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Furunculosis
Last reviewed: 07.06.2024
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Furunculosis (or furuncle, intradermal abscess) is an infectious skin disease characterized by the formation of painful, inflamed areas on the skin called furuncles. Boils usually appear as red, inflamed, festering "weasel-like" acne-like rashes or abscesses.
The process of developing a boil begins with an infection of the hair follicle (the sac from which hair grows), usually caused by the bacterium Staphylococcus aureus. The infection causes inflammation around the hair follicle, resulting in a bubble filled with purulent fluid. The boil can be painful and cause redness and swelling of the skin.
Risk factors that contribute to the development of furunculosis include improper skin care, trauma or injury to the skin, lowered immunity, tight clothing, and hygiene problems.
Boils are usually treatable. The doctor may recommend warm compresses to mature the boil and antiseptic ointments. Large, deep or chronic boils may require opening and drainage by a doctor. In some cases, antibiotics may be prescribed.
It is important to remember that you should not attempt to open a boil yourself, as this can lead to infection and complications. If you suspect a boil or other skin condition, see your doctor for an accurate diagnosis and treatment.
Causes of the furunculosis
Furunculosis is usually caused by an infection of the hair follicles (the sacs from which hair grows) by the bacterium Staphylococcus aureus. By infiltrating micro-injuries or seborrheic glands in the skin, this bacterium can cause inflammation and infection, leading to the formation of boils. Here are some of the main reasons for the development of furunculosis:
- Bacterial infection: The most common cause of furunculosis is infection of the hair follicle by the bacterium Staphylococcus aureus. This bacterium can be found on the skin, and when the integrity of the skin is compromised, it can penetrate the hair follicle, causing infection.
- Microtrauma and skin damage: Microtrauma, friction, squeezing, or damage to the skin can create conditions for bacteria to enter and infections to develop.
- Reduced immunity: People with a weakened immune system, such as due to medical conditions, stress, or treatment with certain medications, may be more susceptible to developing furunculosis.
- Poor hygiene: Poor skin hygiene can contribute to the accumulation of bacteria and infection.
- Tight clothing: Wearing very tight or chafing clothing can cause skin irritation and microtrauma, contributing to the development of furunculosis.
- Seborrheic glands: In some cases, furunculosis can develop due to increased activity of the seborrheic glands, which secrete skin oil.
- Contact with infected objects: Surfaces or objects that have been contaminated with Staphylococcus aureus bacteria can be a source of infection.
Pathogenesis
The pathogenesis of furunculosis includes the following major steps:
- Colonization by Staphylococcus aureus: Bacteria of this species can live on the surface of the skin and mucous membranes without causing symptoms of disease. They can invade hair follicles and skin pores through microtrauma or other mechanisms.
- Inflammation and infection of hair follicles: Once Staphylococcus aureus is introduced into the hair follicles, an inflammatory process begins. The bacteria multiplies inside the follicle and causes infection. This is accompanied by redness, swelling and soreness at the site of the lesion.
- Formation of a purulent layering (abscess): Inflammation and infection result in the formation of a pus pump, which is a kind of "pocket" of pus inside the follicle. It can be very painful and located under the skin.
- Boilrupture: A purulent boil may eventually rupture, releasing pus to the outside. This can lead to symptom relief, but can also risk spreading the infection to surrounding tissues.
- Recovery: Once the boil has ruptured, the cleansing and healing process of the affected area begins. A new hair follicle begins to form and the skin regenerates.
Staphylococcus aureus can be transmitted from person to person through contact with the purulent contents of the boil or with infected objects such as towels, clothing and hygiene items. Therefore, furunculosis can be considered contagious, especially when the infection is passed from one person to another.
To prevent transmission and infecting others, it is important to follow certain precautions such as:
- Isolation of infected areas: If a boil is present, contact with the purulent contents should be avoided and the purulent contents should not be allowed to spread to other parts of the body or objects.
- Cleanliness and hygiene: Wash your hands regularly with soap and water. Use separate towels, clothing and hygiene items to avoid spreading infection.
