Also known as skin abscesses, boils form as a result of a cut or break in the skin, which leads to a bacterial infection. They are characterized as a red, tender area with a painful, pus-filled center that can open spontaneously or by surgical incision. Some boils are caused by an ingrown hair. Others are caused by plugged-up sweat glands, such as some types of cystic acne. Anyone can get a boil. They grow quickly and are usually painful until they drain. However, left alone a boil will naturally come to a head and burst open, allowing the pus to drain and the skin to heal. People with weakened immune systems are more susceptible to boils than the general population.
Boils tend to occur on parts of the body that have hair or sweat glands and are exposed to friction, typically on the face, neck, armpits or buttocks. There are a variety of different types of boils:
Furuncle or Carbuncle. These abscesses are caused by the Staphylococcus aureus bacterium. A furuncle is an individual boil; carbuncles are deep clusters of boils that most often form on the back of the neck, shoulders or thighs.
Pilonidal Cyst. An infected hair follicle around the buttocks area caused by long periods of sitting. Pilonidal cysts almost always require medical treatment.
Hidredenitis Suppurativa. These are multiple abscesses that form from blocked sweat glands in the armpits or groin areas.
Cystic Acne. These boils are situated more deeply into skin tissue than the more superficial forms of acne. It typically occurs among teenagers.
Boils respond well to home remedies. To promote healing, apply heat to the boil in the form of hot soaks or compresses. Keep the area clean, apply over-the-counter antibiotic ointment and then cover with gauze. Do not puncture or squeeze the boil because it can lead to further infection. If the boil does not go away within two weeks, is accompanied by a fever or is painful, contact your dermatologist. The doctor will clean, lance and drain the boil and prescribe an antibiotic to alleviate the infection.
Candidiasis is the medical term for yeast infections in the body. There are three forms of candidiasis that relate specifically to the skin:
Oral Candidiasis (Oral Thrush). This infection is characterized by lacy, white patches on top of reddened areas that occur on the tongue, throat or elsewhere in the mouth. It is usually accompanied by a fever, colic or diarrhea. Oral thrush can be painful and lead to an uncomfortable burning sensation in the mouth. People who are diabetic, have suppressed immune systems, patients undergoing antibiotic or chemotherapy treatment and denture wearers are more susceptible to this infection. It is particularly important to catch it early in infants and children. Because of the discomfort caused by oral thrush, they may stop eating and/or drinking.
Diaper Rash. Candidiasis breeds in warm, moist environments and in the natural creases of the skin. Some diaper rashes are bacterial, but many are caused by yeast infections. To treat diaper rash, use over-the-counter powders and ointments and antifungal creams and lotions. Plan on frequent diaper changes to give the skin a chance to be exposed to air regularly. If diaper rash doesn’t abate in seven to 10 days, contact your dermatologist.
Candidal Intertrigo. This yeast infection occurs in moist overlapping skin folds, such as areas in the inner thighs, armpits, under the breasts, below the belly, behind the ears and in the webbed spaces between the fingers and toes. It is more common among people who are overweight. It is characterized by red, raw skin surrounded by scaling and, in some cases, lesions that itch, ooze or hurt. Candidal intertrigo is treated with medicated topical creams.
Cellulitis is a common bacterial skin infection that is caused by either Staphylococcus or Streptococcus bacteria. Both of these bacteria occur naturally on the skin. A break or cut in the skin causes the bacteria to enter the body, which leads to an active infection. Cellulitis most often occurs from:
- cracking or peeling skin between the toes,
- insect bites or stings, and
- a skin cut, break or trauma.
Cellulitis appears as a swollen red area of skin that is tender and hot to the touch. Symptoms include chills, fever, muscle ache, fatigue, pain or tenderness in an area with a skin rash or sore. The redness increases in size as the infection spreads. It typically comes on suddenly and spreads quickly. Cellulitis can arise anywhere on the body, but usually appears on the face or legs. Be sure to contact your dermatologist as soon as you observe these symptoms to start an effective treatment.
To prevent cellulitis, be sure to clean any cut or break in the skin promptly with soap and water and cover the wound with a bandage until it scabs over. Watch for redness, tenderness, drainage or pain as these are signs of infection.
