You treated a painful boil, it finally healed, and you breathed a sigh of relief, only for another one to show up weeks later in nearly the same spot. If boils keep coming back, it usually is not bad luck or poor hygiene. Most of the time it means the bacteria that cause them are living on your skin, and they keep finding their way back into a hair follicle.
The good news: recurring boils are common, well understood, and very treatable once you know what is driving them. Here is what is actually going on, and how doctors break the cycle.
What causes recurring boils?
Recurring boils are almost always caused by a bacterium called Staphylococcus aureus, often just called staph. A boil (medically, a furuncle) forms when staph infects and inflames a hair follicle, creating the deep, pus-filled, painful bump you recognize. In one study, S. aureus was the culprit in 89% of recurrent furuncles and 100% of non-recurrent ones.
The reason boils recur, rather than happening just once, is that many people carry staph on their skin and in their nose without feeling sick. This is called being a carrier. An estimated 10 to 20% of the general population are staph carriers, and that reservoir of bacteria can repeatedly reinfect a follicle whenever the skin is slightly broken by a shave, a scrape, friction, or an insect bite.
- The hidden reservoir: the inside of the nose (anterior nares) is the main place staph lives, along with the armpits, groin, and the cleft between the buttocks
- A way in: boils often start where skin is broken or rubbed, such as the back of the neck, thighs, buttocks, and underarms
- A source of reinfection: as long as the carrier state continues, new boils can keep forming
When are boils considered "recurrent"?
Doctors generally define recurrent furunculosis as three or more boil attacks within a 12-month period. If you have had that many, it is worth treating the underlying carrier state rather than just each individual boil as it appears.
Recurring boils can also be a sign of MRSA, a type of staph that resists common antibiotics. That is one reason a clinician may want to swab a boil or your nose, identify exactly which bacteria are present, and choose treatment accordingly.
Why do I keep getting boils? Common risk factors
If you seem prone to boils when others around you are not, there is usually a reason. The single most important predictor of recurrence is a positive family history, partly because staph spreads easily between household members who are carriers and share close quarters and personal items.
Other host factors make your skin a friendlier home for staph or make infections harder to clear. None of these mean you did anything wrong, and several are manageable with the right care.
- Nasal carriage of staph, the leading risk factor, present in roughly 60% of people with recurrent boils
- A family member or housemate who also gets boils (carrier spread)
- Diabetes mellitus
- Obesity
- Anemia or iron deficiency
- Atopic dermatitis (eczema)
- Recent antibiotic use
- A weakened immune system
- Carrying staph at more than one body site, which is linked to relapse
How to treat and stop recurring boils
For a single boil, the American Academy of Dermatology recommends warm compresses as the best at-home care: soak a clean washcloth in hot water and hold it to the area for 10 to 15 minutes, 3 to 4 times a day, until the boil drains and heals. Never squeeze, pop, or pierce a boil yourself, because that can push the infection deeper and spread it.
Stopping the recurrence is a different job. Because the problem is the staph living on your body, dermatologists target that reservoir with what is called decolonization. A standard approach is mupirocin 2% ointment applied to the nostrils 2 to 3 times daily for 5 to 7 days, combined with 4% chlorhexidine gluconate body washes or dilute bleach baths. Crucially, carrier family members are often treated at the same time, otherwise you can simply re-catch staph from someone you live with. Antibiotics may also be added when an active infection needs them.
Everyday habits help keep the cycle broken. Wash your hands often, bathe regularly (especially after exercise), do not share towels, razors, or washcloths, and keep any cuts or scrapes clean and covered until they heal.
- Warm compress, 10 to 15 minutes, 3 to 4 times daily, for an active boil
- Never squeeze or lance a boil at home
- Decolonization (prescription) to clear staff carriage, family included
- Don't share towels, razors, or washcloths
When to see a doctor about boils
Self-care is reasonable for a single small boil, but recurring boils specifically deserve a clinician's attention, because the recurrence is the signal that the underlying carrier state or a health factor needs to be addressed. A board-certified dermatologist can swab for the exact bacteria, check for things like MRSA or diabetes, and prescribe a decolonization plan for you and your household.
Seek care promptly if a boil is on your face, is very large or extremely painful, is not improving with home care, keeps coming back, or comes with fever and chills or a generally unwell feeling, which can signal a deeper infection such as a carbuncle. Anyone with diabetes or a weakened immune system should be seen sooner rather than later.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new skincare treatment, especially if you have underlying health conditions, are pregnant, or are taking medications.
