Overview

Boils are raised pus-filled bumps of varying sizes on the skin. The initial red itchy bump changes to yellow as it continues to swell. The most common places they appear are on the face, neck, armpits, shoulders, and buttocks.

Boils form frequently under unhygienic conditions and the infection can spread to other adjoining areas of the body or people through the transmission of bacteria.

Boils

Staphylococcus aureus, a bacteria, lives on the surface of our skin. It produces toxins which cause infections.

Panton, valentine, leucocidin, exfoliatins, enterotoxins and shock syndrome toxin1 are the toxins released by S. aureus. These toxins cause eruptions on broken skin¹ called boils.

Nature of boils

Boils formed may be:

• Primary 
• Secondary

When they occur independently, they are primary boils. Style, furuncles, and abscesses are primary boils.

Secondary boils arise in existing lesions. A pre-existing wound may develop boils due to infection.

Formation of boils 

The skin has hair follicles which lie in contact with the sebaceous glands. The hair follicles are lined by cells. The sebaceous glands produce oily secretion which they pour on the surface of skin through pores. The cells, oily secretions, and hair clog these pores. This traps bacteria, which release toxins and cause bumps to form on the skin.

Boils form on our skin due to the following reasons:²

Bacterial infections

A boil or furuncle is an infection of the hair follicle. S. aureus inhabits our skin, and enters the skin through cuts or wounds. On reaching the deeper layer of skin, bacteria produce toxins, causing inflammatory reactions within the hair follicles with pus formation.

Clogged follicles

Friction from tight clothes, shaving, and poor hygiene block the pores of the hair follicles. Clogged follicles trap bacteria, which release toxins, irritate the skin and form pus.

Weak immune system

A weak immune system due to medical conditions or medications predisposes us to infections. Individuals who suffer from any of these are likely to develop boils. 

• Diabetes
• Burns
• Eczema
• Undergoing chemotherapy 

Hormones

Sebum (an oil from skin glands) production from the skin increases with increasing hormone production in the body.

The skin remains soft and supple due to the secretion of this sebum, released on the skin surface through pores. Excess production of sebum blocks hair follicles and causes the accumulation of pus. During puberty, more sex hormones circulate in the body. Hair follicles get blocked and cause acne.

Contact with chemicals

Detergents and chemicals harm the skin. Boil formation may occur as an allergic reaction to them.

Spread of infection

Infections by Staphylococcal bacteria are contagious. They occur on the skin but can spread to other parts of the body from there. 

The spread of bacteria occurs due to:

• Skin contact
• Sharing infected personal items
• Contaminated medical equipment
• Poor hygiene

Risk factors for boils

The following are risk factors for boil formation:³

• Boils spread among individuals by touching or by bursting boils with deficient hygiene.
• A reservoir of methicillin-resistant S. aureus is the nasal passage. People who have moustaches develop boils because of these bacteria.
• Asymptomatic carriers in the household.
• Iron deficiency anaemia.
• History of recent hospital admission.
• Previous use of antibiotics causes resistance
• History of Diabetes mellitus 

Signs and symptoms of boils

• Swelling
• Pain
• Redness
• Abscess
• Fever

Hygiene and boil prevention

Importance of regular handwashing

Our first defence mechanism against any invasions of our body by disease-causing microorganisms is hygiene. Handwashing and bathing are simple and effective methods for good hygiene. Cleaning with soap and water keeps our skin surface free of disease-causing organisms.

Keeping our environment clean

We should wear washed and dry clothes to prevent the spread of diseases.

All items like cosmetics, razors and towels which come in contact with our skin should not be shared as we can acquire infection through their use. We should take all precautions to keep our personal items clean.

Avoiding sharing of items

Never share towels, razors, and clothing with others. It predisposes us to catch infections.

Caring for wounds and getting regular dressings protects them from infections.

Treatment and management of boils

Bacterial skin infections may present as local or progressive ones. 

Localised infections are limited to specific regions. A boil formed in the eye is localised and is called a stye.   

Progressive infections have systemic toxicity. The S.aureus bacteria enters the bloodstream and causes sepsis. It triggers septic shock which may even be fatal.

Antibiotic treatment

Recurrent staphylococcal infections require antibiotics and expert consultation.⁴

Incision and drainage

Large boils may require incision and drainage of the pus by your health practitioner

Warm compression

Warm compresses on the boils help to draw out the pus, relieve the pain and drain the abscess. Antiseptics also yield results in small boils.

Warm applications with compression speed healing. A spike forms through which the pus drains.

Hygiene

• Good hygiene practices make use of soap and water. A gentle wash with soap and water lowers the bacterial colony count on the skin. ³. As the boil drains, toxins, and cell remnants spread to the adjacent areas. It increases the area of the spread of infection. Washing the entire surface with a mild soap and water sanitizes it. It removes pus, bacteria and toxic materials released from its rupture.
• We should use a clean, dry bandage over it to promote uneventful and infection-free healing.
• Never prick it with a needle. It may worsen the infection.

Home remedies for treatment of boil

Turmeric is an extensively used spice in Asian cooking. It contains curcumin. Curcumin has anti-bacterial and anti-inflammatory properties which are well-known and well-established. It is an oral and topical medicine in Ayurveda (a traditional branch of alternative medicine in India).

Turmeric is boiled in milk, cooled, and then taken two to three times a day. A paste of turmeric with water or ginger is used topically over wounds.

It is an effective home remedy.

FAQs

How are boil and carbuncle different?

A bacterial infection of one or more hair follicles is a boil. A carbuncle has many boils within the infected area.

Can I pop a boil?

There is always a chance to spread the infection to neighbouring areas. Popping may even leave a scar so it is not recommended

Summary

Boils are pus-filled skin infections commonly caused by Staphylococcus aureus, a bacteria that inflames hair follicles, resulting in red, swollen bumps often found on the face, neck, and armpits. Poor hygiene, clogged follicles, and weakened immunity increase the likelihood of boils, which can spread through direct contact or shared personal items. Boils are classified as primary, forming independently, or secondary, arising from pre-existing lesions. 

Preventive measures include regular handwashing, personal hygiene, and not sharing personal items. Treatment may involve antibiotics, warm compresses, and drainage, while turmeric offers a natural remedy due to its antibacterial and anti-inflammatory properties. It’s essential to avoid popping boils to prevent the infection from spreading to other areas