- Do not squeeze boils: Attempting to squeeze boils on your own can worsen the infection and spread bacteria. It is better to see a doctor for proper treatment.
- Use antiseptic agents: Topical treatment with antiseptic ointments or application of antiseptic dressings can help prevent the spread of infection.
- Avoid contact with other people until the boil has healed: This is especially important if the boil has ruptured and is oozing pus.
Symptoms of the furunculosis
The main symptoms of furunculosis may include:
- Painful swelling: The initial sign of furunculosis is usually the appearance of a red and painful swelling at the site of a hair follicle.
- Redness and swelling: The area around the boil may become red and swollen.
- Purulent Content: As the boil develops, a purulent content may form in the center of the tumor and may ooze out when it is opened.
- Soreness: Furunculosis is accompanied by soreness in the area of the lesion, especially when touched or pressed.
- Changes around the boil: Abscesses or vesicles with purulent contents may appear around the boil.
- Increased body temperature: In some cases of furunculosis, fever may occur.
- Itchingand burning sensation: In some cases, furunculosis may be accompanied by an itching and burning sensation at the site of the lesion.
Furunculosis, like many other skin diseases, can have psychosomatic aspects. Psychosomatics relates physical symptoms or illnesses to a person's emotional and psychological states. Here are what psychosomatic factors may be associated with furunculosis:
- Stressand emotional state: Experiencing stress and anxiety can affect immune system function and increase the risk of developing infectious diseases, including furunculosis. Stress can also increase inflammation in the body.
- Reduced immunity: Psychological stress and depression can weaken the immune system, making the body more vulnerable to infections, including infections that cause boils.
- Skin Care Routine: Emotional state can affect a person's ability and willingness to follow hygiene and skin care routines. For example, stress can lead to inadequate skin care, which can contribute to the development of furunculosis.
- Self-image and self-esteem: The presence of a disease on the skin, such as a boil, can affect a person's self-image and self-esteem, causing additional stress and anxiety.
- Psychological factors and mechanisms: There are many psychological mechanisms through which stress and emotions can affect the immune system and inflammatory processes in the body. These may include activation of inflammatory cytokines and neuroendocrine changes.
It is important to note that the psychosomatic aspects of furunculosis can be individualized and vary from person to person. Although psychosomatics may play a role in the development and prognosis of the disease, it does not preclude the importance of medical treatment and professional skin care.
Furunculosis in children
Furunculosis can occur in children just as it does in adults. It is an infectious disease that occurs due to inflammation of the hair follicle caused by the bacterium Staphylococcus aureus. In children, furunculosis is most commonly found on the skin, especially in areas where there is hair, such as the head, face, neck, back, armpits, groin, lower limbs, etc.
Symptoms of furunculosis in children are similar to those in adults and include:
- Red and painful swelling at the site of the lesion.
- Redness and swelling of the surrounding tissues.
- Purulent contents that may be secreted when the boil is opened.
- Soreness with pressure or touch.
- Possible increase in body temperature.
For the treatment of furunculosis in children, it is recommended:
- Do not self-treat: Do not attempt to open the boil yourself, as this can lead to infection of surrounding tissues and complications.
- Provide antiseptic treatment: Consider your doctor's recommendations for antiseptic ointments or treatment of the boil.
- Take antibiotics: If complications develop or if the furunculosis returns frequently, your doctor may prescribe antibiotics.
- Maintain hygiene: Make sure your child maintains good hygiene to prevent the spread of infection.
- Avoid manipulating the boil: Do not let the child or anyone else try to squeeze the pus out of the boil.
If your child's furunculosis becomes chronic or is accompanied by high fever, severe swelling or other worrisome symptoms, see your doctor for a consultation and appropriate treatment.
Furunculosis in pregnancy
Pregnancy can affect a woman's immune system and its ability to fight infections. Furunculosis is an infectious disease associated with inflammation of the hair follicle and the formation of a purulent plaque. During pregnancy, these infections can be particularly unpleasant. It is important to know how to treat furunculosis in pregnancy:
- Timely treatment: If you have furunculosis or any other skin infections, it is important to consult your doctor immediately. The doctor will be able to assess the extent of the infection and recommend the treatment that is safest for pregnancy. You should not attempt to squeeze the boil yourself, as this can worsen the infection and lead to complications.
