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Boils

Introduction

When bacteria invade and inflame one or more of your hair follicles, they result in a painful, pus-filled bump under your skin known as boils. Boils (also known as Furuncles) commonly start as tender reddish or purplish spots. The pus-filled nodes soon expand and become more painful until they rupture and drain. The most frequently affected areas are the face, back of the neck, armpits, thighs, and buttocks. A single boil may typically be treated at home. But it is recommended not to poke or put pressure on it because this could spread the infection.

Causes

Staphylococcus Aureus, a bacteria typically found on the skin and inside the nose, is the most common cause of boils. As pus collects beneath the skin, a bump appears. Boils can form when the skin is broken by a minor injury or an insect bite, allowing bacteria to enter the body quickly. Other forms of bacteria or fungi found on the skin's surface can also cause them. When the hair follicle is damaged, the infection can spread further into the strand and the surrounding tissues.

Boils can appear anywhere on the body in the hair follicles. The face, neck, armpit, buttocks, and thighs are the most commonly affected. You could have one or more boils. The condition could be a one-time or long-term (chronic) problem.

Signs and Symptoms

A boil usually has the following signs and symptoms:

  • A painful, red bump that starts small but can grow to be more than 2 inches in diameter (5 centimeters)
  • Swollen, reddish, or purple skin around the bump
  • Spreading to other parts of the body or merging with other boils
  • Fast growth
  • Weeping, oozing, or crusting
  • Over a few days, the bump will grow in size as it fills with pus.
  • Formation of a yellow-white tip that eventually rupture, allowing the pus to drain out

Other symptoms could include:

  • Fever
  • Fatigue
  • Itching before the boil appears.
  • Redness of the skin around the boil

Diagnosis

The appearance of a boil is generally enough for a health care provider to diagnose it. A sample of cells from the spot may be submitted to the lab for staphylococcus or other bacteria to be cultured. Pus culture is the gold standard laboratory test for diagnosing boils. Other non-specific findings may be observed. The following are examples of laboratory findings that support the diagnosis of abscesses: 

  • Sensitivity and Culture Blood
  • Complete Blood Count (CBC)
  • White Blood Cell Count
  • C-reactive Protein
  • Erythrocyte Sedimentation Rate

Infections can be both sub-acute and chronic. The most frequent bacteria to grow is Staphylococcus aureus. Other bacteria, on the other hand, maybe present. The results of the sensitivity test help in determining the antibiotic regimen to be employed.

Medications

Large or recurrent boils that originate in sensitive regions (such as the crotch, breasts, armpits, around or in the nostrils, or the ear) may require antibiotic treatment. Antibiotics should not be used for more than one month at a time, with at least two months (preferably longer) between doses, or their effectiveness will be lost.

Treatment

After a period of itching and mild pain, boils usually heal independently. As pus builds up, they often become more painful. To heal, boils usually need to be opened and drained. This usually happens within two weeks. You should:

  • Put warm, moist compresses on boil several times a day to speed drainage and healing.
  • Never press a boil or attempt to cut it open at home, as it can spread the infection.
  • After the boil has opened, keep applying warm, wet compresses to the affected area.

To drain deep or large boils, a surgical procedure may be required sometimes. If the boils have been present for more than two years, plastic surgery may be necessary to remove them. If you are experiencing any of the following symptoms, seek help from your healthcare provider:

  • Fever or other symptoms with the boil.
  • The boil is painful or makes you uncomfortable.
  • A boil is located on your spine or in the center of your face.
  • Boil lasting more than seven days.
  • Boil reappears.

A boil must be kept clean at all times. To do so, follow these steps:

  • Boils should be cleaned and dressed regularly.
  • Before and after touching a boil, wash your hands thoroughly.
  • Washcloths and towels should not be reused or shared. Clothing, washcloths, towels, sheets, and other objects that have come into contact with affected regions should be washed in hot water.
  • Use a sealed bag to dispose of used dressings so that the liquid from the boil does not contact anything else.
  • If the boil is nasty or reappears, your doctor may prescribe antibiotics to be taken by mouth or as an injection.
  • Using antibacterial soaps and lotions won't help much once the boil has formed, so try to avoid synthetic chemicals and cosmetic products.

Prognosis

Some people get boils regularly and are unable to prevent them. Boils in sensitive areas like the ear canal or nose can be painful and unpleasant. Bacteria from a boil or carbuncle can sometimes enter the bloodstream and spread to other regions of the body. The infection, also known as blood poisoning (sepsis), can spread throughout your body, causing infections in places including your heart (endocarditis) and bones (osteomyelitis).

Prevention

It is not always possible to avoid boils, especially if your immune system is weak. However, taking the following precautions will help you avoid staph infections:

  • Hands should be washed with mild soap regularly; frequently use an alcohol-based hand rub. Always remember that hand hygiene is your primary line of defense against pathogens.
  • Cover any open wounds. Keep them clean and covered with sterile, dry bandages until cuts and abrasions heal.
  • Personal items should not be shared. Towels, sheets, razors, clothing, athletic equipment, and other personal belongings should not be shared. Staph infections can spread from person to person as well as through things. If you have a cut or sore, wash your towels and linens in hot water with bleach added, and then dry them in a hot dryer.

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