Boils and carbuncles

Overview

A boil is a painful, pus-filled lump that forms under the skin when a hair follicle becomes infected. A carbuncle is a cluster of boils that join together to create a larger, deeper infection. Both are caused by bacteria, most often Staphylococcus aureus.

Yes, boils are very common. Carbuncles are less common but still occur.

Anyone can get a boil, but they are more common in people with diabetes, weakened immune systems, poor hygiene, or skin conditions like eczema. People who are overweight or live in crowded conditions also have a higher risk.

Symptoms

Common symptoms

• A red, painful lump under the skin that grows over a few days.
• The center of the lump becomes soft and filled with pus (a white or yellow tip).
• Warmth and swelling around the area.
• The boil may burst and drain pus on its own.

Symptoms in children

• Children can develop boils in the same way as adults, especially on the face, neck, armpits, or buttocks.
• They may be more irritable or complain of pain.
• Avoid squeezing or picking at the boil — it can make the infection worse.

Symptoms in older adults

• Older adults may have slower healing and a higher risk of the infection spreading.
• The skin may be thinner, so boils can be more painful.
• Any signs of spreading redness or fever should be checked promptly.

Causes

Main causes

• Infection of a hair follicle by bacteria, most often Staphylococcus aureus.
• Bacteria enter through a small cut, scratch, or other break in the skin.

Risk factors

• Poor hygiene.
• Sharing towels, razors, or clothing with someone who has a boil.
• Skin conditions like eczema or acne.
• Having diabetes, which can weaken the immune system.
• Being overweight.
• Living in close quarters, such as dormitories or care homes.

When to see a doctor

See a doctor urgently if:

• You have a boil that is very painful, large, or does not start to heal within a week.
• You have signs of spreading infection: red streaks, fever, chills, or swollen lymph nodes.
• You have repeated boils (multiple episodes).

Book a routine appointment if:

• You have a boil that is not causing severe symptoms but you are worried about it.
• You want to discuss ways to prevent future boils.

Diagnosis

Your doctor can usually diagnose a boil or carbuncle by looking at it and feeling the skin. They will ask about your symptoms and medical history.

Tests that may be done

• In some cases, your doctor may take a swab of the pus to identify the bacteria causing the infection.
• If you have recurrent boils, your doctor may check your blood sugar or test for other conditions.

What to expect at your appointment

Your doctor will examine the area and may gently press on it to see if it is ready to drain. They will explain the best treatment for your situation.

Treatment

Treatment depends on the size and severity of the boil or carbuncle. Many small boils heal with self-care, while larger or more severe ones may need medical treatment. The goal is to help the infection drain and prevent it from spreading.

Self-care at home

• Apply a warm, moist cloth (compress) to the boil for 10–15 minutes, 3–4 times a day. This helps bring the pus to a head and allows it to drain naturally.
• Keep the area clean and dry. Wash your hands before and after touching the boil.
• Cover the boil with a clean, dry bandage once it starts to drain to prevent spreading the infection.
• Do NOT squeeze, pop, or cut the boil yourself. This can push the infection deeper into your skin.

Medical treatments

For larger boils or carbuncles, your doctor may recommend lancing (making a small cut) to drain the pus under sterile conditions. They may also prescribe an antibiotic if the infection is widespread or if you have other health conditions. Antibiotics are usually taken by mouth or applied as a cream.

When is surgery considered?

Lancing and drainage is a common minor procedure done in the doctor's office for carbuncles or large, deep boils. It involves numbing the area, making a small cut, and letting the pus drain. Afterward, the wound is packed with special gauze to keep it open so it can continue to drain.

Living with this condition

While a boil is healing, keep the area clean and covered. Change the bandage daily or whenever it gets wet or dirty. Wash your hands thoroughly after any contact. Avoid activities that may rub or irritate the area.

Lifestyle tips

• Practice good hygiene: shower daily, wash your hands often, and use clean towels.
• Do not share personal items like razors, towels, or clothing.
• Wash sheets and towels in hot water if you have an active boil.

Diet and exercise

A balanced diet rich in fruits, vegetables, and whole grains can support your immune system. Drinking plenty of water helps with healing. Gentle exercise is fine as long as it does not rub or put pressure on the boil.

Mental health and emotional wellbeing

Boils can be painful and sometimes embarrassing, especially if they are on visible areas like the face. It is normal to feel self-conscious or worried. Talk to your doctor about any concerns. Remember that with proper care, boils usually heal without long-term problems.

Prevention

Yes, you can reduce your risk of boils by keeping your skin clean and dry, avoiding sharing personal items, and taking care of any cuts or scrapes promptly. If you have a medical condition like diabetes, managing it well can also help prevent boils.

Vaccines

There is no vaccine specifically for boils or carbuncles.

Screening programmes

No routine screening is needed for boils. However, if you get them often, your doctor may check for underlying conditions such as diabetes.

Complications

If left untreated

• The infection can spread to nearby skin, causing a deeper infection called cellulitis.
• Rarely, the bacteria can enter the bloodstream and cause sepsis, a serious body-wide infection.
• Scarring can occur, especially if the boil is large or was squeezed.

Long-term outlook

With proper care, most boils heal completely within 1–3 weeks. Carbuncles may take longer and require medical treatment. Serious complications are uncommon. If you follow the self-care steps and see your doctor when needed, the outlook is very good.

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