Chicken Pox (Herpes Varicella Zoster)
Chicken pox is a common illness, particularly among children. It is characterized by itchy red spots or blisters all over the body. Chicken pox is caused by the Herpes Varicella Zoster virus. It is highly contagious, but most cases are not dangerous.
Chicken pox can be passed on from two to three days before the rash appears until the blisters are crusted over. It spreads from exposure to infected people who cough, sneeze, share food or drinks or by touching the blisters. It is often accompanied by a headache, sore throat and possibly a fever. The incubation period (from exposure to first appearance of symptoms) is 14 to 16 days. When the blisters crust over, they are no longer contagious and the child can return to normal activity. This normally takes about 10 days after the initial appearance of symptoms.
It is important not to scratch the blisters as it can slow down the healing process and result in scarring. Scratching may also lead to another infection. To help relieve the itching, soak in a cool bath. The child should get plenty of bed rest and can take over-the-counter analgesics to reduce any fever. More serious cases are usually seen in people with other long-term health problems.
Although about four million children get chicken pox each year, it may be preventable via a vaccine. Children should receive two doses of the vaccine — the first between 12 and 15 months and the second between ages four and six. Older children who have not been vaccinated can be effectively treated with two catch-up doses. Adults who have never had the illness should also be vaccinated.
A particular type of skin infection (cellulitis) that is characterized by blisters; skin that is red, swollen, warm and/or painful to the touch; or by lesions with raised borders that most frequently appear on the face or legs. It also appears as sores on the cheeks and bridge of the nose. It is usually caused by the Streptococcus bacteria and occurs in both adults and children.
Erysipelas requires medical treatment, so you should contact your dermatologist as soon as you suspect you may have this infection. Antibiotics (usually penicillin) are generally prescribed. In severe cases, the patient may need to have antibiotics delivered intravenously.
Folliculitis is an inflammation of one or more hair follicles. It appears as a rash or white-headed pimples or pustules near a hair follicle. It can occur anywhere on the body, but typically affects hairy areas, such as the neck or groin. Follicles can be damaged from repeated friction (such as rubbing of too tight clothes) or a blockage of the hair follicle (for instance, from shaving). In most cases, follicles become infected with the Staphylococcus bacteria.
There are two types of folliculitis:
Superficial Folliculitis affects the upper area of the hair follicle and may cause red, inflamed skin, small clusters of red bumps, blisters that break open and crust over and/or itchiness and tenderness. When the infection occurs in men’s’ beards, it is called Barber’s Itch. When it is caused by a fungal infection, it is known as Tinea Barbae (ringworm).
Deep Folliculitis affects the entire follicle from its deepest parts under the skin to the surface of the skin. This less-common form of folliculitis is seen in people who are undergoing chronic acne antibiotic treatment, people with HIV or people with boils and carbuncles.
Generally, folliculitis is treated with antifungal medications.
Granuloma is a generic term that refers to a small nodule. It can be any type of nodule, from benign to malignant. Granulomas occur throughout the body. Two types of granuloma apply expressly to the skin:
Pyogenic Granuloma. Pyogenic granuloma looks like small, reddish bumps on the skin that tend to bleed. It is caused by an injury to the skin. It is most frequently found on the hands, arms and face. In some cases, the nodules will spontaneously disappear. More often, the lesions need to be removed by surgery. There may be some scarring as a result of these treatments.
Granuloma Annulare. This type of nodule can occur in any person, but is more common in children and young adults. It is characterized by a ring-shaped lesion that is round and firm; red, white or purple skin around a clear crater of normal skin. It can appear individually or in groups. Most often, it appears on tops of hands and feet, elbows and knees. Most people have no other symptoms, but some may experience itchiness at the site of the lesion. Granuloma annulare can resolve itself and may or may not disappear over time without treatment. However, if the incidence is widespread or aesthetically undesirable, a dermatologist may prescribe a steroid cream or inject steroids just below the skin’s surface to speed healing. Another successful treatment is PUVA, in which a medication called psoralen is given and then the area is exposed to ultraviolet light.
Head lice are small parasitic insects that thrive in human hair by feeding on tiny amounts of blood from the scalp. An estimated six to 12 million infestations occur in the U.S. annually. It is particularly common among pre-school and elementary school children. Head lice do not transmit any diseases, but they are very contagious and can be very itchy. They are characterized by the combination of small red bumps and tiny white specks (also known as eggs or nits) on the bottom of hair closest to the skin (less than a quarter-inch from the scalp).
Head lice are visible to the naked eye. The eggs look like yellow, tan or brown dots on a hair. Live lice can also be seen crawling on the scalp. When eggs hatch, they become nymphs (baby lice). Nymphs grow to adult lice within one or two weeks of hatching. An adult louse is about the size of a sesame seed. Lice feed on blood from the scalp several times a day. They can also survive up to two days off of the scalp.
Head lice are spread through head-to-head contact; by sharing clothing, linens, combs, brushes, hats and other personal products; or by lying on upholstered furniture or beds of an infested person. You can determine if your child has head lice by parting the child’s hair and looking for nits or lice, particularly around the ears and nape of the neck. If one member of your family is diagnosed with head lice, you’ll need to check every member of the same household.
Medicated lice treatments include shampoos, cream rinses and lotions that kill the lice. Many of these are over-the-counter, but prescription drugs are available for more severe cases. It is important to use these medications exactly as instructed and for the full course of treatment to eliminate the lice. Do not use a cream rinse, conditioner or combined shampoo and conditioner on your hair before a lice treatment. You also should not shampoo for one or two days following the application of a treatment. After applying the medicated treatment, use a special comb to comb out any nits on the scalp. Repeat the entire treatment seven to ten days after the initial treatment to take care of any newly hatched lice. Please note that you should not treat a person more than three times with any individual lice medication.
To get rid of the lice, you’ll also have to:
- Wash all bed linens and clothing worn by the infested person in very hot water.
- Dry clean clothing that is not machine washable.
- Vacuum upholstery in your home and car.
- Any items, such as stuffed toys, that can’t be machine-washed can be placed in an airtight bag and stored away for two weeks. Lice cannot survive this long without feeding.
- Soak combs, brushes, headbands and other hair accessories in rubbing alcohol or medicated shampoo for at least one hour or throw them away.
If your child still has head lice after two weeks with over-the-counter medicated products, contact your dermatologist for more effective treatment.
Herpes Simplex Virus
Herpes Simplex is a group of viral infections that cause sores on the mouth (oral herpes) or genitals (genital herpes). There are two types of Herpes Simplex Virus:
Herpes Simplex Virus Type 1 is the most common form of herpes that affects most people at least once during childhood. It is passed from person-to-person through contact with saliva. It is responsible for the formation of cold sores (fever blisters) and canker sores around the mouth and lips. It may also cause an enlargement of lymph nodes in the neck. Generally, this type of herpes does not need any treatment; however, oral medications to treat are available. It will disappear on its own in seven to ten days.
Herpes Simplex Virus Type 2 is sexually transmitted either to the genital area or mouth. About one in five adults in the U.S. has this form of the herpes virus, although many people don’t know they have it. The infection is characterized by sores that look like small pimples or blisters, which break open quickly and ooze fluid. This is followed by a period of crusting over and scabbing until the lesions finally heal, which can take up to four weeks. The infection spreads to areas of skin that come into contact with secretions from the blisters. The lesions most frequently appear on the vagina, vulva, penis, scrotum testicles, thighs or buttocks. They may be accompanied by a fever, swollen glands, headache or painful urination. Many people with genital herpes experience sensations of itching, tingling, burning or pain in areas where lesions will develop.
Genital herpes is diagnosed through a viral culture test of the blister fluid from a lesion and blood tests. There is no known cure. Treatment is designed to reduce pain and hasten healing and includes antiviral medications. For people with more severe, prolonged or frequent outbreaks, your dermatologist may prescribe a stronger antiviral drug.
