What are the other Names for this Condition? (Also known as/Synonyms)

• Furuncle

What is Boil? (Definition/Background Information)

• A Boil may be described as a form of bacterial skin infection in which there is abscess formation at or near a hair follicle. The most common causative bacterium is Staphylococcus aureus
• The condition may be associated with a variety of factors such as diabetes, smoking and alcoholism, malnutrition, and poor immunity
• Depending on the severity of the Boil, it may present pain and discomfort, besides cosmetic concerns. Boils are generally managed using topical agents and antibiotic therapy with good outcomes

Who gets Boil? (Age and Sex Distribution)

• Boils may be observed in both children and adults
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Boil? (Predisposing Factors)

The risk factors for the formation of Boils may include:

• Alcoholism
• Anemia
• Hidradenitis suppurativa
• History of smoking
• Immunocompromised status
• Iron deficiency
• Lymphoproliferative disorders
• Malnutrition
• Obesity
• Resistance to antibiotics
• Uncontrolled diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Boil? (Etiology)

A Boil occurs when bacterium present on skin penetrate the hair follicles and causes an infection resulting in the accumulation of pus and dead cell material. It is a deep form of folliculitis (hair follicle infection).

• The common causative pathogen is the bacterium Staphylococcus aureus, which begins to colonize the hair follicle
• Some of the predisposing factors include diabetes mellitus, immune deficiency, and malnutrition
• Some individuals with recurrent Boils are known to have a family history of the condition or other skin conditions

What are the Signs and Symptoms of Boil?

The signs and symptoms of Boil may include:

• Presence of a slowly growing red bump centered on a hair follicle
• The lesion is tender and grows to fill with pus (pustule)
• The deep skin layers are involved; sometimes, the top skin layers are also simultaneously involved (superficial folliculitis)
• In some, multiple Boils may fuse to form a carbuncle
• Large Boils that form an abscess may rupture and ooze pus and blood
• Pain, irritation, and discomfort is usually seen

If the surrounding tissues are infected, it can lead to fever and general illness. Additionally, the signs and symptoms of the underlying condition, if any present, may be noted.

How is Boil Diagnosed?

A diagnosis of Boil may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation
• Blood tests, analysis of pus, and culture of the fluid being drained (for causative pathogen), as needed
• Other investigative procedures may be necessary to diagnose the underlying disorder (if any)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Boil?

The possible complications due to Boil include:

• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections
• Cellulitis
• Infection may spread to other areas
• Complications may arise from the underlying condition, if any noted
• Recurrence of the condition following treatment
• Resistance of the lesion to therapy
• Treatment complications

How is Boil Treated?

The following measures may be recommended by the healthcare provider for treating Boils:

• Use of topical antiseptic agents (povidone iodine or chlorhexidine cream)
• Administration of oral antibiotics (such as penicillin)
• In case of resistance to conventional antibiotics, the healthcare provider may recommend special antibiotic therapy (such as doxycycline, sulfonamides, clindamycin, or rifampicin)
• Incision and drainage of the purulent material:
  • For small lesions the small incision is left open to permit the flow of more pus as it forms
  • In large lesions, a ribbon of gauze impregnated with iodoform is inserted into the empty space, and a short strip is left outside. This ensures that the opening does not get blocked, trapping pus inside. In a few days, the gauze ribbon is removed, and the healing can continue
• General skin care:
  • Wash the region using antiseptic cleansers or soaps regularly
  • Maintain good hand and body hygiene
  • Use hand sanitizer frequently, especially prior to application of topical agents on the Boil
  • Cover the Boil using a clean gauze, as recommended
  • Use isopropyl alcohol solution to wipe the skin around the Boil
  • Antiseptic creams may be prescribed for the insides of the nostrils (since the bacteria is often present in nasal secretions)

Regular follow up visits with the healthcare provider is important and recommended.

How can Boil be Prevented?

The risks for Boils may be lowered by considering the following steps:

• Adherence to a healthy lifestyle including good nutritious food and plenty of exercise
• Avoid smoking and alcohol
• If obese or overweight, consider suitable weight loss regimen
• Maintain personal body hygiene and cleanliness; take body baths regularly
• Practice frequent handwashing
• Avoid picking nose
• Wear cotton underwear
• Avoid tight-fitting clothes, particularly those made of synthetic material
• Avoid sharing towel and bedspreads with others
• Undertake early and appropriate treatment for any infections or skin conditions
• Do not self-medicate using antibiotics

What is the Prognosis of Boil? (Outcomes/Resolutions)

The prognosis of a Boil is generally good with adequate antibiotic treatment and good skin care. In most cases, the condition clears in a maximum of about 10-14 days.

Additional and Relevant Useful Information for Boil:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/