Boil vs. Pimple: What's the Difference?
- Boils are types of skin infections, while pimples are areas of inflammation where the organisms in the site are not really infectious.
- Causes for boils include plugged or infected hair follicles, exposure to bacteria, open wounds, skin infections, or skin gland problems.
- Causes of pimples (acne) include blocked pores, overproduction of oils from glands in the skin, and hormone changes.
- Both boils and pimples appear as red bumps on the skin, but boils usually get larger and have drainage of pus, fever, and pain. Pimples are typically smaller and localized.
- Treatment for boils includes warm compresses, surgical drainage by a physician and antibiotics.
- Treatment for pimples involves the application of over-the-counter benzoyl peroxide and/or retinoids. If acne is severe, prescription medication or other medical treatments may be required.
- The prognosis for both boils and pimples is good. Most will heal on their own or with at-home or over-the-counter treatments. Boils can become problematic if not treated promptly and properly. Acne may recur and cause permanent scarring and skin discoloration.
- To prevent boils, practice good hygiene, keep skin clean, avoid contact with others who have skin infections, don't share personal hygiene items, and seek medical care if boils do not improve or recur with treatment at home. Since acne is a genetic and hormonal problem, there is no true prevention strategy. Prompt treatment may prevent more severe disease in the future.
What Is a Boil?
A boil is a pocket of infection in and under the skin. The medical term for a boil is an abscess. A boil usually starts as a small infection or area of redness in a hair follicle (folliculitis/ingrown hair), skin gland, or small open wound. Over the course of days, a pocket of infection accumulates pus, begins to swell, and scar tissue forms a painful cavity. This cavity expands, and the overlying skin turns red as the boil becomes bigger. Boils are commonly found in skin areas where there are high amounts of bacteria such as skin folds, groin, buttocks, armpits, or inner thighs.
Acne is the result of an allergy.
What Is a Pimple?
A pimple is a small, localized inflammation, usually in a single oil gland in the skin. A pimple goes by many other names such as whiteheads, blackheads, zits, and acne. Pimples can appear anywhere on the body there are specialized oil glands, specifically on the face, neck, back, chest, and shoulders.
What Are Causes and Risk Factors for Boils and Pimples?
Causes for boils include plugged or infected hair follicles (sometimes from shaving), exposure to bacteria such as Staphylococcus aureus from an open wound (for example, cuts or insect bites), skin infections secondary to diabetes, or skin gland problems such as hidradenitis suppurativa.
Risk factors for boils include the following:
- Exposure to Staphylococcus aureus (especially the methicillin-resistant version, or MRSA bacterium)
- Sharing personal hygiene items such as razors
- Weakened immune system
- Having skin gland problems such as hidradenitis suppurativa
- Previous boils
Causes of pimples include blocked pores, overproduction of oils from glands in the skin (especially during puberty), and hormone changes (during puberty).
Risk factors for pimples include the following:
- Clogged pores (with dead skin cells or other debris)
- Certain medications such as steroids
- Genetics (acne runs in families)
- Cosmetics that clog pores
What Are Signs and Symptoms of Boils and Pimples?
Signs and symptoms of boils include the following:
- Red bump on the skin that enlarges
- Fever and chills
- Drainage of pus from the boil
- Pain and tenderness
- Skin redness
Signs and symptoms of pimples include the following:
- Small black spots on the skin (blackheads)
- Small white papules (whiteheads)
- Red papules pustules
- Large, hard, red sore nodules just under the skin surface (cystic acne)
- Dark spots or scars on the skin after the pimple has healed
How Do Health Care Professionals Diagnose Boils and Pimples?
Boils and pimples are generally diagnosed with a physical examination. Your family physician can usually treat boils and pimples. Patients with severe boils may be referred to a dermatologist or a surgeon for incision and drainage.
What Is the Treatment for Boils and Pimples?
At-home treatment for small boils involves applying a warm, damp compress in order to draw it to a head so the pus-filled area will drain on its own.
If the boil is larger or does not drain on its own, a doctor can make a small incision into the boil to drain the pus (incision and drainage, or I and D). Do not attempt to cut or pop a boil on your own as you can make the infection worse and cause permanent skin damage.
Pimples are usually treated with over-the-counter remedies that contain salicylic acid or benzoyl peroxide. These may be face washes or creams.
If acne is more severe, a dermatologist can prescribe medications such as antibiotics, isotretinoin (Sotret, Myorisan, Amnesteem, Claravis, and Absorica), prescription-strength soaps or creams, or birth control pills (for females).
Other medical treatments for acne include lasers or light therapy, chemical peels, or corticosteroid injections, but these are not part of most acne regimens.
What Is the Prognosis for Boils and Pimples?
Most boils will drain on their own and will heal themselves from the inside within a few days. If the boil does not drain on its own and enlarges, it may require medical treatment. Left untreated, a large boil can cause scarring, severe infection, or rarely even death.
Pimples from acne tend to flare up during adolescence, fluctuations of hormones (such as pregnancy), and times of increased stress. Usually, pimples will heal on their own or with over-the-counter treatment. Severe acne may need prescription medication or other medical intervention to treat. Severe acne may also leave permanent scarring on the skin after it heals.
Is It Possible to Prevent Boils and Pimples?
To prevent boils...
- Practice good hygiene. Wash regularly with soap and water and keep your skin clean.
- If exposed to someone with a boil or skin infection, wash the area thoroughly with soap and water.
- Don't share razors, towels, bathing suits, underwear, or other personal items.
- If you have a boil, do not try to pop or open it on your own as you may spread the bacteria.
- If you have more than one boil or a recurrence of boils, see your doctor for treatment.
- Open wounds on skin should be cleansed thoroughly and covered to lessen the chance of infection.
To prevent pimples...
- Keep your skin clean. Wash your face with a cleanser specifically designed for acne-prone skin.
- Use cosmetics that are oil-free or noncomedogenic, which will not clog pores.
- If you have oily hair, wash it frequently with shampoo made for oily hair.
- See your doctor or dermatologist if your pimples or acne are severe or recurrent.
Reviewed on 2/26/2019
Medically reviewed by Michael E. Manning, MD; Board Certified Internal Medicine/Allergy & Immunology
American Academy of Dermatology. "Acne." <https://www.aad.org/public/diseases/acne-and-rosacea/acne>.