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Home > Skin & Beauty > Skin Conditions > Boils and Abscesses: Symptoms, Treatment, and Complications

Boils and Abscesses: Symptoms, Treatment, and Complications

December 28, 2020 - Updated on June 24, 2022
5 min read
By Akanksha Shah Sanghvi, MD, Clinical Dermatology

In this article:

  • Cause of Boils and Abscesses
  • Symptoms Associated With Boils and Abscesses
  • Medical Treatment for Boils and Abscesses
  • Diagnosing the Cause of Boils and Abscesses
  • Risk Factors for Boils and Abscesses
  • Complications of Untreated Boils or Abscesses
  • When to See a Doctor
  • Final Word

A skin boil, also called a furuncle, refers to the formation of small, red nodules in the skin pores. These boils may either be present in the hair follicle or oil gland as a painful nodular structure.

boils and abscess

Boils generally develop in exposed skin areas such as the arms, hands, neck, and face. However, they can also spread to the shoulders and back. Boils can even occur on the eyelids and the condition is called a stye.

Boils are accompanied by inflammation and pus accumulation. They are smaller than an abscess, but if left untreated, boils can develop into a larger abscess eventually.

Cause of Boils and Abscesses

causes behind boils and abscesses

The most common cause of boils and abscess is skin infection due to bacteria such as: (1)

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  • Staphylococcus
  • Streptococcus
  • Chlamydia (in case of vaginal boils)

These bacteria are a part of the normal microbial flora present on the skin surface, such as armpits, nostrils, and upper thigh junction.

However, a cut in the skin can provide a path for the bacteria to enter the hair follicles and oil glands, wherein the body’s immune system is not as strong. This causes inflammation in the hair follicles known as folliculitis.

Once inside the skin pores, the bacteria cause an infection, which persists for around 10 days. Within this period, the body’s immune system assigns white blood cells to the site of infection.

The WBCs, along with cell debris, can collect in the wound, leading to the formation of pus and thus resulting in a painful abscess.

Symptoms Associated With Boils and Abscesses

Boils appear as red, elevated bumps, often with a yellowish-white top due to the accumulation of pus. Abscesses, on the other hand, have a distinctive pinpoint at the center of the bump from where the pus can ooze out.

Additionally, boils and abscesses may be accompanied by the following symptoms:

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  • Fever
  • Erythema
  • Nausea
  • Swollen lymph nodes

Medical Treatment for Boils and Abscesses

treatment options for boils and abscesses

The treatment for boils and abscesses depends on their severity. The various treatment options include: (2)

1. Topical antibiotics

Topical antibiotics may be given if there are severe and large boils that are painful. You may be prescribed to apply 2% fusidic acid cream or 2% mupirocin 2% cream twice a day. These are generally used in combination with other treatments.

Boils, folliculitis, or abscesses may recur if the bacteria causing them become resistant to antibiotic treatment. In such cases, the doctor may prescribe clindamycin, which is another topical medication mainly used for targeting antibiotic-resistant staphylococcus bacteria or methicillin-resistant Staphylococcus aureus (MRSA).

2. Oral antibiotics

The doctor may also suggest the use of oral antibiotics if there are several boils or abscesses.

3. Topical antiseptics

These are available in the form of creams containing benzoyl peroxide, soaps, and hypochlorite solutions. For recurrent infections, antibiotics are used in adjunction with topical antiseptics.

4. Pain medication

Drugs such as ibuprofen and acetaminophen may be given to help manage the pain.

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5. Surgery

This involves making a cut on larger abscesses to help drain out the pus. This procedure is also known as a surgical incision or lancing the boil. Gauze may be used to help keep the abscess open for continued drainage.

Diagnosing the Cause of Boils and Abscesses

While boils and abscesses can be identified based on their appearance alone, the doctor may take a closer look to find the source of the problem. The physical exam includes looking for ingrown hair or injury.

Further, the doctor may order a culture of the skin cells to identify the presence of infection-causing bacteria. For recurrent boils and abscesses, you may require blood and stool tests.

Risk Factors for Boils and Abscesses

The following factors can predispose you to bacterial infections and, thus, developing boils and abscesses by weakening or damaging the protective skin barrier:

  • Diabetes (3)
  • Endocarditis
  • Skin problems such as eczema
  • Kidney failure (4)
  • Obesity (5)
  • Weak immune system
  • Poor nutrition
  • Iron deficiency
  • Lack of hygiene
  • Chemotherapy
  • Contact with harsh chemicals
  • Medications such as antibiotics and cortisone
  • Contact with a staph-infected person
  • Hormonal imbalance during puberty
  • Smoking (6)
  • History of boil or abscess (5)
  • Chlorinated swimming water
  • Young age or childhood

Complications of Untreated Boils or Abscesses

complications associated with boils and abscesses

If left untreated, the infection causing boils and abscesses can give rise to the following complications:

  • Tooth abscess
  • Cellulitis
  • Fatigue
  • Permanent scarring
  • Redness around the eye or infected area
  • Infection in the bones, spinal cord, or even brain
  • Sepsis

When to See a Doctor

Boils generally resolve on their own or with proper self-care, but they can be troublesome in severe cases.

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It is best to consult a doctor if:

  • The boils appear in clusters, known as a carbuncle.
  • Persistent boils and abscesses that don’t heal within 2 weeks.
  • The boils are spreading.
  • The lymph nodes are swollen.
What you may ask your doctor
  • Can the boils spread to other body parts?
  • Can smoking be the cause behind the boils?
  • How can I prevent reinfection?
  • Do I need to use/avoid specific skin products?
What your doctor may ask you
  • When did the boils first appear?
  • Have you tried any treatment?
  • Are you a regular smoker?
  • Do you have a medical condition or are you on prescription drugs?

Final Word

A boil or abscess is a pus-filled red bump on the skin and causes pain, especially when touched.

While generally not a severe problem, the bacterial infection that causes boils may spread and cause complications. Therefore, it is best to consult a doctor if the boil or abscess doesn’t resolve on its own within a week or two.

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Continue Reading Continue Reading10 Home Remedies for Boils and Abscesses
References
  1. Kobayashi SD, Malachowa N, DeLeo FR. Pathogenesis of Staphylococcus aureus abscesses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450319/. Published June 2015.
  2. Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC. Interventions for bacterial folliculitis and boils (furuncles and carbuncles). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513076/. Published August 15, 2018.
  3. Venkatesan R, Baskaran R, Asirvatham AR, Mahadevan S. ‘Carbuncle in diabetes’: a problem even today! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535106/. Published June 19, 2017.
  4. Mehmood M, Khasawneh FA. Staphylococcus lugdunensis gluteal abscess in a patient with end stage renal disease on hemodialysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387343/. Published January 28, 2015.
  5. Shallcross LJ, Hayward AC, Johnson AM, Petersen I. Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582880/. Published October 2015.
  6. BC; DBKSC. Recent smoking is a risk factor for anal abscess and fistula. https://pubmed.ncbi.nlm.nih.gov/21552051/. Published 2011.
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