Folliculitis or carbuncle: what is the difference?

Folliculitis and a carbuncle should be taken seriously and treated with effective remedies as early as the initial stage. Both skin inflammations occur in women and men on hairy areas of the body, for example on the face, in the intimate area, on the buttocks, back, or neck.

Medical professionals also refer to folliculitis as folliculitis, as the infection affects the upper part of a hair follicle. Inflammation of the hair follicle is located directly on the surface of the skin and becomes visible through a pus-filled pustule that surrounds the hair. A small, painful lump can be felt with the fingers along the hair at the affected area. The mild form of folliculitis can be treated well at home, e.g., with the green drawing ointment or ilon Classic. Thanks to the anti-inflammatory and circulation-promoting ointment, folliculitis heals quickly.

If the purulent inflammation of a hair follicle enlarges due to bacteria and germs that have penetrated the skin, a boil can develop from folliculitis. This is noticeable as a reddened, deep-seated pus-filled swelling in the skin that hurts when pressed and feels warmer than the surrounding skin.

A boil is roughly the size of a pimple; at most, a boil grows to two centimetres. They are often the result of, for example, a small injury while shaving or an insect bite. When several boils merge together in the skin, dermatologists refer to this as a carbuncle. This usually deep, extensive skin infection is often accompanied at an advanced stage by fever, a general feeling of illness, and hair loss.

Depending on the extent of the boil or carbuncle, treatment by a doctor is required. Outpatient surgical removal of the encapsulated pus collections may also be necessary to protect the patient’s health.

Caution with a carbuncle on the nose

Has a seemingly harmless case of folliculitis on the face developed into a carbuncle? Then the progression should be monitored closely, especially if it occurs along the nose. Most importantly, do not attempt to squeeze or lance the pus-filled swelling yourself under any circumstances. Carbuncles in the upper lip and nose area are not to be taken lightly. Squeezing can end in a life-threatening situation.

The reason is the particularly sensitive area between the upper lip, nose, and eyes. This triangular shape was first described by British dermatologist Dr Vishal Maden as the “triangle of death”. In this invisible triangle, fine blood vessels and nerve pathways run beneath the skin and lead directly to the brain.

If a pus-filled swelling on or in the nose bursts, there is a risk that germs and bacteria from the deep-seated skin inflammation can reach the brain via the bloodstream and lymph vessels and trigger life-threatening meningitis, a stroke, or facial paralysis. Symptoms of these serious conditions include sudden neck stiffness, fever, severe headaches and body aches, skin discoloration, as well as nausea and vomiting.

Because of the sensitive nerve fibres, it is important not to apply external pressure to a carbuncle and to treat the infection early and effectively. Congenital immune disorders, diabetes mellitus, obesity, smoking, or taking certain medications promote the development of carbuncles and folliculitis. Lack of disinfection after shaving also influences the development of folliculitis and carbuncles.

Folliculitis and carbuncle:
When should you see a doctor?

First, redness and swelling of the skin—regardless of the area of the body—should always be monitored closely. If a purulent skin inflammation forms on a hair follicle, a strip of ilon Salbe classic can be applied and the affected area covered with a plaster.

If the purulent skin inflammation continues to grow and hurt after several days, you should see a GP or dermatologist for treatment of the folliculitis. Hardened pus collections in the skin need a drainage channel to the skin surface so that the pus can drain on its own. A doctor can create this with a small incision. Sometimes a carbuncle also has to be cut out of the skin completely.

As a general rule, it is better to see a doctor too early rather than too late with a carbuncle. In the early stage, the course of the disease can be kept under control without risking the spread of the pathogens (Staphylococcus aureus) to surrounding tissue or other organs.

Stop inflammation before a boil or carbuncle develops – ilon Salbe classic

Heat, sweat, and skin-on-skin friction often lead to redness, small pimples, and irritated skin. If action is not taken in time, the inflammation can worsen—up to an abscess or boil.

The plant-based ilon Salbe classic has a targeted anti-inflammatory and antibacterial effect—including against MRSA—soothes irritated skin, reduces swelling, and noticeably relieves pressure pain. Thanks to its almost colourless texture and subtle scent, it is pleasant to apply and barely visible. Proven first aid from the pharmacy.

ilon® Classic Ointment. Active ingredients: larch turpentine, turpentine oil (maritime pine type), eucalyptus oil. A traditional herbal medicinal product for the treatment of mild, localised, purulent skin inflammation, such as small pus-filled nodules, inflamed hair follicles and inflamed sweat glands, based solely on long-standing use. Contains butylhydroxytoluene. (Information as of December 2024)

For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist.

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