A carbuncle is a group of infected hair follicles that merge to form a large, painful, infected mass--an abscess. The bacterium Staphylococcus aureus most commonly causes this skin infection. A carbuncle appears as a broad, red, warm, swollen lesion. It can arise from any skin surface with hair and commonly affects areas with thick skin such as the nape of the neck, thighs or back. Treatment for a carbuncle involves facilitating drainage of the abscess, preventing spread of the infection and promoting healing.
Warm Compresses
The University of Maryland Medical Center explains that the dead tissue, bacteria and pus within a carbuncle must drain for the abscess to heal. As pressure builds within the carbuncle from the accumulation of pus, the skin lesion typically begins to "point." A point is an area where the skin thins and eventually ruptures, allowing drainage of the contents of the carbuncle. A point is similar to the head of a pimple, on a larger scale. Carbuncles usually form several points due to the extensive nature of the lesion.
Application of warm, moist compresses several times daily can help a carbuncle point more quickly. A washcloth or rag soaked in warm water proves a suitable compress. To prevent the spread of infection, cloths used as compresses should not be reused until laundered in hot water and dried on high heat. Washing the hands with soap and water for at least 15 seconds after touching a carbuncle also reduces the risk for spreading the bacteria.
Incision and Drainage
Some exceedingly deep carbuncles do not point and continue to grow. These exquisitely painful skin lesions often require incision and drainage. With this procedure, the doctor numbs the skin and makes a small incision into the pocket of the abscess with a sterile scalpel. Drainage of the abscess pocket leads to an immediate reduction in pain. InteliHealth.com, in collaboration with the faculty of Harvard Medical School, notes that sterile gauze placed into the abscess pocket with a wick to the skin surface facilitates continued drainage of large carbuncles. As the pocket decreases in size and drainage recedes, the gauze is removed. Rarely, a carbuncle continues to drain due to persistent infection. Such cases may require a more extensive surgical procedure to remove dead tissue and clean the abscess pocket.
Antibiotics
MayoClinic.com notes that doctors sometimes prescribe oral antibiotics for carbuncles. Oral antibiotics are most commonly prescribed for people with an increased risk for spread of the infection, including patients with HIV/AIDS or diabetes, organ transplant recipients, and people taking immunosuppressant medications. Topical antibiotics are also sometimes prescribed.
References
- University of Maryland Medical Center: Carbuncle
- MayoClinic.com: Boils and Carbuncles
- InteliHealth.com: Boil and Carbuncle
- Merck Manual for Healthcare Professionals: Furuncles and Carbuncles, Treatment
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D., et al., Editors; 2004
