Boils

A boil is a painful swelling of the skin caused by a bacterial infection in a hair follicle. Technically called furuncles, boils usually develop in hairy parts of the body that are exposed to friction and pressure. They appear most often on the face, scalp, back of the neck, armpits, and buttocks, and are more common in men than in women. Possible causes of boils are poor personal hygiene or an immune system compromised by diabetes or other chronic illness. Nutritional deficiencies and exposure to certain industrial chemicals may also be implicated. A boil can be as small as a green pea or larger than a marble. In larger ones, the infection involves both the hair follicle and surrounding tissue. Boils that form in a cluster are called carbuncles. When they appear simultaneously in different parts of the body, the condition is called furunculosis. This occurs when the bacteria are spread from the original site to other parts of the body by contaminated objects such as towels, unwashed hands, or shaving implements.

Diagnostic Studies And Procedures

Boils are easily diagnosed by their char acteristic appearance. As a boil begins to form, it is accompanied by mild pain and itching. When pus collects and the boil increases in size, it becomes more painful and tender to the touch. Typically, within two weeks or less, it will come to a head and have a white or yellow center; if there are no complications, it will burst spontaneously, then drain, and heal. The bacterial agent responsible for most boils is Staphylococcus aureus. Staph infections are not dangerous when they are strictly local and promptly eliminated, but when the organisim invades the bloodstream, the resulting illness can be life threatening .

Medical Treatments

A boil or carbuncle that resists self treatment and becomes more painful and red should be seen by a doctor, especially if it is accompanied by a feeling of malaise and a fever. In such cases, oral antibiotics are given (usually one of the newer penicillin variants), and if necessary, the boil is lanced surgically and drained. A topical antibiotic is applied and the area is covered with sterile gauze. The doctor usually provides instructions to follow until the area is completely healed. If the boil is large and deep, the doctor may, after lancing and draining it, leave it uncovered and insert an anti biotic impregnated wick of gauze into the incision to kill any remaining bacteria. The wick is pulled out a bit each day, and finally removed completely when the infection is cleared up. This procedure may leave a hairline scar. Many people develop boils when their resistance to infection is low, or when they are in crowded unsanitary surroundings. Recurrent boils or car buncles, however, should be brought to a doctor's attention to find the underlying cause. This is especially important when boils occur in or around the nose, providing a route for the infection to travel to the brain.

Alternative Therapies

Herbal Medicine

Herbalists advocate the application of poull1ces soaked in a strong infusion of comfrey and linseed oil. Such applications are said to soften the boil and make it easier to drain. Also recommended for poultices are dried burdock and echinacea. Some herbal books suggest applying a paste made from the powdered root of gold enseal. Caution is needed, however, because goldenseal may cause skin ulcers .

Nutrition Therapy

A nutritionist may review the diet and suggest the elimination of sugar, food allergens, and other components that might suppress the immune system. There is some evidence that dietary zinc supplements are effective in preventing recurrent boils. Other supplements that are thought to be helpful are vitamins A, C, and E and beta carotene.

Self Treatment

Prompt self-treatment clears up most boils. Hot compresses applied several times a day bring the boil to a head more quickly so that it can be drained. You can use tap water that has been boiled and cooled to a tolerable temperature, or make Epsom salt packs by dissolving two tablespoons of the salts in a cup of hot water. Never squeeze a boil to break it open, as this can force the bacteria inward into the bloodstream. Use the compresses to encourage a spontaneous opening, clean the area carefully with hydrogen peroxide, alcohol, or Beta dine, and cover it with sterile gauze. Do not make an airtight dressing, however; exposure to oxygen promotes healing. Antibacterial soaps can help to prevent boils but are not an effective treatment for existing ones.

Other Causes of Skin Infections

Impetigo, a bacterial skin infection, can produce abscesses that resemble boils. See a doctor promptly if a sore persists or recurs or if several boil like lesions appear in a cluster.

Resistant Germs

In recent years, an alarming number of bacteria have developed resistance to our most widely prescribed antibiotics. Researchers are especially worried about Staphylococcus aureus, the micro organism responsible for most boils. S. aureus, which normally resides in the throat and nose, can cause toxic shock syndrome and other deadly types of blood poisoning if it invades the blood stream. This bacterium has developed resistance to all antibiotics except vancomycin, and researchers warn that it is only a matter of time until S. aureus can also elude this drug, raising the specter of a rise in fatal staph infections.