Folliculitis, Boils and Carbuncles

What are folliculitis, boils, and carbuncles?

Folliculitis is the inflammation of hair follicles due to an infection, injury, or irritation. It is characterized by tender, swollen areas that form around hair follicles, often on the neck, breasts, buttocks, and face. Boils (also referred to as furuncles) are pus-filled lesions that are painful and usually firm. Boils happen when infection around the hair follicles spreads deeper. They are usually located in the waist area, groin, buttocks, and under the arm. Carbuncles are clusters of boils that are usually found on the back of the neck or thigh. Staphylococcus aureus is the most common bacteria to cause these infections. 

What are the symptoms of folliculitis, boils, and carbuncles?

The following are the most common symptoms of folliculitis, boils, and carbuncles. However, each person may experience symptoms differently.

Symptoms for folliculitis may include:

  • Pus in the hair follicle

  • Irritated and red follicles

  • Damaged hair

Symptoms for boils may include:

  • A painful lump in the skin

  • Pus in the center of the lump

  • Whitish, bloody discharge from the boil

Symptoms for carbuncles (clusters of boils) may include:

  • Pus in the center of the boils

  • Whitish, bloody discharge from the boils

  • Fever

  • Fatigue

  • Tenderness and pain at the site

The symptoms of folliculitis, boils, and carbuncles may resemble other skin conditions. Always talk with your healthcare provider for a diagnosis.

How are folliculitis, boils, and carbuncles diagnosed?

Diagnosis of folliculitis, boils, and carbuncles are made by your healthcare provider after a thorough medical history and physical exam. After examining the lesions, your healthcare provider may culture the wounds (take a sample of the drainage of the wound, allow it to grow in the lab, and identify specific bacteria). He or she does this to help confirm the diagnosis and to help in selecting the best treatment.

Treatment for folliculitis, boils, and carbuncles

Specific treatment for folliculitis, boils, and carbuncles will be discussed with you by your healthcare provider based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medicines, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include:

  • Topical antibiotics (for folliculitis)

  • For carbuncles and boils, a warm compress may be used to help promote drainage of the lesion

  • Surgical incision (making an opening in the skin overlying the infection) and drainage of the pus 

  • Oral or intravenous (IV) antibiotics (to treat the infection)

  • Cultures may be obtained to identify the bacteria causing the infection

  • Acetaminophen or other pain relievers  

Keeping the skin clean helps to prevent these conditions from happening and is essential for healing. Scrub your hands with soap and warm water for at least 20 to 30 seconds after touching a boil. Do not re-use or share washcloths or towels. Change the dressings often and place the dressings in a bag that can be tightly closed and thrown out. 

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