What is a Furuncle: Causes, Symptoms, Treatment, Home Remedies, Prognosis, Recovery, Prevention

A furuncle is a type of infection in skin which usually begins in oil gland or hair follicle. It begins with reddish appearance on skin with tender lump in the centre. Gradually in a time period of 4-7 days, it starts to turn white because of the pus formation in the lump. If it is left untreated, the infection reaches to surrounding tissues turning into a furuncle.

• Usually furuncle occurs on neck, buttocks, armpits, face or shoulders.
• Sometimes multiple furuncle can occur together leading to serious infection termed as carbuncle.

A furuncle does not require attention of a medical expert but you can refer to a dermatologist if required. Primary-care specialists such as internal medicine specialist, paediatrician, family practitioner etc… can also help in managing a furuncle. In case of severe furuncle infection, it is best to refer to a surgeon or infectious disease specialist. Emergency-medicine doctors can also take care of any severe furuncle infection.

A furuncle is a bacterial infection caused by bacteria which is known as staph or staphylococcus. A furuncle usually turn into serious infection forming abscesses. The bacteria usually enters into the skin through hair follicle or tiny breaks present on the skin. Certain specific medical conditions can increase the risk of developing furuncle. Some of them are as follows:

• Diabetes.
• Weak immunity.
• Unhealthy diet.
• Poor hygiene.
• Exposing skin to harsh chemicals that can cause skin irritation.

Initially a furuncle appears like a limp on the skin with reddish appearance and some pain. Quickly, it turns larger with pus formation with higher degree of pain. You can identify furuncle when it becomes severe by following signs and symptoms:

• The skin surrounding the lump show swelling with reddish appearance and lots of pain.
• Many more boils start to develop around the main boil.
• Swelling in lymph nodes surrounding the limp.

• If the furuncle gives you a fever.
• Red steaks start to appear around the lump with reddish skin.
• Severe pain in lump.
• Lump continues to accumulate pus.
• More furuncles appears on the surrounding.
• If you are suffering from certain medical conditions such as diabetes, heart murmur, weak immunity or even taking medicines for suppressing immune system.
• Usually a furuncle does not cause any serious concern but if you not healthy or infection gives you fever, you might need immediate medical attention including hospitalization.

A furuncle can affect anybody but individuals with weak immunity or those who are taking medicines to suppress immune system have increased risk of developing a furuncle. Immune system helps the body in fighting against microorganisms. Weak immune system can also lead to several other medical conditions like failure of kidney and diabetes. Certain diseases that can reduce the production of antibodies can also increase the risk of developing a furuncle.

There are many medicines that are meant to suppress your immune system and raise the risk of furuncle infection. Some of the common examples of such medications are prednisone and those taken during chemotherapy for treatment of cancer.

Usually a furuncle gets better without causing any other medical problems, some people with furuncle might undergo secondary infection. It can be a minor skin infecting affecting the underlying layers of skin termed as cellulitis. In very rare cases, it can lead to much severe infections like poisoning of blood (sepsis).

Some of the common complications of furuncle are as follows:

• Abscess of the spinal cord, skin, kidneys, brain or other organs is a complication of furuncle.
• Infection in brain.
• Infection in heart.
• Infection in bone.
• Permanent scarring.
• Blood poisoning (sepsis).
• Infection in spinal cord.
• Infection in other body parts and also underneath layers of skin.

A furuncle can be easily determined with just a physical examination. However, your doctor would want to test a culture of your infection to determine the bacteria causing infection and suitable antibiotic. If furuncles appear frequently, then you doctor would recommend for blood test to check for diabetes or any other possible medical condition.

In certain cases where the size of furuncle is large, you doctor would need to make a cut to let the puss drain out. It is not painful as all the operation is carried out after giving a local anaesthesia.

In case of deeper infections, your doctor might insert a gauze to keep your furuncle open for easy draining of puss. After two or three days, the gauze is usually taken off.

In case of severe furuncle infection, blood test might be required. Also you would need to take certain antibiotics to manage the infection.

Staph infection is a special case of infection in furuncle causing a large abscess in skin. It requires surgical treatment along with intravenous antibiotics to drain out the puss.

Deeper and larger furuncles might require surgical cuts to let the puss drain out. See your doctor if:

• The furuncle stays for more than 2 weeks.
• Furuncle keeps coming back.
• Furuncle is located somewhere in spine or face.
• Furuncle leads to other medical problems or infections.
• Furuncle causes extreme pain.

