What You Need to Know About Carbuncles

Carbuncles are caused by Staphylococcus aureus bacteria that live in the nasal passages and throat and on the surface of the skin. The bacteria can enter the skin through a skin scrape or puncture, small injury and reach the hair follicles in the dermal skin layer. Existing skin conditions like acne or eczema also can increase the chances of developing carbuncles. Other body areas that stay moist and already host bacteria, including the mouth, nose, groin, and armpits, are also highly susceptible areas for developing carbuncles. Infections usually show up on the back of the neck, thighs, hips or shoulders, and they are very likely to leave a scar. These infections are common for middle-aged or senior men and people who have diabetes.

The area of the skin infected with carbuncles can be highly contagious. Skin-to-skin contact can spread the infection to other body parts and other people. Infants and older adults with weak immune systems are especially at risk to this type of exposure.  In essence, anyone with a weakened immune system should avoid being near carbuncles or boils. Other conditions that increase the likelihood of contagion include kidney disease, liver disease, and poor hygiene.

Although it is rare, the infection from a carbuncle can enter the bloodstream and create a state of sepsis, or poison, that spreads to other parts of the body. In some cases, the infection can even reach the heart and bones and create permanent damage, including death.

Many people who develop carbuncles have successfully self-diagnosed the condition and simply wait for the infected area to naturally begin to drain pus and start to heal. However, some circumstances make it necessary to see a licensed physician to treat the sore, raised area. If the area has not begun to improve after a week, it is time to seek professional help. Other symptoms that might indicate the infection has escalated include outbreaks in the face, rectum, groin, or spine areas, fever or severe pain, swelling and discoloration in other skin areas near the carbuncle site, and difficulty or disruption of simple body movements like walking. Infants, those with diabetes and other serious illnesses should not wait to see a doctor. Carbuncle treatment will need to be considered in conjunction with other current treatments. A good rule of thumb is to practice close monitoring and quick response.

Other skin conditions can be mistaken for carbuncles.  This includes impetigo, folliculitis, acne, and rosacea. The presence of redness, swelling and skin irritation makes the misdiagnosis common. Additionally, patients who have already received antibiotics for carbuncles and not seen any marked improvement within two days may have contracted methicillin-resistant Staphylococcus aureus, also called MRSA, which will not respond to commonly used antibiotics. It is important to speak with your medical provider if an antibiotic is not successfully treating carbuncles.

The approach to treatment for carbuncles heavily depends on the severity of the condition and the intensity of pain. Typically, doctors prescribe an antibiotic and pain medications.  Some doctors also recommend antibacterial soaps for daily bathing. This helps to keep pus from infecting other areas of the body. In severe cases, surgery may be required to drain extremely large carbuncles with a needle or scalpel.

Medical experts do not recommend that anyone drain a carbuncle without medical supervision on their own. Trying to cut the infected area with unsterilized instruments and draining pus may cause the infection to spread and worsen this condition. However, doctors do advise placing a warm, moist cloth on the carbuncle for 15 minutes several times a day. This speeds up natural draining. Once the carbuncle starts draining, it is best to cover the area with a bandage or gauze to protect the skin and absorb the draining pus. Anyone who touches a carbuncle should also stay vigilant about handwashing.

If a person practices simple hygiene routines daily they can greatly reduce carbuncle risks. This includes washing hands before eating and after each bathroom use, showering often to remove bacteria from the skin, and washing towels, sheets and clothes regularly in water hot enough to kill bacteria. Additionally, people who have carbuncles should avoid rubbing any infected or broken skin and squeezing boils to speed up pus drainage.

Although the scars left by carbuncles can fade over time, they never disappear completely. There are some treatment options, however, to make them less noticeable. Corticosteroid injections and pressure dressing help raised scars start to soften and flatten. Doctors also prescribe medications which help break down scar tissue. Patients who have not seen results with any of these remedies choose makeup to conceal scars or opt for plastic surgery.

The types secondary infections associated with carbuncles vary depending on where they spread. Cellulitis affects the deepest skin layers and is the most common occurrence. Additionally, infections can spread to the joints (septic arthritis), inside the bones (osteomyelitis), the inner layer of the heart (endocarditis), blood (septicemia) and inside the brain (abscess).

Cavernous sinus thrombosis happens when an infection creates a blood clot in the spaces behind the eye socket. The clot places pressure on the brain and makes carbuncle patients experience severe headaches, eye swelling, and sharp eye pains. Without proper and swift treatment, this rare illness can result in death.