Chronic furunculosis: available treatments

What causes chronic furunculosis?

Boils usually arise when hair follicles become infected with Staphylococcus bacteria. Chronic furunculosis results when the infection recurs repeatedly. This may be due to you or a person you live with being a carrier of Staphylococcus bacteria, which can live harmlessly on the skin or in the nose, but make you more prone to repeated infection of the hair follicles. Around 30–50% of healthy adults may be carriers of Staphylococcus bacteria without even realising it.

Who gets it?

• Boils can arise in anyone of any age; however, they are most common during teenage years and early adulthood. Teenagers are particularly prone to chronic furunculosis because of the greasy nature of their skin, which is caused by changes in hormone levels.
• You may also be more at risk of chronic furunculosis if you are obese, have a poor immune system or an underlying illness. It can also occur if you have another skin condition that makes your skin more vulnerable to infection, such as eczema or scabies. Other possible reasons include exposure to industrial chemicals or poor hygiene.
• There is conflicting evidence for whether people with diabetes are more prone to boils and/or chronic furunculosis; however, doctors are fairly convinced that people with diabetes experience symptoms of chronic furunculosis that are much worse than those in non-diabetics.

Where does it occur?

Boils can occur anywhere on the skin where there is hair growth, but they tend to occur most commonly in areas where the skin is in contact with clothing or other areas of skin, or is particularly sweaty. The most common areas affected by chronic furunculosis are the groin, armpits, neck and the buttocks. Boils may also occur on the face, within the ear canal and even around the eyelashes (commonly known as a stye).

How is it managed?

If you suffer from chronic furunculosis, your doctor may wish to perform tests to check whether you have any underlying conditions or problems with your immune system that may make you more prone to skin infections. A swab may also be taken to establish whether Staphylococcus bacterial infection is the cause of your chronic furunculosis.

Find a Dermatologist (skin specialist) near you

Medical treatments

• Treatment of chronic furunculosis may require a course of antibiotic tablets, and possibly antibiotic nasal cream, to clear the Staphylococcus bacteria from your body and prevent ongoing recurrent infections.
• Small boils may subside on their own; however, larger boils or carbuncles (clusters of boils) may need to be lanced, drained and then covered with a sterile dressing. This should always be done by a health professional to avoid further damage to the skin and reduce the risk of spreading the infection. You should never attempt to burst or squeeze a boil yourself as this can spread the infection further across the skin.

What you can do to avoid it

• Washing your hair and body with antiseptic cleansers, changing clothes and bedding regularly, washing clothes and bedding at 50 degrees or more, and not sharing towels can help to eliminate bacterial infection.
• If you have painful boils, applying moist heat for 10 minutes 3 to 4 times daily using a flannel soaked in hot water can help ease the discomfort, localise the infection and promote drainage. Applying heat directly also increases blood flow to the area, thereby helping to fight the infection and aiding in the healing process.
• You can also use over-the-counter medicines such as paracetamol or ibuprofen to relieve any pain caused by your chronic furunculosis.

Are there any associated complications?

Chronic furunculosis may lead to blisters or abscesses which, as well as being painful, may leave scars on your skin. There is also a slight risk that infection on the skin can enter the bloodstream and spread to other parts of the body, including the bones or the brain, leading to serious illness. Fortunately, complications of this type are rare but it is always best seek professional medical help if you start to suffer from chronic furunculosis, to avoid spreading the infection and to minimise long-term scarring.