What Is Nasal Furunculosis

Overview

Nasal furunculosis is a condition characterised by the development of boils or abscesses in the nose. This happens in the front part of the nasal cavity, which is known as the nasal vestibule. The nasal vestibule is made of cartilage, skin cells, and hair follicles. It is at the base of these hair follicles that the nasal abscess occurs because of a bacterial infection. Nasal furunculosis and nasal vestibulitis are very commonly associated, in fact, furuncles are one of the symptoms of nasal vestibulitis. Nasal vestibulitis, as the name suggests, is the infection of the same area, and when abscesses  or “furuncles” present with vestibulitis, it is called furunculosis.^1,4

Causes of nasal furunculosis

Nasal furunculosis is usually caused by the bacterial Staphylococcus aureus, which is commonly found on the skin and in the nasal passages. 

Staphylococcus aureus is a bacteria that is part of our skin flora. Which means we carry it on our skin without it hurting us. It is also known as an opportunistic pathogen, which means when the integrity of the skin is compromised, it finds its way into the damaged area, colonising the affected area and releasing toxins that cause inflammation. 

Certain factors and health conditions can increase the risk of developing nasal furunculosis, which includes poor personal hygiene, nose picking, nasal trauma, chronic sinusitis, nose piercings, and a weakened immune system.^1,3

Signs and symptoms of nasal furunculosis

The most common symptom of nasal furunculosis is a painful lump or boil inside the nasal vestibule. 

Nasal discharge, redness and swelling of the nose, tenderness, dryness, nosebleeds, and crusting of the nostrils are other symptoms associated with nasal furunculosis. 

In severe cases, systemic symptoms such as fever and malaise may be seen.^1,4

Diagnosis of nasal furunculosis

Diagnosis of nasal furunculosis will be made by a doctor, and it is usually made based on clinical presentation as well as physical examination. 

A detailed history will be taken during the examination as your physician will eliminate possible other causes that may seem similar to nasal furunculosis. 

In some cases, a culture of the area may be taken to find out the specific pathogen causing the abscess, but this is rare because the development of culture takes time and thus will delay the treatment.^1,3

Management and treatment for nasal furunculosis

Treatment of nasal furunculosis usually involves antibiotics, incision and drainage of the abscess, and pain management. 

Topical antibiotic creams and oral antibiotics may both be prescribed. 

In some cases, if the abscess is big enough, a one-time injection of antibiotics to the affected area might also be needed. 

Patients will also be advised to practise good personal hygiene and avoid picking their noses. 

Saline drops or emollients may also be recommended to increase the moisture of the skin cells in the area. 

In the cases of recurrent furunculosis, patients may need to undergo a process called nasal decolonization, which involves surgical drainage and the use of topical or systemic antibiotics to eliminate the bacteria from the nasal passages. completely.^1,4

Complications of nasal furunculosis

The nasal cavity is an area with a high blood supply. This means the infection can get into the bloodstream, and it can migrate to other parts of the body, such as the brain, eyes, and lungs. In rare cases, nasal furunculosis can also lead to the development of serious conditions, such as cavernous sinus thrombosis or even sepsis.^2,4

FAQs

Who is at risk of nasal furunculosis?

As discussed above, certain factors and health conditions can increase the risk of developing nasal furunculosis. Individuals with weakened immune systems, chronic sinusitis, or poor personal hygiene are at increased risk of developing nasal furunculosis.^1,3

How common is nasal furunculosis?

Because staphylococcus aureus is commonly found as part of the nasal flora, it makes nasal furunculosis a relatively common condition, and it can affect both children and adults. Although skin infections are a common occurrence, only three in a hundred people who seek medical attention would have a boil, which does not necessarily have to be nasal furunculosis. People with conditions such as eczema, conjunctivitis, and asthma are more likely to develop nasal furunculosis.¹

How can nasal furunculosis be prevented?

Nasal furunculosis can be prevented by practising good personal hygiene, making sure the skin is well moisturised, avoiding nasal trauma, including nose picking, and treating underlying conditions such as chronic sinusitis.^1,3

When should I see a doctor?

You should contact your GP if you develop symptoms of nasal furunculosis. These symptoms may be a painful lump or boil inside the nose as well as redness, swelling, and tenderness of the affected area or even systemic symptoms against infection such as fever.

Summary

In summary, nasal furunculosis is a condition in which boils or abscesses develop in the nasal vestibule due to a bacterial infection, most commonly Staphylococcus aureus. Poor personal hygiene, nose picking, nasal trauma, chronic sinusitis, nose piercings, and a weakened immune system are some of the factors that increase the risk of developing nasal furunculosis. The symptoms include a painful lump or boil inside the nose, redness, swelling, tenderness, dryness, nosebleeds, and crusting of the nostrils. Diagnosis is usually made based on clinical presentation and physical examination, with treatment involving both topical and systemic antibiotics as well as incision and drainage of the abscess. Good personal hygiene, avoiding nose picking and nasal trauma, and treating underlying conditions can help prevent nasal furunculosis. In severe cases, nasal furunculosis can lead to serious complications such as cavernous sinus thrombosis or sepsis, making it important to seek medical attention if symptoms occur.