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What are boils?
Boils result from a localized skin infection. They start as a hard, tender lump that reddens. Eventually, the lump becomes filled with whitish or yellow pus, which comprises millions of dead white blood cells the body has deployed to fight the infection, bacteria, and proteins. The boil or abscess may burst and drain by itself or may need surgical drainage (referred to as an incision and drainage or I&D).
What are home remedies for boils?
Home treatment is an option for most simple boils. Ideally, treatment should begin as soon as a boil is noticed since early treatment may prevent later complications.
The primary home remedy for most boils is heat application, usually with hot or warm water soaks or warm compresses. It may be necessary to apply them 20 minutes at a time for three to four times daily. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the site of infection.
If a boil occurs as a result of shaving, it is recommended to avoid shaving in that area until the boil has healed to avoid spread of bacteria.
As long as the boil is small and firm, opening the area and draining the boil is not helpful, even if the area is painful. However, once the boil becomes soft or "forms a head" (that is, a small pustule or area of pus is noted in the boil), it can be ready to drain (lance). Once drained, pain relief can be dramatic. Most small boils, such as those that form around hairs, drain on their own with hot soaks.
What is the treatment for boils?
On occasion, and especially with larger boils, medical treatment is required. In this situation, the boil will need to be drained or "lanced" by a health care professional. Frequently, these larger boils contain several pockets of pus that must be opened and drained.
Over-the-counter antibiotics are often used to eliminate any accompanying bacterial infection, especially if there is an infection of the surrounding skin. However, antibiotics are not needed in every situation. In fact, antibiotics have difficulty penetrating the outer wall of an abscess well and often will not cure an abscess without additional surgical drainage.
When an antibiotic is used, the choice depends upon the type of infection that is present as well as the results of tests to identify the precise bacteria that infect the area. Examples of drugs used in the treatment of boils include preparations of clindamycin (Cleocin and others), mupirocin (Bactroban), and cephalexin (Keflex).
What type of doctors treat boils?
Many boils resolve without specific treatment, but a dermatologist is a doctor commonly consulted for management of a boil. Other health care specialists who may treat boils include a primary care doctor, which may be a family practitioner, pediatrician, or internal-medicine doctors. With severe boils or spreading infection, an infectious-disease specialist or surgeon may be consulted. Emergency-medicine doctors may treat certain cases of severe infection caused by boils or abscesses.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
Satter, Elizabeth Kline. "Folliculitis." Medscape. May 22, 2018. <http://emedicine.medscape.com/article/1070456-overview>.
Singhal, Hemant. "Skin and Soft Tissue Infections - Incision, Drainage, and Debridement." Medscape. May 10, 2018. <http://emedicine.medscape.com/article/1830144-overview>.
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