used for cancer chemotherapy, can suppress the normal immune system and increase the risk of developing boils.


The diagnosis of boils can be made by observation. Blood tests or specialized lab tests are not required to make the diagnosis of a boil. If the infection within a boil has spread to deeper tissues or is extensive, cultures of the pus can be taken to identify the precise type of bacteria. This helps decide the antibiotics for treatmHome treatment is good for most simple boils. Treatment should begin as soon as a boil is noticed, since early treatment may prevent later complications.

The home remedy for most boils is heat application, usually with hot soaks or hot packs. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the infection.

As long as the boil is small and firm, opening and draining the boil is not helpful, even if the area is painful. However, once the boil becomes soft or “forms a head,” it may be ready to drain.

Once the pus is drained, pain relief can be dramatic. Most small boils, like those that form around hairs, drain on their own with hot soaks.

Larger boils will need to be drained or “lanced” by a health care professional. Larger boils contain several pockets of pus that must be opened and drained.

Antibiotics are often used to eliminate an infection of the surrounding skin. Antibiotics are not needed in every situation. Antibiotics have difficulty penetrating the outer wall of an abscess and often will not cure an abscess without additional surgical drainage.

When Do I Need To See A Doctor?

Boils usually resolve on their own and therefore have an excellent prognosis, but there are special cases in which medical care should be sought when boils develop.

Any boil associated with a fever should get medical attention. Increased reddening of the nearby skin and/or formation of red streaks on the skin, the failure of a boil to “form a head,” or the development of multiple boils are other symptoms that warrant a visit to the doctor.

A “pilonidal cyst,” a boil that occurs between the buttocks, is a special case. These almost always require medical treatment, including drainage and packing (putting gauze in the opened abscess to assure it continues to drain). Any painful boil that is not rapidly improving should be seen by a health care professional.


Author: Steve Berchtold

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