The Random But Real Difference Between A Boil & A Pimple

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Unless you're incredibly lucky, you've likely had a pimple or some kind of skin infection in your life. They're very common, particularly during adolescence, but many of us experience minor acne well into our 20s — or even 30s. However, there are different kinds of skin problems and inflammations, and I'm here to tell you about one that can be difficult to figure out: the difference between boils and pimples, which can be easily confused.

If you've had experience with boils, you'll know that they can start out looking very similar to pimples and mild acne, but require very different treatment. Mistaking a boil for a run-of-the-mill blocked pore can lead to further infection or scarring, so it's important to diagnose them correctly and seek proper treatment early on.

Boils have been treated by humans for thousands of years — we have boil remedies in texts surviving from ancient Egypt — but we're not much further forward than we were centuries ago in treating them. If you're suspicious of a lump or bump on your skin, don't pick (seriously!) and observe it carefully. If it turns out to be a boil, you may need a doctor's help to make it disappear. Here are six random but real differences between boils and pimples.


Boils And Pimples Have Different Causes

The roots of acne and boils are different, explains Healthline, but they come from the same place. Pores that form the opening to hair follicles are vulnerable to both pimples and boils, but pimples are more common; they're caused by "dead skin cells, which form a plug that traps oil, bacteria, and dirt inside."

Boils, meanwhile, form in quite different conditions. "They’re caused by bacteria like Staphylococcus aureus, which usually live harmlessly on the surface of your skin," says Healthline. "Sometimes these bacteria can get inside the hair follicle and cause an infection." Staphylococcus aureus isn't automatically a problem; it resides in both skin flora and in our guts with minimal issues. However, when it does create an infection, it's a serious one — and that's reflected in boils.


Boils Are Bigger

While both pimples and boils are infections that cause pink-red swelling and accumulation of pus, that lovely combination of white blood cells and bacteria, boils tend towards more serious infection, and that's reflected in their size. The U.S. National Library of Medicine explains that while a boil may begin small, "over time, it will feel like a water-filled balloon or cyst". It can be "about the size of a pea, but may be as large as a golf ball". Either way, you can tell it's a boil and not a pimple if it's disproportionately large.


Boils Form In Specific Areas

Pimples are common in specific areas, like the oiliest section of your face or back. Boils, meanwhile, tend to accumulate elsewhere. The National Health Service notes that while boils have been known to develop virtually everywhere, "you're most likely to get one in an area where there's a combination of hair, sweat and friction, such as the neck, face or thighs." Follicles don't develop infections from Staphylococcus aureus or similar bacteria without a properly moist environment and a lot of irritation.


Boils Require Treatment With Compresses And Pain Medication

We've all been tempted to squeeze our pimples, even though we know we should leave them alone in case we cause damage or scarring. The consequences of draining a boil are worse, because it's not an isolated build-up of skin cells; it's an infection. "A boil or carbuncle should never be squeezed or pricked with a pin or sharp object to release the pus and fluid," explains the Cleveland Clinic. "This can spread the infection to other parts of the skin."

To treat them, gentle methods are advised. The American Association of Dermatologists recommends warm compresses. "Applying heat in the form of a warm compress is the best way to treat boils and styes yourself," they say. "Hold the compress to the affected area for 10 to 15 minutes. Do this three to four times daily until the boil or stye releases pus and heals." For extreme infections, the Johns Hopkins Medical Faculty notes, "surgical incision" to drain the pus and antibiotics to treat the infection might be necessary — but these are only to be done by professionals, not at home. No oat scrubs or mint treatments will help a boil.


Extensive Boils, Like Pimples, Can Be Hereditary

Rather like pimples, it turns out that extensive boils can have a hereditary component, but only if you have them often. The condition is called hidradenitis suppurativa or acne inversa, and the U.S. National Library of Medicine explains that we now believe it to be partially caused by genetics. "Recent studies have shown that the condition actually begins with a blockage of hair follicles in areas of the body that also contain a high concentration of apocrine glands (such as the armpits and groin)," they note. These blockages appear to be hereditary, but it's not entirely clear how right now.


Prevention Of Boils Involves Hygiene Precautions

You can't catch pimples from anybody else. Boils, however, carry a risk of infection, and preventing them involves taking measures against the spread of bacteria. The Cleveland Clinic advises that you should "avoid close contact with someone who has a staph infection, boil, or carbuncle," wash with antibacterial soaps and "don’t share or re-use washcloths, towels, and sheets."

If you have a pimple that's large, painful and doesn't seem to be going away, it's possible that you may actually have a boil in disguise — and that you definitely shouldn't poke it. Don't be afraid of going to your doctor to ask for help; boils are infections that can need antibiotics and specialist assistance.