boil

and Carola Felchner, science journalist

Mareike Müller is a freelance writer in the medical department and assistant doctor for neurosurgery in Düsseldorf. She studied human medicine in Magdeburg and gained a lot of practical medical experience during her stays abroad on four different continents.

More about the experts

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

A boil occurs when a hair follicle becomes infected. It usually begins with a small, red "pimple" and then develops into an often painful lump with a plug of pus. Boils often heal on their own. But sometimes a doctor has to cut them open or prescribe antibiotics. Read here why you should never express a boil yourself, what role the immune system plays and what promotes the appearance of pus pustules.

Brief overview

• What is a boil? A deep, purulent inflammation of a hair follicle (follicle). It can appear on any hairy part of the body. Often one can find boils on the buttocks, face or neck, in the armpits, in the genital area or on the inner thighs.
• Symptoms: typical symptoms of inflammation (pain, reddening, etc.), visible elevation of the skin with a core of pus
• Causes: bacteria, mostly staphylococci. Risk factors are, for example, a weakened immune system, poor hygiene and clothing that is too tight.
• Occurrence: Boils are common worldwide. The hot and humid climate in the tropics and subtropics in particular can promote skin infections such as boils. Overall, men are more likely to suffer from boils than women.
• Treatment: It is often enough to wait and disinfect. In severe cases, treatment by the doctor (e.g. cutting open, pull ointment, antibiotics)
• Prognosis: A boil usually heals without any problems. In rare cases there are complications such as inflammation of the lymph nodes, blood poisoning, meningitis.

Boils: treatment

The best thing you can do yourself is to stay away from the boil. No matter how tempting it is - if you press the pus knot or even cut it, the bacteria can spread with the pus that escapes.

If you want to remove or pierce boils yourself, you risk serious complications such as blood poisoning (sepsis)!

On the other hand, it makes sense to keep the affected area of ​​the body still. This prevents the germs from being carried over. If you have a boil on your face, you often automatically move the affected area as little as possible. If, for example, a whisker follicle is painfully inflamed, speaking and chewing can be quite uncomfortable.

You can support the healing process with a red light application: The heat accelerates the ripening of the boils.

Home remedies can also be useful, for example a marigold tincture: applied topically, it can help against inflammation and suppuration.

At the onset of the disease, it is also advisable to put warm, damp compresses with antiseptic agents such as povidone-iodine on the boil.

Always pay attention to adequate hygiene. Disinfect the boil and wash your hands thoroughly after touching the pus lump. This will prevent the bacteria from spreading to other parts of the body, where they could cause further infection.

Boil treatment at the doctor

If the boil is very painful, treatment by the doctor may be useful. The same applies if someone has multiple boils or the pus sores keep coming back. Then there is often an underlying disease behind it such as diabetes (diabetes mellitus), chronic infections, blood cancer (leukemia) or possibly also HIV / AIDS. The consistent therapy of the underlying disease also supports the treatment of boils.

If there is no opening in a boil, the doctor can apply a pulling ointment. Such ointments with the active ingredient ammonium bituminosulfonate have anti-inflammatory effects and reduce the production of sebum in the sebum glands. They are generally used for inflammatory skin conditions such as boils.

In severe cases, boils are treated with antibiotics. The main aim of this is to prevent the infection from spreading via the bloodstream (blood poisoning or sepsis) and other complications such as meningitis.

Antibiotic treatment is particularly important if you have a boil on your face. Patients with extensive facial furuncles are often treated as inpatients in the hospital. There the antibiotics are administered directly into a vein. In addition, patients are not allowed to speak or chew (liquid food only) and should keep bed rest.

• "Don't mess around with boils"

  Three questions for

  

  Dr. med. Uwe Kirschner,
  Specialist in skin and venereal diseases
• 1

  How do I tell the difference between a pus pimple and a boil?

  

  Dr. med. Uwe Kirschner

  It's not that easy at all. In the beginning, every boil is a pus pimple. If the inflammation then goes deeper and is tied to a hair, then one speaks of a boil. Pain, on the other hand, is not a criterion. A pus pimple on the tip of the nose can also hurt, on the other hand, boils are sometimes in places that are not painful - such as the inside of the thigh.

• 2

  Why do men and smokers get boils more often?

  

  Dr. med. Uwe Kirschner

  Quite simply, men have more hair, so their chances of developing a boil are higher. Smokers, on the other hand, have poorer blood circulation in the skin, which also means a poorer immune defense. Incidentally, diabetics and people with a weakened immune system also tend to have boils - if you get boils frequently, you should definitely see your doctor for clarification.

• 3

  Can I also prevent boils?

  

  Dr. med. Uwe Kirschner

  Yes, proper personal hygiene can help. Use a sharp blade when shaving and disinfect the skin afterwards. And very important: Do not press around on purulent areas of the skin. If you do this with dirty fingers, an infection can develop quickly, which in the worst case can even lead to blood poisoning. It is better to use a pulling ointment in the early stages and, if in doubt, see a doctor.

