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Symptoms, Their Causes & Cures: Boils

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Boils

WHEN TO SEE YOUR DOCTOR

* You have a boil with redness around it.

* You have red streaks spreading from the boil.

* You also have a fever.

* You also have diabetes.

* You are taking antibiotics or cortisone medication.

What Your Symptom Is Telling You

A boil is just what it looks like: a big pimple. Perhaps it's called a boil because of how it feels—hot and painful.

The angry, red swelling and pain are the result of an infection, usually an infection involving Staphylococcus cuteus (staph) bacteria. Staph germs love hospitals, so it's very easy to pick up boils during an extended hospital stay. Or you might have a carrier of the staph bacteria in your family or among your acquaintances. It's hard to tell who's the culprit. The people carrying the bacteria that cause boils may never develop boils of their own. The germs can hang out in the nasal passages without causing any symptoms—until they get passed on to another person.

You can also get a boil after taking antibiotics. Staph bacteria may become resistant to antibiotics, and with all their competition killed off they can spread and create problems, such as boils. Taking cortisone may decrease resistance to boils.

Doctors say you are more likely to develop a boil if you have a condition like diabetes or if your immune system is suppressed.

Symptom Relief

There's just one home treatment uniformly recommended for boils. Beyond that, for sure and safe results, see your doctor.

Soothe it with heat. Try treating the boil with a hot compress, says J. Michael Maloney, M.D., a dermatologist in private practice in Denver. "Put a washcloth under hot water and lay it over the boil for five minutes, or sit in a hot bath if the boil is on your bottom," he says. After several days of hot compress treatments, often a boil will spontaneously rupture and drain some puslike, yellow, foul-smelling material. Afterward, you should feel much better, Dr. Maloney says.

Get it lanced. If your boil won't respond to hot compresses, you should see your doctor, who may decide to lance it, says Alan R. Shalita, M.D., professor and chairman of dermatology at the State University of New York Health Science Center at Brooklyn. "Your doctor will numb the boil, nick the center and drain out the contents," he says.

Do not lance a boil yourself, he adds, because you can spread the infection.

Cure the infection. Your doctor will most likely do a bacterial culture and treat the boil with an appropriate antibiotic, says Dr. Shalita. Often, he says, boils are treated with dicloxacillin—a penicillin derivative designed specifically for staph infection. If your boils occur over and over in the armpits and genital area, this may be related to a type of acne, not an infection. In that case, your doctor may recommend long-term antibiotics, says Libby Edwards, M.D., chief of dermatology at the Carolinas Medical Center in Charlotte, North Carolina.

For these types of boils, you'll need to take antibiotics with anti-inflammatory properties, such as tetracycline, erythromycin or minocycline, she says. Penicillin won't help clear them up.

Keep it clean. Once your boil has drained, be sure to keep the area clean with an antibacterial soap, says Dr. Maloney. Good soaps to use are pHisoHex, Dial or Safeguard.

Consider cortisone. If your doctor says your boil is actually an early acne or epidermal cyst, and the center is not yet too full of liquid, "a tiny amount of injected cortisone may tremendously improve it within a day," says Dr. Edwards.

Clean up the carriers. If boils seem to be passing around the family, your doctor can help to break the cycle, says Ralph Coskey, M.D., clinical professor of dermatology at Wayne State University School of Medicine in Detroit. "Antibiotics in the nose may prevent repeated spreading back and forth among family members," he says. Your doctor can do a simple nasal culture test to determine who is carrying the infection.

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