- Use of antiseptic agents: Your doctor may recommend the use of antiseptic ointments or solutions to reduce infection and inflammation. Be sure to follow his instructions for use.
- Prevent recurrences: It is important to keep your skin hygienic to prevent new boils from developing. Washing the skin regularly with mild soap and using antiseptic products can help.
- Immune System Support: Maintaining a healthy lifestyle, including eating right, exercising moderately and getting enough rest, can help support the immune system and prevent skin infections.
- Follow your doctor's recommendations: It is important to follow all prescriptions and doctor's recommendations for treating furunculosis and taking antimicrobial medications, if prescribed.
Stages
Furunculosis goes through several stages of development before the furuncle (intradermal abscess) matures and heals. Here are the main stages of furunculosis:
- Initial stage (inflammation of the hair follicle): In this stage, the skin around the hair follicle becomes red, inflamed and painful. It may be itchy and sensitive to touch. In this phase, there is an inflammatory change caused by infection with the bacterium Staphylococcus aureus.
- Abscess (pus abscess) formation: Within a few days of the initial symptoms, a purulent abscess (pus) begins to form around the hair follicle. Pus builds up inside the abscess and the boil becomes more visible and painful.
- Mature stage (maturation of the boil): The boil matures and becomes more pronounced. In this stage, the abscess may take on a distinctive appearance, with a white or yellow pustule (pus-filled protrusion) in the center, surrounded by red and inflamed skin. The boil may become very painful.
- Opening and drainage (opening the boil): In some cases, a boil may open on its own, and sometimes a doctor's intervention is needed to open it and remove the pus (drainage). This relieves pressure and speeds up the healing process.
- Healing and healing: After drainage, the boil gradually begins to heal. The wound begins to heal and the skin recovers. This process may take a few days to a few weeks.
Forms
- Acute furunculosis: This type of furunculosis is characterized by the sudden development of one or more boils. Acute furunculosis can be caused by an infection of the hair follicles, which leads to the rapid formation of painful, inflamed abscesses on the skin. Acute furunculosis can occur after trauma, microtrauma, skin contamination, or infection with the bacterium Staphylococcus aureus.
- Chronic furunculosis: This type of furunculosis is characterized by recurrent or prolonged cases of furunculosis. People with chronic furunculosis may develop boils over and over again, often on the same areas of the skin. This type of furunculosis may be associated with deeper problems, such as a lowered immune system or chronic infections.
- Interfingerfurunculosis: Interfinger furunculosis develops between the fingers or toes. It can be particularly painful and cause discomfort when you move your fingers. This type of furunculosis is also associated with hair follicle infection and can be caused by trauma or microtrauma between the fingers.
- Recurrent furunculosis (recurrent furunculosis): This type of furunculosis is characterized by the appearance of boils over and over again in the same person. Recurrences can be caused by immune system disorders, increased susceptibility to infections, or the presence of chronic diseases such as diabetes. Treatment for recurrent furunculosis may include strengthening the immune system, taking antibiotics, and practicing good hygiene.
- Multiple furunculosis: This type of furunculosis is characterized by the formation of several furuncles simultaneously or sequentially on different parts of the skin. Multiple furunculosis may be associated with immune system disorders or the presence of chronic infections. Treatment depends on the cause and may include antibiotics, antiseptic measures and immune system strengthening.
- Eosinophilic furunculosis: This rare type of furunculosis is characterized by the presence of eosinophilic granulocytes (a type of white blood cell) in the furuncle that forms. Eosinophilic furunculosis may be associated with allergic reactions or other immunologic disorders. Treatment of such furunculosis may require consultation with an immunologist or allergist, as well as antibiotics and antihistamines, depending on the cause.
Complications and consequences
Complications and consequences of furunculosis may include the following:
- Abscess: In severe cases of furunculosis, the infection can spread to deeper layers of the skin and create an abscess, a collection of purulent fluid bounded by a capsule. An abscess may require drainage and antibiotics for treatment.