• 

  Dr. med. Uwe Kirschner,
  Specialist in skin and venereal diseases

  Resident dermatologist in Mainz with a special consultation for recurring abscesses and hidradenitis suppurativa / acne inversa.

Boils: symptoms

A boil can grow anywhere the skin is hairy. However, it often forms on the face (like boils on the ear), neck and armpits. Boils in the pubic area and on the thighs and boils on the buttocks are also very common.

The small pus nodules express themselves with the typical signs of inflammation at the relevant point:

• pain
• Redness
• overheat
• swelling

The first thing patients notice is an inflammation of the skin. It begins as a painful, tight knot. After a while, pus drains from the boil. After that, the symptoms usually subside.

Sometimes boil patients feel weak and exhausted overall. Others, on the other hand, have no such general symptoms.

When several boils form next to each other and flow together, one speaks of carbuncle. If boils appear repeatedly on different parts of the body, it is a case of furunculosis.

Boils: causes and risk factors

Boils are bacterial infections of hair follicles and surrounding tissues. The hair follicle (hair follicle) is the term used to describe the tissue that surrounds the hair follicle and, to a certain extent, anchors the hair in the skin.

Deep hair follicle inflammation is triggered by bacteria, usually Staphylococcus aureus. These generally live on the skin and mucous membranes, often without being noticeable in any way. However, if they get into deeper tissue layers or if the immune system is weakened, they can trigger various infectious diseases, including boils.

Specifically, folliculitis occurs first. This is a superficial hair follicle inflammation. As the infection progresses, it can spread to the layers of skin around the hair follicle. The tissue dies, the result is a purulent meltdown (necrolysis) - a boil has developed. Initially, this deep-seated inflammation often manifests itself in a pimple-like red bump on the skin. A plug of yellow pus then develops later.

This creates a boil

A purulent inflammation of the hair follicle (pimple) can lead to a boil if the pus cannot drain.

Self or smear infection

The bacteria that cause a boil usually live naturally on the patient's skin. If these "own" bacteria infect a hair follicle, it is a matter of self-infection.

But it can also happen that the furuncle triggers are transmitted via a smear infection: The bacteria get on the skin of a healthy person via direct skin contact with patients or via contaminated objects. The tiniest injuries to the sweat glands or along the hair follicle can penetrate the body and trigger an infection.

Boils: Risk Factors

Certain factors promote the development of boils. These include:

• Closure of the hair follicle by accumulation of secretion in the sebum glands
• smallest injuries (microtraumas)
• Tendency to allergic diseases (atopy)
• tight, abrasive clothing
• insufficient disinfection after shaving or depilation
• poor personal hygiene
• weakened immune system, either as a result of an underlying disease (such as poorly controlled diabetes mellitus, chronic infections, leukemia, HIV / AIDS) or from taking drugs that suppress the immune system (immunosuppressants such as cortisone)

Boils: examinations and diagnosis

Most of the time it just takes a little patience with a boil. As soon as the pus has leaked, the inflammation usually subsides on its own. But if the boil is very painful or sits on the face, it is better to see your doctor. Depending on the situation, facial furrows increase the risk that the bacteria will get into the brain and cause complications (such as an abscess) there.

A visit to the doctor is also advisable if several boils appear at the same time or the pus nodules keep recurring.

conversation

The doctor will first ask you in detail about your medical history (anamnesis). He can ask you the following questions, among others:

• How long has your skin been inflamed?
• How bad is the pain?
• Are there any other areas of skin affected?
• Have you ever had this inflammation?
• Do you have fever?
• Do you suffer from any illnesses (diabetes, neurodermatitis, chronic infections, etc.)?

Physical examination

This is followed by a physical exam. The doctor particularly examines the affected skin area. He is specifically looking for pus and crust formation there. Then he looks at the rest of the skin to discover any other possible inflammation. He will also scan your lymph nodes to check for any swelling.

The information from the anamnesis interview and the physical examination are usually sufficient to be able to make the diagnosis of boils.

Further investigations

Further examinations can be useful, particularly in severe cases and in the case of frequent or recurring boils. The patient may have a previously undiscovered underlying disease such as diabetes, chronic infections, leukemia or HIV. For example, if you are suspected of having diabetes, you can determine your blood sugar level.

Sometimes it is also useful to have a swab of the inflammation. In the laboratory, the pathogens that are in the boil can be identified. The doctor can then select antibiotics that are specifically effective against this germ.

Boils: course and prognosis

As a rule, a boil heals without complications. But mostly a small, indented scar remains.

In rare cases, the inflammation can spread, especially if you have a severely weakened immune system. As a result, an inflammation of the lymph nodes (lymphadenitis) or inflammation of the lymphatics (lymphangitis) can develop.

A furuncle of the lips or nose in particular can trigger dangerous sepsis (blood poisoning). Furuncle on the face can also cause inflammation of the eye socket (orbitaphlegmon), inflammation of the meninges (meningitis) or a blood clot in the brain (sinus cavernosus thrombosis).

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