Can You Tell the Difference Between a Boil and a Cyst?



 Boils  Cysts
Grow quickly from a patch of red, itchy, or smooth skin, which swells and lightens in the center Smooth, round lumps that grow gradually; more flesh-colored, with a lighter center
One or more yellow or white papules (pustules), surrounded by red, oozing, or leaking fluid One or more central punctum (black dots) surrounded by white or yellow skin
About one-third inch in diameter; can get as large as two inches or more Grows to a size of about one-half to several inches
Typically affects the neck, face, armpits, and buttocks, or areas where skin rubs together Most often on the face, back, and chest, but can grow anywhere; also found in the lungs, ovaries, or other parts of the body
Growths filled with pus, a yellowish fluid Contains keratin, a soft, yellow substance made of dead skin cells; a cheese-like substance
Painful when touched, itchy  Painless to the touch; swelling and pain only if infected 
Fever and fatigue Additional symptoms only if inflamed

There are significant differences between cysts and boils, even though they look similar. They also have different causes and risk factors. Treatment and prevention options can also vary.

Different Causes

Boils arise when bacteria, usually Staphylococcus aureus, infect the follicle, which surrounds the hair root. This spreads sebum, an oily substance that lubricates skin. As a result, an abscess—an enclosed pocket of pus and dead tissue—forms.

In contrast, cysts aren’t infections. The cells of the epidermis, or the outside layer of skin, constantly regenerate. Old, dead cells are shed and replenished with new, healthy ones from the layer beneath (the dermis). Cysts develop when problems shedding these cells occur, causing them to collect. Over time, this turns into a skin sac surrounding dead cells and fluid.

The exact causes of cysts are unknown. Some arise when hair follicles become clogged, trapping in the skin cells. Penetrating injury—such as a body piercing—can also cause cysts to form, as can a rare genetic disorder, Gardner syndrome.

Home Treatments May Work for Boils but Not Cysts

In many cases, boils resolve with at-home techniques that manage symptoms. Pain eases, and healing begins when the pus drains from the boil, but you shouldn’t try to pierce it yourself. Healthcare providers typically recommend you:

  • Apply a clean cloth soaked in warm water to the affected area for 10 minutes at a time, multiple times a day
  • Clean the area with antibacterial soap and dress and bandage the area if pus leaks
  • Wash hands if pus leaks, as boils can spread
  • Pat it with antibacterial soap rather than scrubbing
  • Take over-the-counter (OTC) pain medications, such as Advil (ibuprofen) or Tylenol (acetaminophen) for pain
  • Seek care from a dermatologist if the boil comes back or symptoms persist

For cysts, hot compresses only help if there’s an infection. While icing affected areas and taking over-the-counter (OTC) medications may reduce pain or discomfort, cysts don’t “drain” on their own. Surgeries are the only way to remove them.

Antibiotics May Help With Boils but Not Cysts

If a boil has burst, topical antibiotics may help prevent infection. For chronic or severe cases or if you have a fever or other symptoms, you may need oral or intravenous (IV) antibiotics.

For cysts, you only need antibiotics if there’s an infection. A direct injection of diluted corticosteroid (often prednisone) into the cyst is an option if there’s swelling.

Boils May Spread

The pus inside boils is rich with bacteria. Contact with this pus can spread boils to other parts of your body and other people. Keep affected areas clean with antibiotic soap and covered when healing. Be careful when disposing of bandages, and wash your hands thoroughly after contact.

Unlike cysts, multiple boils can join together to form carbuncles. These are larger growths with multiple pustules.

While there are significant differences between boils and cysts, the two conditions share certain attributes. Both can become chronic or recurrent, diagnosis is similar, and some treatment options overlap.

Both Can Become Chronic

Depending on the underlying cause, both cysts and boils can become chronic or recurrent. If the entirety of a cyst isn’t surgically removed, it can come back. Cysts are almost always benign—meaning they’re noncancerous—but healthcare providers may test samples for cancer.

Boils can also become recurrent, coming back even after drainage and treatment. This condition is known as furunculosis. In these cases, the boils may also spread among family members. 

Diagnosis Is Similar

Diagnosing boils and cysts generally relies on physical evaluation, with clinical testing sometimes needed to confirm the diagnosis. Information like how fast the bump is growing and whether it’s painful can help providers distinguish between them and other skin conditions. Imaging is needed only in rare cases.

Diagnosis also relies on taking a culture, which involves using a swab to take a fluid sample and testing it in a lab to look for bacteria that can indicate a different skin condition, such as a bacterial infection.

Surgery May Treat Both Conditions

Healthcare providers will lance a boil to drain the fluid if it does not heal or worsens. This simple surgical procedure can relieve symptoms. You may also take antibiotics to ensure success.

Lancing is also used to treat swollen, infected cysts. The only way to ensure cysts don’t grow back is surgery to remove them entirely. Performed while under local anesthesia (so you’re awake but feel no pain), removal is either done with a scalpel (surgical excision) or a CO2 laser device.

Due to the risk of infection and spread, you should never try to drain a boil or infected cyst. Leave this to the medical professionals. 

Because boils and cysts have distinct causes, you can have both. Someone who has developed cysts is still susceptible to S. aureus or other bacteria that cause boils. Infected cysts start to resemble boils, so healthcare providers often need to distinguish between the two when diagnosing.

How can you tell the difference? The easiest way is to assess levels of pain. Uninfected cysts are typically painless to the touch, whereas boils are more pliant and painful. 

Knowing when you need medical help is critical if you have a bump on your skin. You should visit your primary healthcare provider promptly if you:

  • Develop boils on your spine or face
  • Have a fever
  • Get red streaks coming from growths
  • Experience fatigue
  • Show signs of infection
  • Have symptoms for one week or more despite home treatments
  • Have excessive pain or discomfort
  • Get new growths or bumps on the body

If cases become severe or persistent, your primary care provider may refer you to a dermatologist or general surgeon. If you’re looking for a specialist, databases by medical organizations, such as the American Academy of Dermatology, can be reliable resources.

Boils and cysts cause bumps on your skin, but there are some differences. Boils are painful, pus-filled, infected growths, whereas cysts aren’t caused by infection and don’t cause pain. That said, infected cysts can resemble boils.

If you have unexplained growths on your body that are not healing or cause excessive pain or discomfort, contact a healthcare provider. They can diagnose your condition and refer you to a dermatologist for treatment.



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