What are recurrent boils, and what causes them?

Recurrent boils are a condition where boils appear repeatedly after being treated or disappearing. A boil is an infection involving a group of hair follicles and the surrounding skin tissue, typically appearing as a painful, red, swollen bump that may contain pus. Most often, Staphylococcus aureus (staph) bacteria are the primary cause of these recurrent skin infections [3].

Boils can develop anywhere on the body where hair follicles are present, but they are most common on the face, neck, armpits, buttocks, and thighs [3]. The recurrence of boils suggests underlying factors that may increase a person's susceptibility, such as carrying the bacteria on the skin or in the nose without showing symptoms, or having certain health conditions that weaken the immune system [1].

What are boils?

A boil, also known as a skin abscess, usually starts as a painful, red-pink, swollen spot on a firm area of skin. Over time, the boil fills with pus and dead tissue, increasing the pain. The pain typically subsides once the boil drains. A boil may burst and drain its contents on its own, but often it requires lancing to drain the pus [3].

Boils range in size from a pea to a golf ball and may contain a white or yellow center (pustules). In some cases, boils can spread to other areas of the skin or merge with other boils to form a condition called carbunculosis [3].

Causes of recurrent boils

Boils occur when Staphylococcus aureus bacteria enter the body through a cut or scratch in the skin [1]. These bacteria can spread from person to person or via contaminated surfaces such as towels, clothing, and doorknobs [1]. Several factors increase the risk of recurrent boils, including:

• Staph carriage: Some individuals carry staph bacteria on their skin or in their noses without getting an infection. However, these bacteria can cause an infection if they enter the body through a wound [1].
• Weakened immune system: People with compromised immune systems, whether due to medical conditions like HIV or due to immunosuppressive medications, are more susceptible to recurrent infections [1].
• Chronic diseases: Conditions such as diabetes, kidney disease, vascular disease, cancer, and eczema increase the risk of recurrent boils [1].
• Personal hygiene: Failing to wash hands regularly or sharing personal items like towels can contribute to the spread of bacteria and recurring infections [1].
• Frequent exposure to bacteria: Individuals who participate in sports requiring direct skin-to-skin contact or who share sports equipment may be at higher risk [1].

When to see a doctor?

You should see a doctor if your boils:

• Appear on your face or spine [3].
• Are accompanied by a fever, red streaks extending from the affected area, significant fluid accumulation, or other signs of infection [3].
• Cause significant pain or discomfort [3].
• Do not heal with home treatment within one week [3].
• Recur after treatment [3].

In some cases, boils can cause serious complications such as the spread of infection to other parts of the body, including the bones, heart, or brain, or even blood poisoning (sepsis) [3]. Therefore, it is important to seek medical care when any of the aforementioned warning signs appear.

Treatment and prevention of recurrent boils

Boils usually require drainage of pus to heal. This process can be accelerated by applying warm, moist compresses to the boil several times a day [3]. Never attempt to squeeze or cut a boil at home, as this can lead to the spread of infection [3]. In some cases, a doctor may need to surgically drain deep or large boils [3]. The doctor may also prescribe oral or injectable antibiotics if the infection is severe or recurrent [3].

To prevent recurrent boils, it is advisable to follow good hygiene practices, such as washing hands with soap and water regularly, especially after touching the boil. Avoid sharing towels, clothing, or personal hygiene items with others [1]. If you have a wound or cut, ensure it is covered to protect against the entry of bacteria [1]. Antibacterial soaps and antiseptic washes can help prevent the spread of infection [3]. For more information about the relationship between recurrent boils and diabetes, you can visit Recurrent Boils: Causes, Treatment, and Diabetes Screening (Arabic).

Medical references

• Boils
• Staphylococcal Infections