Boils
(Skin Abscesses)
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Pilonidal Cysts: What Are the Risk Factors?
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD
 Pilonidal cysts arise at the base of the tailbone (coccyx) of the lower back,
just above the natal cleft (the cleavage between the buttocks). Doctors
sometimes use the term pilonidal disease to refer to the range of problems that
can affect this area. In simple cases, a small, solitary cyst-like area
containing fluid is present without evidence of infection. In other cases, the
areas may become infected and filled with pus, creating a so-called pilonidal
abscess. When the condition is particularly severe, the infection can spread,
creating multiple abscesses and sinus tracts (abnormal paths of tissue
destruction). The term "cyst," which is generally used in this case, is actually a
misnomer since true cysts have a characteristic cellular lining that is lacking
in the vast majority of cases of pilonidal disease.
Small pilonidal cysts may not cause any symptoms if they do not become
infected. Symptoms and signs of a pilonidal cyst or abscess include swelling (a
localized "bump" may be noticed), pain, and redness at the base of the spine. In
the case of a pilonidal abscess, the pain and redness usually are greater, and
fever may be present.
Most experts believe that the cysts arise due to trauma to the area that
results in ingrown hairs. Pilonidal cysts often contain hair when excised, but
hair follicles have not been demonstrated in them, suggesting that the hair may
have been introduced from outside the cyst. Pilonidal disease was a common
problem among servicemen during World War II, thought to be due to the
mechanical trauma of riding in jeeps, trucks, and tanks.
What is a boil? What are the symptoms of a boil?
A boil is a localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard and tender. Eventually, the center of the abscess softens and becomes filled with infection-fighting white blood cells that the body sends from the bloodstream to eradicate the infection. This collection of white blood cells, bacteria, and proteins is known as pus. Finally, the pus "forms a head," which can be surgically opened or spontaneously drain out through the surface of the skin. A boil is also referred to as a skin abscess.
There are several different types of boils. Among these are:
- Furuncle or carbuncle: This is an abscess in the skin caused by the bacterium Staphylococcus aureus. A furuncle can have one or
more openings onto the skin and may be associated with a fever or chills.
- Cystic acne: This is a type of abscess that is formed when oil
ducts become clogged and infected. Cystic acne affects deeper skin tissue than the more superficial inflammation from common acne. Cystic acne is most common on the face and typically occurs in the teenage years.
- Hidradenitis suppurativa: This is a condition in which there
are multiple abscesses that form under the armpits and often in the groin area. These areas are a result of local inflammation of the sweat
glands. This form of skin infection is difficult to treat with antibiotics alone and typically requires a surgical procedure to remove the involved sweat glands in order to stop the skin inflammation.
- Pilonidal cyst: This is a unique kind of abscess that
occurs in the crease of the buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the area of skin from which hair grows (the hair follicle). With irritation from direct pressure, over time the inflamed area enlarges to become a firm, painful, tender nodule
that makes it difficult to sit without discomfort. These frequently form after long
trips that involve prolonged sitting.
What causes boils to form?
There are many causes of boils. Some boils can be caused by an
ingrown hair. Others can form as the result of a splinter or other
foreign material that has become lodged in the skin. Others boils, such as those of acne, are
caused by plugged sweat glands that become infected.
The skin is an essential part of our immune defense against materials and microbes that are foreign to our body. Any break in the skin, such as a cut or scrape, can develop into an abscess should it become infected with bacteria.
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| What does a boil look like? |
Next: Who is most likely to get a boil? »
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Boils
Staph Infection (Staphylococcus Aureus) »
What is Staphylococcus?
Staphylococcus is a group of bacteria that can cause a multitude of diseases as a result of infection of various tissues of the body.
Staphylococcus is more familiarly known as Staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal.
The name "Staphylococcus" comes from the Greek staphyle, meaning a bunch of grapes, and
kokkos, meaning berry, and that is what Staph look like under the microscope, like a bunch of grapes or little round berries. (In technical terms, these are gram-positive, facultative anaerobic, usually unencapsulated cocci.)
Over 30 different types of Staphylococci can infect humans, but most infections are caused by
Staphylococcus aureus. Staphylococci can be found normally in the nose and on the skin (and less commonly in other locations) of 20%-30% of healthy adults. In the majority of cas...
Read the Staph Infection (Staphylococcus Aureus) article »
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