Folliculitis, Boils, and Carbuncles

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What are folliculitis, boils, and carbuncles?

Folliculitis, boils, and carbuncles are types of infections of one or more hair follicles. A hair follicle is the base or root of a hair. The infections can occur anywhere on the skin where there is hair. They happen most often where there may be rubbing and sweating. This includes the back of the neck, face, armpits, waist, groin, thighs, or buttocks.

There are 3 different kinds of infections:

Folliculitis. This is the most superficial type of inflammation of the hair follicles. This can appear on the neck, breasts, buttocks, back, chest and face.
Boil. This is an infection of the hair follicle that goes into the deeper layers of skin. A small pocket of pus (abscess) forms. It’s also known as a furuncle. They often occur in the waist area, groin, buttocks, and under the arms.
Carbuncle. This is a group of infected hair follicles with pus. A carbuncle is larger and deeper than a boil. Carbuncles are often found on the back of the neck or thigh.

What causes folliculitis, boils, and carbuncles?

Bacteria called Staphylococcus aureus (staph) are the most common cause of these infections. But other kinds of bacteria can also cause them.

Who is at risk for folliculitis, boils, and carbuncles?

Anybody can develop folliculitis, boils, or carbuncles. A person is more at risk if they:

Have diabetes or a weak immune system
Have other skin infections
Have close contact with someone with a skin abscess, boil, or carbuncle
Have skin injuries, such as scrapes, cuts, or insect bites
Are getting IV (intravenous) medicine
Have been in hot tub or spa water that isn't correctly treated

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

Symptoms can occur a bit differently in each person.

Symptoms for folliculitis may include:

Irritated and red follicles
Pus in the hair follicle
Damaged hair

Symptoms for a boil may include:

A warm, painful lump in the skin
Pus in the center of the lump
Whitish, bloody fluid leaking from the boil

Symptoms for a carbuncle may include:

Pus in the center of a group of boils
Whitish, bloody fluid leaking from the boils
Fever
Tiredness
Pain in the area

The symptoms of folliculitis, boils, and carbuncles can be like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How are folliculitis, boils, and carbuncles diagnosed?

Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. The physical exam will include a skin exam. A sample of the pus from the infection may be sent to a lab. This is called a culture. It’s done to see what type of bacteria caused the infection. It can help the healthcare provider decide the best antibiotic for treatment. You may need to see a specialist to treat a moderate to severe boil or carbuncle.

How are folliculitis, boils, and carbuncles treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is.

Folliculitis and mild boils may go away with no treatment. Warm cloths (compresses) may help ease symptoms and speed healing. Your healthcare provider may also prescribe topical antibiotics to apply to your skin.

Moderate to severe boils and carbuncles are often treated by draining. A healthcare provider cuts into the sore and drains the fluid (pus) inside. This is called incision and drainage. You may also need to take antibiotic medicine by mouth (oral) or by IV in a vein. You may also need to put antibiotic ointment or cream on the area.

During treatment:

Keep your skin clean.
Wash your hands for 20 seconds before and after touching the infected area.
Don’t reuse or share washcloths or towels. Wash these in soap and hot water.
Change the bandages often. Place them in a bag that can be closed and thrown out.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of folliculitis, boils, and carbuncles?

Possible complications include:

Infection spreading to other parts of the body
Return of the infection
Scarring
The infection spreads into the blood

Can folliculitis, boils, and carbuncles be prevented?

To help prevent these infections:

Clean and protect any skin injuries.
Wash your hands often.
Keep your nails cut short.
Keep your face clean, use clean razors, and bathe often.
Use only well-maintained spas or hot tubs.
Don't have contact with others who have active skin sores.

When should I call my healthcare provider?

Call the healthcare provider if you have:

Symptoms that don’t get better, or get worse
Fever
Other new symptoms
A sore nodule with pus that is getting bigger

Key points about folliculitis, boils, and carbuncles

Folliculitis, boils, and carbuncles are types of infections of 1 or more hair follicles.
The infections can occur anywhere on the skin where there is hair. They happen most often where there may be rubbing and sweating. This includes the back of the neck, face, armpits, waist, groin, thighs, or buttocks.
Bacteria called Staphylococcus aureus (staph) are the most common cause of these infections.
Symptoms may include redness, pus, pain, and fluid leaking from the sore.
Folliculitis and mild boils may go away with no treatment or with topical treatments applied to your skin. Moderate to severe boils and carbuncles are often treated by draining. You may also need to take antibiotic medicine by mouth (oral) or by IV in a vein.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions.