Abscesses and boils (furuncles)

Overview

An abscess is a bacterial collection of pus, either on the skin or inside the body. In contrast, the term boil refers only to abscesses of the hair follicles, sweat glands or sebaceous (i.e. oil) glands. Both cause severe pain and present as pus-filled lumps. Moist warm compresses and skin disinfection can bring relief.

Symptoms

Symptoms

Abscesses can occur anywhere in the body. The most common areas include the armpits (sweat gland abscess), the neck and the face (furuncle of the upper lip, furuncle of the nose). Abscesses on the surface of the body are easy to recognise:

• Reddened and painful lumps under the surface of the skin (often accompanied by a pulsating sensation)
• Over time, the tissue inside this lump dies and pus is formed
• An abscess can burst spontaneously
• Once the pus drains, there is immediate relief from the tension and pain

Not every “pimple” develops into an abscess or boil (these are substantially bigger and more painful).

Complications

• Fever and swollen lymph nodes in the vicinity of the abscess: infection is progressing
• Abscesses inside the body (e.g. in an organ) are invisible from the outside and occur almost exclusively in people with weakened immune systems
• When bacteria enter the blood stream, blood poisoning (sepsis) can occur as a rare complication

Causes and treatment

Causes

Abscesses and boils are caused by bacteria. The bacteria enter the body through a weak spot in the skin, but can also spread through the bloodstream. Factors that promote the onset include:

• Immune deficiency, e.g. having diabetes (diabetes mellitus)
• Poor personal hygiene

Further treatment by your doctor / in hospital

Possible tests

• Pus smear (search for bacteria)
• Blood test (measurement of inflammatory markers)
• Ultrasound (sonography)
• CT scan (computed tomography)

Possible therapies

• Antibiotics
• Opening of abscess/boil with a scalpel
• Abscesses inside the body are less accessible and long drainage catheters (thin tubes to drain the abscess) often have to be inserted into the pus-filled cavity, guided by ultrasound or CT

What can I do myself?

Skin infections are mostly superficial and harmless. Popping them often makes them worse, because the bacteria are pushed deeper into the tissue.

• At the beginning, moist warm compresses can promote spontaneous drainage of the pus
• Regularly disinfect the affected skin area
• Boils in the face, in particular furuncles of the nose, should not be popped

Prevention

• Good personal hygiene
  • Careful: overly aggressive hygiene dries out the skin and disrupts the skin’s acid mantle, weakening the protection it affords against bacteria

When to see a doctor?

• The drainage of pus doesn't lead to any improvement
• Self-help measures had no success (see “What I can do myself”)
• Repeated occurrence of abscesses or boils (furunculosis)
• Fever (in particular chills)
• Boils in the face and/or new swelling in the inner corner of the eye (risk that bacteria can spread to the brain)

Synonyms

Abscesses and boils, Furuncles