- Spread of infection: If a boil is not treated properly, the infection can spread to nearby tissues and cause other boils or cellulitis (a common soft tissue inflammation). In some cases, the infection can even reach the blood and cause sepsis, which is a serious and dangerous complication.
- Scars: A scar may be left on the skin after a boil is healed. The size and appearance of the scar may vary depending on many factors, including the size and depth of the boil, the treatment method, and the individual patient's personality.
- Recurrences: Some people are prone to recurrences of furunculosis, i.e. The appearance of new boils after the previous ones have healed. This may be due to immune system traits, medical conditions, or poor hygiene.
- Post-infectious complications: In rare cases, furunculosis can lead to more serious complications such as pneumonia, meningitis, osteomyelitis (inflammation of the bones), or pericarditis (inflammation of the heart lining).
Treatment of the furunculosis
Treatment for furunculosis may involve several steps and depends on the severity and extent of the infection. Here are general guidelines for treatment:
- Warm compresses: Applying warm compresses can help speed up the maturation of the boil and reduce soreness. To do this, soak a soft cloth in warm water and apply it to the boil for 20-30 minutes several times a day.
- Antiseptic ointments: Your doctor may recommend the use of antiseptic ointments, such as mupirocin ointment, to prevent the spread of infection and speed healing. Follow your doctor's instructions when applying the ointment.
- Avoid opening the boil yourself: Do not try to open the boil yourself as this can lead to infection and complications. The doctor can perform drainage if necessary.
- Antibiotics: The doctor may prescribe antibiotics if the boil is associated with an infection and is severe. Antibiotics are chosen depending on the sensitivity of the bacteria to them.
- Avoid pressureand trauma: Avoid applying pressure or traumatizing the boil to prevent the spread of infection and reduce soreness.
- Personal hygiene: Practice good personal hygiene and make sure that hands and tools used to care for the boil are clean. This will help prevent additional infections.
- Prevention: After recovering from a boil, try to prevent it from reappearing. This may include taking better care of your skin, keeping it clean, and avoiding microtrauma.
Antibiotics for furunculosis
Furunculosis, usually caused by the bacterium Staphylococcus aureus, may require antibiotic therapy in certain cases. However, the choice of antibiotic and dosage should be determined by the physician based on the clinical picture and sensitivity to the bacterial infection.
- Azithromycin: Azithromycin can be used to treat infections caused by the bacterium Staphylococcus aureus. However, it is important to know that this antibiotic is not always the best choice for the treatment of furunculosis, unless bacterial sensitivity to azithromycin is confirmed by testing.
- Amoxicillin: Amoxicillin can also be an effective antibiotic for furunculosis, but it is more commonly used to treat other infections. The choice of amoxicillin or another antibiotic will depend on the doctor's clinical judgment.
- Ciprolet (Ciprofloxacin): Ciprolet (or ciprofloxacin) is an antibiotic that may be effective in treating infections caused by Staphylococcus aureus. Again, its prescription should be based on the prescription and clinical judgment of the physician.
- Amoxiclav (amoxicillin/clavulanic acid): Amoxiclav is a combination antibiotic and can be used to treat boils, especially if they have become purulent and the infection is spreading.
- Ceftriaxone: This antibiotic from the group of cephalosporins can be used for more serious infections, but the decision to use it should be made by a doctor.
- Doxycycline: Doxycycline is a tetracycline antibiotic and may be used to treat certain infections, including boils.
- Unidox Solutab (doxycycline): This antibiotic is also doxycycline-based and can be used for furunculosis, depending on your doctor's recommendations.
- Cefixime (Suprax): Cefixime belongs to the group of cephalosporins and can be prescribed in cases of complicated furunculosis with bacterial infection.
- Levofloxacin: Levofloxacin is a fluoroquinolone antibiotic and may be considered by a doctor to treat furunculosis if necessary.
- Cefuroxime (Zinnat): Cefuroxime also belongs to the group of cephalosporins and can be used for furunculosis with bacterial infection.
