Furuncle (Folliculitis, boils, etc.)

[SLSW]

During the last year and one half, on four occasions I was (and am) plagued with a huge boil or zit or furuncle or whatever jargon you wish to accept.  This has only been one at a time but extremely painful, embarrassing, and scarey.  The first occurred out of nowhere under my arm.  One day is looked like a large red pimple but by the end of one week had grown to an enormous size being very hard and painful.  It resembled a milk cow's utter.  I read about it, followed instructions to use warm compresses and bacitraycin first aid antibiotic.  It finally started to ooze thick white pus and little by little I was homefree (after ten days).  However, I went to my general practitioner and he suggested an antibiotic (Cephalexin) which I did not fill.  One week later, I got the same boil on my head.  Since my hair covered it, it was not noticeable.  I filled the prescription and took four pills per day.  After about a week, it also drained and resulted in a bald spot about the size of a quarter.  By some miracle my hair re-grew in that spot.  During this episode I went to a dermatologist who thought (did not biopsy) it was a staph infection and wanted me on Cephalexin for six months.  I consulted another dermatologist who said that was overkilling and unnecessary.  After seven months the same thing happened under the other arm.  Once again I filled a ten day prescription for Cephalexin but this time had the doctor drain the furuncle.  A few weeks later the same thing happened again under the other arm.  I followed the same procedure.  Last week another furuncle developed on the back of my neck making it difficult to sleep and exercise.  I am taking a double dose of Cephalexin (500 mg) four times a day for ten days and using warm compresses waiting for it to explode.  

Is this to plague me the rest of my life?
What is causing it?
I am a very clean 51 year old man with no other medical problems.  
Is there a stronger medication to eliminate this from my system once and for all?
I'm at my wits end with pain, fear, and embarrassment.

[Alan Rockoff, MD]

Regather your wits--it will take a little work, but you should be fine.

It sounds as though you are describing recurrent boils caused by staphylococcus germs (staph).  In an otherwise healthy person, these are often the result of colonization of the nostrils with staph (which don't cause any symptoms in the nose itself--they just live their and sow mischief elsewhere.)

Oral antibiotics are necessary, but to eradicate the staph usually requires washing with an antiseptic soeap like Phisohex and applying an antibiotic like Bactroban in the nostrils every night.  These are available by prescription and need to be applied and used daily for several weeks.

The hair regoriwth was not miraculous--staph infections aren't deep enough to desctroy follicles.

I suggest consulting your dermatologist again about these matters.  If anyone around you has recurrent infections (not likely, but worth asking), I suggest calling attention to this.

Take care.

Dr. Rockoff