Boils (Furuncles): Why They Keep Coming Back and What Helps

A boil, or furuncle, is a painful, red, pus filled lump that forms when a hair follicle becomes infected, most often with the bacteria Staphylococcus aureus (staph). Most single boils heal with warm compresses and good hygiene, but boils that keep coming back usually have a reason, such as staph living in the nose or skin, spread within the family, or a condition like diabetes, and should be checked by a doctor.

Boils are very common in India, especially in hot, humid weather when sweat and friction irritate hair follicles. This guide explains what boils are, why they recur and what you can do safely at home.

What is a boil?

The NHS describes a boil as a hard and painful lump that fills with pus. It often begins as an itchy or tender spot, grows over a few days, and may come to a yellow or white head before bursting and draining.

• Furuncle is the medical name for a single boil
• Carbuncle is a cluster of boils joined together under the skin. The NHS notes these are less common and mainly affect middle aged men
• Furunculosis means having boils repeatedly

Boils can appear anywhere with hair, but common sites are the face, neck, armpits, buttocks, groin and thighs.

What causes boils?

Staph bacteria normally live on the skin and inside the nose of many healthy people without causing harm. A review in Clinical, Cosmetic and Investigational Dermatology explains that the nose is the main site where staph lives, and that it can also settle in warm, moist folds behind the ears, under the breasts and in the groin.

Boils develop when these bacteria enter a hair follicle through a small break in the skin. Things that make this easier include:

• Sweat, friction and tight clothing, especially in summer and the monsoon
• Shaving, waxing or plucking, which can damage follicles. See our guide on ingrown hairs and razor bumps
• Scratching itchy skin from eczema, scabies or insect bites
• Close contact with someone who has boils

The NHS lists people more likely to get boils as those with diabetes, HIV, eczema, people taking medicines such as steroids, and people with obesity or malnutrition.

Why do my boils keep coming back?

Most people get one or two boils and never have another. Recurrent furunculosis is usually defined as three or more episodes within 12 months. The CCID review describes several reasons:

• Staph carriage. Staph living in the nose or skin folds keeps reinfecting the skin
• Family spread. A positive family history was the strongest predictor of recurrence in one study, because staph passes between people who live together and share towels, beds and razors
• Underlying conditions. Anaemia, diabetes, previous antibiotic use, previous hospital stays and poor hygiene were also linked to recurrence
• Weakened skin barrier, for example from eczema

The review also notes that in recurrent cases, doctors may take swabs from the boil and from carrier sites such as the nose, test blood sugar or HbA1c to look for diabetes, and do a blood count.

	Single boil	Recurrent boils
How common	Very common	Less common
Usual cause	Staph entering a follicle	Ongoing staph carriage, family spread or a risk factor
Usual care	Warm compresses, hygiene, sometimes drainage	Doctor’s assessment, tests, treatment of carriers and contacts

What can I do at home for a boil?

For a small boil in an otherwise healthy person, the NHS suggests:

1. Hold a warm, damp cloth on the boil a few times a day to help it drain
2. Keep the area clean and gently wash it once it drains
3. Cover it with a clean dressing once it starts to leak
4. Take paracetamol for pain if needed, following the pack instructions
5. Wash towels, clothes and bedding used on the boil at a high temperature
6. Wash your hands before and after touching the boil

And what not to do:

• Do not squeeze, pick or pierce the boil
• Do not share towels, razors, clothes or bedding
• Avoid swimming pools and shared gym equipment until it heals
• Avoid applying turmeric paste, toothpaste or hot oil, which can irritate the skin
• Avoid buying antibiotic tablets or creams over the counter. Wrong or incomplete antibiotic use can encourage resistance

How can I prevent boils from coming back?

Hygiene steps from the CCID review and DermNet that the whole household can follow:

• Bathe daily and wash hands often with soap and water
• Keep cuts and scratches covered with clean, dry dressings
• Use your own towel, razor and bedding, and wash them regularly
• Clean shared surfaces such as door handles, bathroom taps and toilet seats regularly
• Wear loose cotton clothing and change out of sweaty clothes quickly
• Avoid picking your nose and keep a clean handkerchief, as DermNet advises
• Manage eczema, itching and skin fold rashes, since damaged skin lets bacteria in. See our guide on intertrigo and skin fold rashes
• Keep blood sugar under control if you have diabetes. Our guide on skin care for diabetes explains why infections are more common

How does a doctor treat boils?

Treatment depends on the size, number and site of the boils and on your general health. Your doctor or dermatologist may:

• Drain a large boil with a small cut under clean conditions
• Prescribe antibiotics if there are several boils, spreading redness, fever or a weak immune system
• Send a swab to identify the bacteria and which antibiotics will work
• Check for diabetes, anaemia or other conditions
• Advise a decolonisation plan for recurrent boils, which may include an antiseptic body wash and a nasal ointment for you and sometimes your family, as described in the CCID review

Decolonisation should only be done with a doctor’s advice, and the review notes that recurrent furunculosis can be difficult to control even with treatment.

Is it a boil or something else?

Other conditions can look like boils:

• Hidradenitis suppurativa, with repeated painful lumps in the armpits, groin or under the breasts that leave tunnels and scars
• Inflamed cysts, which grow slowly and may become infected
• Severe acne nodules on the face, chest or back. See our guide on back and body acne
• Folliculitis, many small pus spots around hair follicles

When is a boil an emergency?

The NHS advises getting urgent medical help if:

• The boil is on your face, especially near the nose or eyes
• The skin around it becomes red, hot, swollen and painful and the redness is spreading, which can be a sign of cellulitis
• You have a high temperature or feel hot, shivery or generally unwell
• You have diabetes or a weak immune system

If someone with a skin infection becomes very unwell, confused, very drowsy or breathless, call 112 or 108 for an ambulance in India. Our article on when to see a dermatologist urgently lists other warning signs.

When to see a dermatologist

See a doctor or dermatologist if:

• A boil has not improved after about two weeks, as the NHS suggests
• You get boils repeatedly or in clusters
• Several family members keep getting boils
• A boil is very large, very painful or keeps refilling
• You have diabetes, anaemia or another long term condition
• Boils leave scars or dark marks you are worried about

If you keep getting boils and want to understand why, Dr. Maria offers online consultations to review your history, discuss tests and plan prevention for you and your family. A boil with fever or spreading redness needs an in person examination first.