- Flemoxine solutab (amoxicillin): This antibiotic from the penicillin group can be effective in treating furunculosis, especially if the infection is caused by the bacterium Staphylococcus aureus.
- Erythromycin: This antibiotic from the macrolide group may be effective for furunculosis.
- Moxifloxacin: Moxifloxacin belongs to the class of fluoroquinolones and can be used in severe cases of furunculosis or resistance to other antibiotics.
- Metronidazole: Metronidazole is usually used to treat anaerobic infections, but in rare cases it may be used for furunculosis, especially if mixed infections are suspected.
Non-specific immunotherapy
Nonspecific immunotherapy is not the primary treatment for furunculosis, but strengthening the immune system can help to better resist infection and prevent recurrence. Nonspecific measures to strengthen the immune system may include the following:
- Good nutrition: Eating a balanced and nutritious diet rich in fruits, vegetables, proteins and vitamins helps in maintaining a healthy immune system.
- Physical activity: Regular physical activity helps strengthen the immune system.
- Getting adequatesleep: Getting enough sleep is important to keep your immune system working properly.
- Stress Reduction: Managing stress and anxiety can help maintain healthy immune function.
- Hygiene measures: Washing hands regularly and keeping skin clean helps prevent infection.
- Avoid smoking and moderate alcohol consumption: Smoking and excessive alcohol consumption can weaken the immune system.
- Immunostimulant medications: In some cases, your doctor may recommend the use of immunostimulant medications or vitamin complexes to strengthen the immune system.
- Vaccination: Vaccination can help prevent some infections that can trigger the development of furunculosis.
Ointments for furunculosis
There are several ointments that can be useful in treating furunculosis and help in speeding up the healing of the boil. Here are a few of them:
- Vishnevsky's Ointment: This ointment, also known as Vishnevsky's Balm, is often used to treat boils and other skin infections. It has antiseptic and anti-inflammatory properties. Vishnevsky's ointment can help in the maturation of the boil and speed up the exit of the purulent contents. It is usually used on compresses.
- Levomekol: Levomekol is a combination product containing an antibiotic (chloramphenicol) and a substance that promotes wound healing (methyluracil). It can help fight the bacterial infection of a boil and speed up the healing process.
- Ichthyol ointment: Ichthyol ointment has antiseptic and anti-inflammatory properties. It can be used to speed healing and relieve discomfort in boils.
- Ointmentwith antiseptics: Some ointments that containantiseptic ingredients, such as chlorhexidine or betadine, can also be helpful in boils to fight bacterial infection.
It is important to remember that the use of ointments should be coordinated with your doctor, especially if the infection of the boil is too severe or does not disappear after applying ointments for a few days.
Treatment of furunculosis at home
Treatment of furunculosis at home is possible for small and uncomplicated furuncles without complications. However, it is important to remember that serious cases complicated by large and deep boils, purulent abscesses or high body temperature require medical consultation and treatment. Here are some recommendations for home treatment of furunculosis:
- Warm compresses: Apply warm compresses to the boil to help open it and speed up the drainage of pus. You can use a hot, damp washcloth or a hot water bottle to do this. Make the compresses several times a day, each time for 20-30 minutes.
- Antiseptic treatment: Treat the boil with an antiseptic to prevent infection and help the inflammation disappear. You can use hydrogen peroxide or iodine solution for this.
- Avoid pressure: Do not try to squeeze the pus out of the boil, as this can lead to infection of the surrounding tissues.
- Avoid rubbing cloths: Cover the boil with a soft, clean cloth to avoid rubbing against clothing and prevent the infection from spreading.
- Maintain good hygiene: Wash your hands and the boil area regularly with soap and water.
- Nutrition and Vitamins: Eat a healthy diet rich in vitamins and minerals to strengthen your immune system to help fight infection.
- Do not tear the crust: When the boil is cut and the pus comes out, do not tear the crust. Let it come off on its own.
- Avoid touching the boil repeatedly: Try to avoid unnecessary touching of the boil to avoid carrying the infection.
