A hair follicle is the part of the skin where hair starts to grow. When bacteria infect a hair follicle, pus collects inside the hair follicle and a painful reddish lump or bump under the skin develops. It is called a boil or furuncle. When furuncles join together they form a big collection of pus called a carbuncle.
Furuncles occur in any part of the body where there is hair, but the parts commonly affected are the face, nape, armpits, and buttocks. A furuncle in the eyelid is called a stye.
A boil has to open in order for the pus inside to drain. A boil can sometimes open and drain on its own but this can take days to weeks. Applying warm pressure/warm compress with clean washcloth on the boil can help it open and drain. When the washcloth cools, it can be reheated with warm water and reapplied for 15 minutes every few hours.
Before applying warm compress, the hands should be thoroughly washed so as not to introduce more bacteria to the infected area. The boil should not be squeezed or popped. Once it drains, it can heal on its own.
Medical consult is necessary if the boil becomes more painful, it is associated with fever, or if it recurs. See a doctor if the boil develops on the face or on the back along the spine because the infection can travel to the brain or nervous system. The doctor will also see if the infection is just a boil and will decide if blood tests and other examinations are needed. He will also decide if you need to take antibiotics.
Skin abscess and cellulitis are also common skin and soft tissue infections. A skin abscess is a collection of pus in the dermis of the skin. It may occur in healthy persons who do not have other ailments. It is usually caused by the bacterium Staphylococcus Aureus. It can also be caused by several bacteria. Skin abscess may develop when pus from a boil extends through the skin dermis to the underlying tissue or subcutaneous fat.
Cellulitis involves reddening, swelling, and warmth over the affected skin. It is common among middle-aged and older adults. It is commonly due to the bacteria group A Streptococcus or Streptococcus pyogenes.
The following are risk factors for cellulitis and/or skin abscess:
Inflammation of the skin like eczema, psoriasis, and inflammation due to radiation therapy;
Impaired lymphatic drainage such as in obstruction by enlarged lymph nodes or after surgical dissection of lymph nodes;
Impaired venous drainage leading to swelling or edema, such as that seen in the lower extremities;
Obesity;
Impaired immune system such as in diabetes mellitus or chemotherapy; and
Presence of other infections like impetigo, herpes zoster or chicken pox;
Cellulitis and abscess can lead to complications like spread of bacteria to the blood stream (bacteremia), to the heart muscle (endocarditis), to the joints (septic arthritis), or to the bone (osteomyelitis). Severe infection spread to adjoining areas, to severe infection sepsis or toxic shock syndrome.
The most important way to prevent skin infection is to wash hands properly with clean water and soap. Ordinary soap may be used. Rub hands for 20 seconds and make a lather, scrub all surfaces of your hands. Rinse well with clean water. Alcohol may be used if soap and water are not available, but it should not always be used as the substitute. Measures to maintain good health and to have regular medical consult for treatment of underlying disease should also be done.
Immediate treatment is urgent in the presence of extensive skin involvement, fever, history of having recurrent skin abscess, when initial antibiotic treatment has no effect, infections involving young patients and elderlies, presence of underlying cancer, weakened immune response, exposures to animal bites, and if involvement of other body organs like the heart is suspected.
We would like to thank our donors of personal protective equipment through Baguio Midland Courier and to PAREB Metro Baguio Realtors Board, Inc. through its president, Gerardo R. Masadao; and corporate social responsibility chair, Arsenio D. Advincula, Jr.
