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Both a furuncle and a carbuncle are skin infections caused primarily by the bacteria Staphylococcus aureus, but there are significant differences between the two. A furuncle, also known as a boil, is an infection of the hair follicle and sebaceous gland, and appears as a pus-filled red inflammation. Carbuncles are a group of furuncles and generally extend deeper into the skin. People with weakened immune systems are more likely to develop a furuncle or carbuncle, although furuncles are quite common.
Furuncles start as a small, red painful area on the skin. They may be caused by staph, other bacteria or fungi that infect a damaged hair follicle. Generally lasting about two weeks, they can develop into a large pus and dead tissue filled boil. Furuncles occur most frequently on the face, neck, armpit and buttocks. They become more painful as they enlarge.
Eventually, a white or yellow pus center develops and the furuncle may begin to ooze pus. Healing doesn’t begin until the furuncle bursts and the pus drains. A warm, damp compress can speed draining and recovery. Generally, they heal on their own, but medical intervention may be required if a furuncle lasts beyond two weeks, recurs or is accompanied by a fever. The presence of fever indicates the bacteria causing the infection may have spread to other parts of the body.
Careful hygiene practices are important to stop the spread of infection. A weeping furuncle should be meticulously cleaned and dressings disposed of sensibly. Hands and washcloths must be well washed after touching a furuncle. All clothing and bedding should be scrubbed in hot water to stop reinfection. People who have recurring furuncles have found that taking antibiotics and practicing improved hygiene help.
Without proper care, a furuncle can lead to complications. The infection can spread to other organs including the brain and to other parts of the skin. Furuncles on the face, in the nose or on the spine require medical attention. An additional complication is that furuncles can form clusters and develop into a carbuncle, a more serious condition.
A carbuncle is a group of furuncles and involves deeper layers of the skin. The mass of dead tissue, infection and pus may reach to the subcutaneous fat layer beneath the skin and could become incapable of self-draining. Carbuncles are highly contagious and easily spread to other areas of the body and other people. They can enlarge, becoming golf ball sized and very painful.
Like a furuncle, a carbuncle must drain before it can heal. Warm, moist compresses help the pus drain, and many carbuncles heal on their own. Medical attention is needed for patients with a fever or with large, deep carbuncles that don’t drain. Carbuncles located on the face or spine also require a doctor’s care. Due to their contagious nature, extreme care should be taken to stop their spread.
A guy at my church had a real carbuncle in the middle of his back. He'd been having pain and let his wife look at the place, but she said it was just a red bump.
He left it alone, but it kept getting worse. Finally, his wife saw it and told him he needed to go to the ER. She showed it to him in the mirror and he said it looked awful.
He went to the ER and the doctor had everything laid out to lance a boil there in the department. Then he looked at the place on my friend's back and freaked out. He said it needed surgery as soon as the doctor could get there
, and he admitted my friend right away and they took him to get him prepped for surgery.
The surgeon said it was a good thing he got the carbuncle when he did because my friend was well on his way to having a bloodstream infection. He had a crater in the middle of his back where the carbuncle was. It was pretty scary.
Depending on the location of the boil (or furuncle -- hate that word!), it may or may not be that painful. I had one on the back of my thigh. I had an itchy place, reached to scratch it and felt a place. I thought it was a mosquito bite, but it felt soft, like it had something in it. Of course, I couldn't see it.
I squeezed a little and, not to be gross, but let's just say it was -- productive. Very productive. I couldn't believe it didn't hurt. But it was summer, I was in shorts most of the time, and it wasn't in a place where I put pressure on it sitting. I showed it to my mom the next morning, thinking it was a zit that had popped, but no, she said it was definitely a boil. I guess I was just lucky it didn't get nasty and infected.