Folk remedies, herbs
Furunculosis can be treated using folk remedies in addition to medical treatment, but it is important to remember that consulting a doctor and following their recommendations remains a priority, especially if the infection is severe or complicated. Below are some folk remedies and herbs that can help with furunculosis:
- Sea buckthornoil: Sea buckthorn oil has anti-inflammatory and healing properties. The oil can be applied to boils to speed up their healing process.
- Garlic: Garlic has antimicrobial properties and can help fight bacterial infection. You can prepare garlic paste, apply it on the boil and secure it with a bandage. Leave it on overnight and wash it off in the morning.
- Cabbage leaves: Fresh cabbage leaves can be crushed to release the juice and applied to the boil as a compress. Cabbage has anti-inflammatory properties and can help reduce inflammation.
- Broomstick: Broomstick can be used to make a tincture or compress. This herb has anti-inflammatory properties and can help speed healing.
- Rawegg: Apply raw egg white to the boil, then cover it with a bandage. The egg white can help draw out the pus and speed up healing.
- Wheatgrass: Crush the leaves of wheatgrass, apply it to the boil and cover it with a bandage. Wheatgrass also has anti-inflammatory properties.
- Ginger: Ginger can help in strengthening the immune system and has anti-inflammatory properties. You can prepare ginger tea and consume it regularly.
- Aloe vera: Aloe vera leaf gel has anti-inflammatory and healing properties. You can apply aloe vera to a boil to reduce inflammation and itching.
Clinical Guidelines
Clinical recommendations for the treatment of furunculosis may vary depending on the severity of the disease and the presence of complications. However, in general terms, the following recommendations may help in the treatment of furunculosis:
- Warm compresses: Apply warm compresses to the boil to help soften the skin and help the pus come out faster. Apply warm compresses several times a day, each time for 20-30 minutes.
- Antiseptic treatment: Treat the boil with an antiseptic such as hydrogen peroxide or iodine solution. This helps prevent infection and speeds up the healing process.
- Do not squeeze the pus out: Do not try to squeeze the pus out of the boil. This can spread the infection and lead to complications.
- Avoidfriction: Avoid rubbing the boil against clothing or other surfaces to prevent irritation and additional injury.
- Maintain good hygiene: Wash your hands and the boil site regularly with soap and water.
- Antibiotics: If the boil does not improve within a few days or if there are signs of complications, your doctor may prescribe antibiotics.
- Surgery: In some cases, surgical opening and drainage of the boil may be necessary, especially if it is large, deep, or highly inflamed.
- Avoid self-medication: Do not take antibiotics without a doctor's recommendation and do not attempt to perform procedures that require medical skills.
- Keep a close eye on yourcondition: If your boil symptoms worsen, see your doctor for further consultation and evaluation.
Prevention
Prevention of furunculosis includes measures aimed at preventing new boils and reducing the risk of recurrence (reappearance) of this condition. Here are some recommendations for prevention:
- Good skin hygiene: Wash your skin regularly using mild soap and warm water. This will help to remove bacteria and impurities from the surface of the skin.
- Avoid opening boils on your own: Do not attempt to open boils on your own as this can worsen the infection and lead to complications.
- Warm compresses: In case of a boil, use warm compresses to speed up its maturation and drainage.
- Antiseptic ointments: If necessary, use antiseptic ointments to treat the site of the boil.
- Avoid microtrauma: Try to avoid microtrauma to the skin that can trigger a boil. For example, shave your hair carefully and avoid excessive pressure or friction on the skin.
- Keep yourimmune system strong: Take care of your overall health. Good nutrition, an active lifestyle, sleep and stress management can help maintain a strong immune system.
- Avoid contact with infected objects: Avoid contact with common objects and surfaces that could be infected with Staphylococcus aureus bacteria.
- Change of underwear and clothing: Change underwear and clothing regularly, especially if they are in contact with areas of skin where boils can occur.
- Smoking and alcohol: If you have these bad habits, try to quit or reduce your intake as they can weaken your immune system and increase your risk of infection.
- Consult a doctor: If you have recurrent furunculosis or other skin problems, see a dermatologist or physician to evaluate and determine possible causes and treatment.