Cleaning the furuncle is important to avoid further furuncle infection. You can ensure this by:

• Cleaning dressing the furuncle regularly.
• Washing your hands after touching a furuncle.
• Keep your towel separate and avoid re using. Washing all the clothes that comes into your contact including bed sheets, towel, clothes etc… in very hot water to kill microorganisms.
• Properly dispose your dressings in the trash to ensure that bacteria from the puss does not affect others.

It is important to clean the furuncle and its surroundings 2-3 times every day until it is healed completely to avoid any complications and further furuncle infection. Cover the affected area of skin with a bandage after application of petroleum jelly. If you notice any further signs of infection, refer to your doctor immediately.

Home remedies are only recommended in case of smaller furuncle. If the furuncle is larger with lot of reddish skin on the surrounding, it is necessary to get it treated from a doctor instead of trying things at home.

• You can ease out some pain by pressing the furuncle with a cloth soaked in boiled water. It also helps in pushing the puss out on the head which then burst out automatically. However, it takes about 5-7 days for this to happen. You can also place a warm cloth soaked in boil water on the affected area. Make sure to squeeze it to let the extra water drain out.
• You need to carefully wash the furuncle with a good antiseptic soap as the puss starts to drain till all the puss is removed. Cover it with a bandage after application of petroleum jelly. Wash the affected part of skin twice or thrice in a day and apply warm compress.
• Trying to force the puss out using needle can make the condition worse and must be avoided.

For the exact time of recovery from a furuncle infection, you need to refer to your doctor as it depends on various factors including severity of the furuncle, treatment procedure used and presence of other medical conditions. Discuss any problem with your doctor openly for better treatment outcomes.

Furuncles cannot be prevented completely but you can take certain precautions to avoid the occurrence of a furuncle. Maintaining proper hygienic conditions and using good antibacterial soap for bathing and washing your hands can keep bacteria away and prevent them from entering into the skin and causing furuncles. You can also use special cleansers lik pHisoderm recommended by experts to further minimize the risk of bacteria. Build-up of hairs on the back of the arm and on thighs must be avoided to reduce the risk of furuncles. You can do this by using abrasive brush on the particular areas during the shower. This will help in opening out oil plugs and removing hair build-up around follicles.

In case a hair follicle is inflamed especially in the buttocks region, you need to be careful about not applying consistent direct pressure on the area to avoid occurrence of pilonidal cysts.

Use of antibiotics is necessary in treating acne and hidradenitis suppurativa to prevent occurrence of skin infection or furuncle formation. In some cases of furuncle, a surgical cut may be required to drain out the puss out of the sweet glands.

There are medications available for severe cases of boil infection like isotretinoin (Accutane). It is a popular medicines which is also used to treat acne and hid adenitis suppurativa. There is an increased risk of reoccurrence in hid adenitis suppurativa.

In certain severe cases where furuncle grows larger and cannot be treated normally, surgical methods are required to manage the furuncle. This usually happens with hidradenitis suppurativa and pilonidal cysts. In case of pilonidal cysts, it is necessary to remove the surrounding cover of the cyst to treat furuncle in an operation theatre.

In some cases of hidradenitis suppurativa, plastic surgery may also be required if a large skin is damaged due to furuncle.

A furuncle can be prevented by following certain guidelines:

• Wash all the clothes including towels, bed linens etc… that comes in contact of a person having furuncle in family.
• Minor skin wounds must be treated properly.
• Good hygienic conditions must be maintained.
• Keep yourself healthy and fit.

The prognosis/outlook for a furuncle infection is good. Furuncle usually does not cause any severe complications and can be easily managed at home with little care. Even if the furuncle is large and requires a cut or surgery, chances or complications are very less. Use of antibiotics depends on the particular condition of furuncle and infection. People who are taking medications for suppressing immune system are at higher risk of complications resulting from a furuncle. The complications usually occur as a result of infection spreading out to underneath layers of skin or surrounding. In extreme cases, it can even cause blood poisoning and spreading to infection to other body parts.

In case of a furuncle caused by microorganisms like MRSA or Methicillin-Resistant Staphylococcus Aureus that are capable of causing severe infection, risk of complications increases. Sometimes, furuncle can reoccur frequently leading to a complicated situation. This usually happens in cases of hidradenitis suppurativa or when the cause of the condition is persistent including cystic acne.