Comprehensive guide on how to treat boils outlines causes, risk factors, types of treatment choice and what NOT to do.
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A boil is an inflammation of the skin caused by bacteria . It resembles a very large pimple, but lies in deeper layers of the skin and is much more painful.
With a boil, the hair follicle and the surrounding connective tissue are inflamed. The hair follicle contains a hair, a hair root, a sebum gland and a small muscle that can straighten the hair. It is also called a hair follicle; therefore, experts refer to the inflammation of a boil as deep folliculitis and perifolliculitis.
As a result of the infection, the skin tissue inside the boil dies and a cavity filled with pus, an abscess, is created. An abscess of the skin can develop from a boil, a badly inflamed insect bite or an injection with a contaminated needle. When several boils fuse together, a carbuncle is created.
Sometimes a boil will heal on its own without any problems. However, medical treatment is often useful. It can accelerate healing, relieve pain and protect against complications.
How to treat boils: symptoms
A boil is noticeable as a painful swelling the size of a cherry stone to walnut. It is warm to the touch and reddened, the pus can shimmer yellowish through the skin. If a carbuncle develops from multiple boils, the inflammation can also trigger a fever. Then you feel weak and battered.
Boils mainly develop on the face, neck and neck. But they can also form in the armpits or groin, on the back, in the pubic area, on the buttocks and on the thighs.
How to treat boils: causes and risk factors
A boil is caused by bacteria , most commonly the pathogen Staphylococcus aureus. Many people find this bacterium on the skin or in the nasal mucosa, for example, without causing any problems.
If the immune system is weakened, the risk of boils or other skin infections increases. This is why people with diabetes, chronic infections, or cancer, for example , have boils more often than healthy people. The same applies to certain allergies such as allergic asthma, skin eczema or conjunctivitis.
Frequency and course
Overall, skin infections are very common. Most skin inflammations have another cause. Only about 3 in 100 people who see their general practitioner about a skin infection have a boil.
A boil develops within hours to days. If the pus has emerged from the reddened and swollen lump on its own or after treatment after a few days, the boil will heal within a few weeks. A small scar remains.
Sometimes a boil heals without draining. The pus is then broken down by the body.
What to avoid and consequences
Squeezing or scratching a boil can cause the bacteria to spread through blood and lymph vessels in the body. For example, if a red stripe pulls away from the boil, the inflammation is migrating along the lymphatic system (lymphangitis). At the same time, lymph nodes in the affected area can become painfully inflamed (lymphadenitis).
Laypeople sometimes interpret the red stripe in lymphangitis as a sign of blood poisoning ( sepsis ). This serious but very rare complication only occurs when a large number of bacteria enter the blood at once and are quickly distributed throughout the body.
When boils on the face – especially in the area of the nose and upper lip – there is some risk that the bacteria into the brain are abducted and there to a meningitis or life-threatening blood clots lead to the large blood vessels (known as venous sinus thrombosis).
Boils can occur repeatedly or in several places at the same time, especially in people with a weakened immune system. Doctors then refer to it as furunculosis.
When multiple boils in adjacent hair follicles fuse into one larger pus focus, a carbuncle is created. A carbuncle is often found on the neck and extends deeper into the tissue than a boil.
How to treat boils: diagnosis
A doctor usually recognizes a boil by its typical appearance and the symptoms described. Further examinations such as blood tests or a pus smear are necessary if boils frequently form, several occur at the same time, or if complications are suspected.
The pus is examined in the laboratory in order to precisely determine the type of bacteria and to be able to use effective antibiotics in a targeted manner. Blood tests help to find out whether the inflammation has spread and whether there are any pre-existing conditions that favor bacterial infections.
How to treat boils: treatment options
Boils are usually treated by a doctor: the doctor opens the pus abscess with a small incision, disinfects the wound and inserts strips of cloth that absorb and drain the pus. The wound heals openly and does not need to be sutured. You should never express a boil yourself – especially not on your face.
As long as a boil is still growing, the abscess is not fully developed. A doctor can feel this by touch. In this phase, attempts can be made to initiate or accelerate the ripening process with moist, warm compresses or so-called pull ointment.
Antibiotics are necessary when complications are likely or have already occurred – for example, if a carbuncle has developed from several boils. Sometimes the antibiotics are then given as an injection in the hospital. It is especially important for a carbuncle to be incised so that the pus can drain away. The larger wound is also repeatedly rinsed with antiseptic solutions.
Boils are usually treated by a doctor. For “mature” boils, a small incision allows the pus to drain and the wound to heal. Antibiotics are useful, for example, if you have a weak immune system or a fever. If you push around with a boil yourself, you risk that the bacteria will spread in the body and lead to complications.
Boils can empty on their own and heal easily. Medical treatment is often necessary, especially with large boils.
If boils occur frequently, this can indicate a disease that weakens the immune system and thus promotes infections. In addition to treating the boils, it is then important to identify and treat the underlying disease.
Bandages and drawing ointment
When a boil develops, the pus cavity inside the swelling ( abscess ) is not yet fully formed. Then usually moist, warm, antiseptic compresses or cotton wool bandages with so-called pulling ointment (active ingredient: ammonium bituminosulfonate, also known as ichthyol) are applied. They are intended to accelerate the “maturation” of the abscess inside the boil so that it later empties and heals on its own – or can be cut open in the doctor’s office and the pus drained.
Incision and drainage
The cutting open (incision) and drainage (drainage) of pus and wound fluid belong to the standard treatment of especially larger boils. The procedure is usually carried out on an outpatient basis. Before the doctor cuts into the skin over the boil, the area around the inflammation is locally numbed or frozen.
In some cases, one or more strips of fabric or silicone are then placed in the open wound. The strips drain the remaining pus and wound fluid to the outside. This will keep the wound clean and allow the tissue to gradually calm down. The strips are usually changed daily, for example by the family doctor.
Often the wound is also rinsed with a sterile saline solution. Sometimes antiseptic solutions, ointments or insoles are also used. As a rule, the wound is not sutured; it gradually closes by itself. Experts call this open or secondary wound healing. As long as the wound is still open, a compress or plaster protects against dirt and pathogens.
Treatment for a more severe course
Usually no further treatment is necessary for a boil. Sometimes, however, additional measures may be necessary – for example, if the boil is on the face or if several furuncle have melted into one carbuncle.
Immobilization
If you have a boil on your face, it’s important to keep the inflamed area still. Because movement and pressure can increase the risk that the bacteria will spread to the brain via the bloodstream. Therefore, one should use the facial muscles as little as possible. That means: do not speak and if possible only eat liquid or pulpy food. Bed rest is also recommended.
Antibiotics
If complications have occurred or are likely, antibiotics are taken as tablets or juice, or given as an infusion or injection. They are distributed throughout the body. This form of treatment is called systemic antibiotic therapy. As a rule, it is only necessary
- a boil on the face, especially on the nose and upper lip,
- if there are multiple boils (furunculosis) or if there is one carbuncle,
- if the inflammation spreads through the lymphatic system,
- if you have symptoms such as fever, increased heart rate, low blood pressure and breathing faster, or if blood tests suggest that the inflammation is spreading in the body.
In most cases, an antibiotic is prescribed that works well for boils, since the same bacterium is almost always responsible.
Pus samples are rarely examined in the laboratory to find out which bacterium is exactly responsible for the inflammation , for example if the boil does not heal under the usual therapy. If blood poisoning (sepsis) is suspected or if there is a risk that the bacteria are resistant to many antibiotics, attempts are made to identify the pathogen more precisely and to find out which antibiotic is best for treating it.
