What is the treatment for a boil or carbuncle?
- Small boils (furuncles) may subside and go without any treatment. You can ease pain by covering the boil with a flannel soaked in hot water. Do this for 30 minutes, 3-4 times a day. (Be very careful that the water is not too hot. It is important to avoid the risk of burns from hot water.)
- Larger boils and carbuncles are best treated by letting the infected fluid (pus) out. Sometimes this is done by a doctor who drains the pus, using a needle and syringe. Sometimes a small cut in the skin is needed to let out the pus (incision and drainage). The wound is covered with a dressing until the skin heals. The skin usually heals quickly once the pus has been drained.
- A course of an antibiotic medicine, such as flucloxacillin, is sometimes prescribed in addition to draining the pus to help clear the infection from the skin.
What if I do nothing?
A boil (furuncle) may become larger and more tense and painful as more infected fluid (pus) accumulates. Typically, after several days (sometimes after a week or more) the boil will burst and pus will leak on to the skin. The pain tends to ease when the boil bursts. Once the pus has gone, the infection in the surrounding skin tends to fade away gradually over several days. A scar may be left at the site of the boil.
A carbuncle tends to increase in size for a few days - up to 3-10 centimetres across, sometimes more. After 5-7 days, various pus-filled lumps appear on the surface and pus leaks on to the skin. It then may break down and form an ulcer on the skin surface before the infection gradually subsides. The skin then gradually heals leaving a deep scar.
While there is infection and pus in the skin, there is a risk that some germs (bacteria) may spread in the bloodstream to cause infections in other parts of the body. This is uncommon but, if it happens, it can lead to serious infections of a bone, the brain, or other parts of the body.
Further reading and references
Boils, carbuncles, and staphylococcal carriage; NICE CKS, July 2015 (UK access only)
Bernard P; Management of common bacterial infections of the skin. Curr Opin Infect Dis. 2008 Apr21(2):122-8. doi: 10.1097/QCO.0b013e3282f44c63.
Shallcross LJ, Hayward AC, Johnson AM, et al; Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care. Br J Gen Pract. 2015 Oct65(639):e668-76. doi: 10.3399/bjgp15X686929.
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