From the Guidelines
Boils, also known as furuncles, are painful, pus-filled skin infections that form around hair follicles or oil glands, typically caused by Staphylococcus aureus bacteria that enter through small breaks in the skin. They usually start as red, tender bumps that fill with pus and grow larger and more painful until they rupture and drain. According to the clinical practice guidelines by the Infectious Diseases Society of America 1, for minor skin infections, such as small furuncles, moist heat, which helps to promote drainage, may be sufficient.
Treatment and Management
- Applying warm compresses for 10-15 minutes several times daily to promote drainage
- Keeping the area clean with antibacterial soap
- Covering with a sterile bandage
- Incision and drainage is the primary treatment for cutaneous abscesses, including boils, and is likely adequate for most simple abscesses 1
- Antibiotic therapy may be recommended for abscesses associated with severe or extensive disease, signs and symptoms of systemic illness, or lack of response to incision and drainage alone 1
Prevention
- Good hygiene practices, including regular handwashing
- Not sharing personal items
- Keeping cuts clean and covered
- People with diabetes, immune disorders, or poor hygiene are at higher risk for developing boils
When to Seek Medical Attention
- If a boil is extremely painful, large (bigger than 2 inches), accompanied by fever, doesn't improve after a week, or recurs frequently
- Your doctor may prescribe oral antibiotics, such as cephalexin 500mg four times daily for 7-10 days, or incise and drain larger boils 1
From the Research
Definition of Furuncles (Boils)
- Furuncles, also known as boils, are abscesses of a hair follicle 2
- They are red, painful collections of purulence in the dermis and deeper tissues caused by Staphylococcus aureus or polymicrobial infections 2
- Furuncles involve a single hair follicle, whereas carbuncles involve several hair follicles 2
Characteristics and Treatment
- Furuncles are a type of acute bacterial skin and skin structure infection (ABSSSI) 3
- Management of furuncles consists of incision and drainage 2, 4
- Oral antibiotics are not necessary in most cases, but should be prescribed for patients with severe immunocompromise or systemic signs of infection 2
- Methicillin-resistant S aureus coverage should be considered for patients with infections that have not improved with treatment 2, 4
Related Infections
- Furuncles are related to other bacterial skin infections, such as cellulitis, erysipelas, and folliculitis 2
- These infections can be caused by a variety of bacteria, including Staphylococcus aureus and Streptococcus pyogenes 5, 2
- Polymicrobial infections, including those involving multiple microbial etiologies, can also occur 6