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Every year, millions of Americans seek treatment for skin problems. Although most

from: skin conditions aren't life-threatening, they can be uncomfortable and emotionally

distressing. This is particularly true of inflammatory conditions such as boils and
carbuncles — painful, pus-filled bumps that form under your skin when bacteria
infect one or more of your hair follicles.

What is boil?

A boil, known medically as a furuncle (FUR-un-cul), is an infected hair follicle
(the place in the skin where a hair is formed). The skin infection starts in a hair follicle or oil gland and are usually caused by Staphylococcus aureus bacteria (staph). This are painful swellings of the skin and begin as red, tender swellings.

Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with infection-fighting white blood cells that the body sends from the blood
stream to eradicate the infection. This collection of white blood cells, bacteria, and proteins
develop a tender lump. After 4-7 days, the lump starts turning white as pus (thick, infected fluid)collects under the skin.

Finally, the pus "forms a head," which can be surgically opened or spontaneously drain out through the surface of the skin.

Boils can develop in any hairy area of the skin. In particular, in sites where there
is friction, or where the skin is sweaty. For example, the neck, face, armpit, arms,
wrists, buttocks, and around the anus.

A boil can occur in anyone at any age. However, they are uncommon in
children, and most commonly occur in teenagers and young adults. You have a higher
risk of developing a boil or carbuncle if you have:

* other skin conditions which may cause you to scratch and damage the skin. For
example, eczema or scabies.
* obesity.
* a poor immune system.
* an illness making you frail or generally unwell.
* you are a 'carrier' of Staphylococcus bacteria
* diabetes, especially when treated by injected insulin
* alcoholism or drug abuse
* poor personal hygiene
* crowded living arrangements
* jobs or hobbies that expose them to greasy or oily substances, especially petroleum
products
* allergies or immune system disorders, including HIV infection.
* family members with recurrent skin infections.

If you have a fever or long-term illness, such as cancer or diabetes, or are taking
medications that suppress the immune system, you should contact your healthcare
practitioner if you develop a boil (abscess).

Most people with boils are otherwise healthy and have good personal hygiene. They do
however carry Staph. aureus on the surface of their skins (Staph. carrier state).
Why this occurs is usually not known, but it is estimated that 10- 20% of the
population are Staph. carriers.

There are several different types of boils. Among these are:

Furuncle or carbuncle: This is an abscess in the skin caused by the bacterium
Staphylococcus aureus. A furuncle can have one or more openings onto the skin and
may be associated with a fever or chills.

Cystic acne: This is a type of abscess that is formed when oil ducts become clogged
and infected. Cystic acne affects deeper skin tissue that the more superficial
inflammation from common acne. Cystic acne is most common on the face and typically
occurs in the teenage years.

Hidradenitis suppurativa: This is a condition in which there are multiple abscesses
that form under the arm pits and often in the groin area. These areas are a result
of local inflammation of the sweat glands. This form of skin infection is difficult
to treat with antibiotics alone and typically requires a surgical procedure to
remove the involved sweat glands in order to stop the skin inflammation.

Pilonidal cyst: This is a unique kind of abscess that occurs in the crease of the
buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the
area of skin from which hair grows (the hair follicle). With irritation from direct
pressure over time the inflamed area enlarges to become a firm, painful, tender
nodule making it difficult to sit without discomfort. These frequently form after
long trips that involve prolonged sitting.





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