On average, adults with genital herpes have about four or five outbreaks a year. The first outbreak is usually the most severe and more outbreaks occur the first year than any subsequent year. Generally, symptoms begin to appear about two weeks after transmission. The virus takes root in nerve cells, lying dormant until it re-emerges with another outbreak. Outbreaks are known to be triggered by stress, illness or excessive sunlight. It is important for people with genital herpes to avoid sexual contact during an active outbreak to reduce the risk of passing the infection on to a sex partner. However, herpes simplex virus type 2 can be transmitted a few days before the appearance of any lesions. That is why people with this infection are encouraged to practice safe sex and use condoms at all times.
Considered a severe form of acne, hidradenitis suppurativa is a chronic skin inflammation that usually occurs deep in the skin in areas of the body with sweat glands, such as the groin or armpits. It is characterized by a combination of blackheads and red lesions that break open and drain pus, which may cause itching or sweating. As the red bumps grow in size, they can become more painful.
Hidradenitis suppurativa occurs when oil glands and hair follicles become blocked with sweat gland fluid, dead skin cells and other elements found in hair follicles. These substances become trapped and push out into the surrounding tissue. A break or cut of the skin then allows bacteria to enter the area and cause the inflammation.
Treatment depends on the severity of the condition. For mild cases, home remedies work well, such as warm compresses and regular washing with antibacterial soap. In more difficult cases, a topical or oral antibiotic medication may be needed to treat the infection. Your dermatologist may also prescribe oral retinoids to stop oil glands from plugging up the hair follicle; non-steroidal anti-inflammatory drugs to relieve pain and swelling; and corticosteroids.
Hives are characterized as itchy red, raised welts (also known as wheals) on the skin’s surface that can spread or join together and form larger areas of raised lesions. They are generally triggered by exposure to an allergen or chemical irritant. They tend to appear suddenly and often disappear equally as suddenly.
Hives are usually an allergic reaction to food, medicine or animals. They can also be triggered by sun exposure, stress, excessive perspiration or other, more serious diseases, such as lupus. Anyone can get hives. They are harmless and non-contagious. Hives may itch, burn or sting. They rarely need medical attention as they tend to disappear on their own. However, in persistent cases, your dermatologist may prescribe antihistamines or oral corticosteroids. The best way to prevent hives is to discontinue exposure to the allergic irritant.
Hives lasting more than six weeks are known as chronic urticaria or, if there is swelling below the surface of the skin, angioedema. There are no known causes of angioedema, but it can affect internal organs and therefore requires medical attention.
Impetigo is a common skin infection usually found in children and infants. It is characterized as single or multiple blisters filled with pus, which pop easily and leave a reddish, raw-looking base and/or honey-colored crust. In most children, impetigo first appears near the nose and then spreads through scratching to other parts of the face, arms or legs. The blisters tend to be itchy.
There are three forms of impetigo:
Ordinary Impetigo is caused by Streptococcal germs. It appears as red sores that rupture quickly, ooze a fluid and then form a honey-colored crust. It primarily affects children from infancy to age two.
Bulbous Impetigo appears as fluid-filled blisters caused by Staphylococcus germs. This contagious infection is carried by the fluid that oozes from the blisters.
Ecthyma, a more serious form of impetigo that penetrates to the second layer of skin (dermis). It is characterized by sores that are painful and/or fluid or pus-filled. These lesions most commonly appear on the legs or feet. The sores break open and scab with a hard yellow-gray crust. It can also cause swollen lymph glands in the affected area.
Impetigo is generally treated with a seven-to-10-day course of prescription oral antibiotics and/or topical antibiotics. The sores tend to heal slowly, so it is important to complete the full course of medications. Please note that over-the-counter topical antibiotics (such as Neosporin) are not effective for treating impetigo.
Intertrigo is a skin inflammation that occurs in warm, moist folds of the body where two skin surfaces chafe against each other. It most commonly appears on the inner thighs, armpits, groin, the crease on the back of the neck, the bottom of breasts in women and below the belly in obese people. It can be caused by a bacterial, yeast or fungal infection. Symptoms include a reddish-brown rash that looks raw and may ooze or itch. In severe cases, the skin may crack or bleed.
Treatment for intertrigo focuses on keeping the affected area dry and exposed to air. Your dermatologist may prescribe steroidal creams, oral antibiotics or antifungal medications (depending on the cause of the infection) to relieve itching and promote healing. Applying warm, moist compresses to the area can also help relieve itching.