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Think you have a carbuncle, a larger cluster of boils? Here's what treatment you can expect after you are diagnosed with a carbuncle, and why you should seek medical advice if you think you have one.

Boils are nasty enough, but they pale in comparison to their "big sibling" — carbuncles.

What do you need to know about diagnosing carbuncles, carbuncle and boil medicine and treatment you may receive, and potential complications of carbuncles?

What Are Carbuncles, And How Do You Get Them?

Boils — also known as furuncles — are pus-filled pockets that develop around hair follicles. They're usually caused by Staphylococcus aureus bacteria, more commonly simply called "Staph". While a boil manifests as a red, inflamed, bump under the skin and goes onto develop a single white or yellow "head" before bursting, a carbuncle is more complex.

Carbuncles are, simply said "Boils +", or groups of boils that develop in the same spot, incorporating several hair follicles and creating an angry mess with several heads.

Carbuncles typically develop on the back of your neck, on your thighs or hips, or around the shoulders. [1] If you are dealing with multiple carbuncles, your condition is referred to as carbunculosis [2]. 

You are at a higher risk of developing carbuncles if:

  • You have diabetes
  • You smoke
  • Your immune system is compromised
  • You have an iron deficiency
  • You are male
  • You are Caucasian
  • You should also be aware that boils are contagious, so coming into contact with someone else's boils is a definite risk factor as well. [3, 4, 2]

Most people who develop carbuncles are, however, otherwise in good health, and the presence of a carbuncle doesn't necessarily point to poor personal hygiene at all. 

What Symptoms Are Associated With Carbuncles?

  • Some people notice that the skin on which a carbuncle will develop is itchy before further symptoms turn up. 
  • Carbuncles present as tight, slightly squishy "mountains" of irritation and are characterized by the presence of multiple pus-filled heads. 
  • Some carbuncles grow rather quickly — they can be as large as a 10 cm or 4 inches, and may spread to other areas of your skin. 
  • Carbuncles may lead to a fever and a feeling of general malaise. [2]

I Think I Have A Carbuncle — What Now?

While people can and do successfully use home remedies for boil treatment, and specifically warm, moist compresses, it's time to bring the big guns out when you're pretty sure you have a carbuncle: see a doctor and let them assess your skin abscess [5]. Some carbuncles do resolve on their own without any complications, but it's best to check to be sure.

Your doctor can evaluate whether your carbuncle might be caused by MRSA [6] and proceed with treatment as needed. 

The most common treatment for carbuncles is minor surgery and antibiotics:

  • Incision and drainage (also called "I&D") is basically exactly what it says on the tin. Saucerization creates a small depression in your carbuncle to facilitate drainage. [7]
  • Commonly used antibiotics for boils and carbuncles include  Flucloxacillin,  Macrolide, and Tetracycline. [8]
In some cases, your doctor will prescribe intravenous antibiotics for your carbuncle, followed by incision and drainage. You'll then undergo irrigation of the carbuncle with an antibiotic solution three times a day over the course of several days. This method is particularly recommended for people who have carbuncles in the facial region, and it facilitates the speediest possible recovery while minimizing the formation of scar tissue. [9]

You will additionally benefit from using antibacterial soaps on the site of your carbuncle, using dressings once the carbuncle begins oozing, and making very sure that others in your household don't have the opportunity to be in contact with towels, washcloths, clothes, or sheets that touched the fluid oozing from your carbuncle. [2]

Complications Of Carbuncles

Carbuncles often leave you with scars [10]. You can ask your doctor about scar-fighting treatment such as aminobenzoate or corticoisteroid injections, and it is also possible to undergo plastic surgery to minimize the appearance of scars caused by carbuncles. 

Carbuncles may also lead to secondary infections, including:

  • Cellulitis, an infection of the deeper layers of your skin. [11]
  • Osteomyelitis, a bone infection. [12]
  • Endocarditis, an inflammation of the inner lining of your heart. [13]
  • Septicemia, an infection of the blood. [14]
  • Cavernous sinus thrombosis, where a carbuncle or boil leads to a blood clot behind the eye socket. [15]

Don't freak out quite yet — you're much more likely not to develop these complications than to encounter them. However, knowing about the possibility of complications should make it quite clear that you need to call emergency medical services if you notice a high fever, breathing difficulties, severe headaches, eye pain, nausea, shivering, muscle and joint pain, or a rapid heartbeat

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