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A boil: what is it? Causes, Symptoms and Treatment

furuncle corresponds to the deep infection of the base of a hair, the pilosebaceous follicle, caused by a bacterium, which in the vast majority of cases is a staphylococcus aureus ( S. aureus ).

The boil is a big pimple very painful, first red and hard, which quickly turns into a pustule (pussetbutton containing pus).

Boils can form all over the body. Their healing is done in a few days, provided they have been treated properly.

In some cases, several boils appear in the same place. This is known as anthrax , a grouping of several boils affecting neighboring pilosebaceous follicles, occurring mainly in the upper back.


Who is affected by boils?

Boils are very common and they affect men and adolescents more.

The hairy areas subject to friction are the most affected: beard, armpit, back and shoulders, buttocks, thighs.

It is difficult to accurately estimate the prevalence of boils, but golden staphylococcal skin infections (which include other infections such as abscesses, folliculitis or erysipelas) account for up to 70% of skin infections that have to be covered.

Causes of boils

Boils are almost always caused by a bacterium called Staphylococcus aureus ( S. aureus ), which is widespread in the environment, but also lives in humans, on the skin, in the nasal cavity or the gut.

About 30% of adults are permanent “carriers” of Staphylococcus aureus, which means they “host” it continuously, especially in the nasal cavity, without developing an infection.

However, Staphylococcus aureus produces harmful toxins and can be very dangerous, infecting the skin, but also internal organs or blood in some cases.

For several years, golden staphylococci have become increasingly resistant to antibiotics and represent a growing threat, especially in hospitals.


Evolution and possible complications of boils

Most often, a simple boil, well cared for, heals in a few days, leaving a scar. The anthrax (grouping of several boils) requires more intensive treatment and may take longer to heal.

Complications are rare, although it is common for a boil to reappear in the same place a few months or even years later.

In some cases, especially in people whose immune system is weakened, a boil can lead to potentially serious complications:

  • furunculosis , characterized by multiple boils repeated, which come back and persist over periods of several months
  • serious infection  : the bacterium can spread in the blood (sepsis ) and to different internal organs if an ill-treated boil worsens. Fortunately, these complications are very rare.

The symptoms of boil

The boil evolves in 5 to 10 days:

  • it begins with the appearance of a nodule (a ball) painful, hot and red, about the size of a pea;
  • it grows and fills with pus that can rarely reach the size of a tennis ball;
  • a white point of pus appears (bourbillon): the boil pierces, the pus is eliminated and leaves a red crater which will form a scar.


In case of anthrax, that is to say, the occurrence of several contiguous boils, the infection is more important:

  • agglomeration of boils and inflammation of a large area of skin;
  • possible fever;
  • swelling of the ganglia

People at risk

Anyone can develop a boil, but some people are at higher risk, including:

  • Men and adolescents;
  • People with type 2 diabetes;
  • People with weakened immune system (immunodepression);
  • People suffering from a skin problem favoring infections (acne, eczema);
  • Obese people (obesity);
  • Patients treated with corticosteroids.

Risk factors

Some factors favor the appearance of boils:

  • lack of hygiene;
  • repeated rubbing (tight clothing, for example)
  • small wounds or punctures on the skin, which become infected;
  • mechanical shaving.

Prevention of boil

Can we prevent boils?
It is not possible to systematically prevent the appearance of boils, but some basic hygiene advice can reduce the risk of skin infection.


Basic preventive measures
  • Wash hands frequently with soap
  • Clean and disinfect small wounds
  • Do not share laundry or toiletries, such as sheets, towels or shavers, and change them regularly.

Warning ! The boil can be contagious. It should not be “triturated” at the risk of spreading the infection to other areas of the body. The affected person and those around him should wash their hands and brush their nails regularly. It is advisable to boil clothes, sheets and towels that come into contact with the boil.

Medical treatments of boil

When a boil appears on the face, grows too much, gets worse quickly or is accompanied by fever, it is important to consult quickly for effective treatment and avoid complications.

Isolated boil

In case of simple boil , local treatment is recommended, in combination with daily hygiene measures.

At the beginning stage, it is possible to apply a hot water compress for about ten minutes, several times a day, to relieve the pain.

The area should be washed with soap and water once or several times a day, then disinfected with a local antiseptic such as aqueous chlorhexidine, without rubbing.

The furuncle must then be protected with a clean dressing, taking care to wash your hands thoroughly before and after the treatment.

Warning  : it is strongly discouraged to pierce or incise the boil yourself (risk of spread or contagion, aggravation of infection).

It is also better to wear loose cotton clothes and change clothes daily.

Complicated boils, anthrax or furunculosis

Some more serious cases require rapid medical management:

  • face boil
  • anthrax or multiple boils,
  • recurrent boils
  • weakened immune system, diabetes
  • fever

In these cases, the treatment is based on:

  • strict hygiene and daily shower with chlorhexidine
  • the doctor can incise and drain the boil to promote healing
  • systemic antibiotic therapy for 10 days may be necessary

In some cases, it is also necessary to eliminate persistent bacteria especially in the nasal cavity and likely to cause recurrence. It may be useful to perform an antibiogram to detect possible resistance to antibiotics, in case of furuncle resistant to treatment.

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