There
are several different types of boils. Another name for a boil is furuncle.
Among these are
·
carbuncle
·
hidradenitis suppurativa (seen in
the armpit or groin)
·
pilonidal cyst
·
cystic acne
·
sty (stye)
Boil Type: Carbuncle
A
carbuncle is an abscess in the skin caused by the bacterium Staphylococcus
aureus. It usually involves a group of hair follicles and is therefore larger
than a typical furuncle, or boil. A carbuncle can have one or more openings
onto the skin and may be associated with fever or chills.
Boil Type: Cystic Acne
Cystic
acne is a type of abscess that is formed when oil ducts become clogged and
inflamed. Cystic acne affects deeper skin tissue than the more superficial
inflammation from common acne. Cystic acne is most common on the face and
typically occurs in the teenage years.
Boil Type: Hidradenitis Suppurativa
Hidradenitis
suppurativa is a condition in which there are multiple abscesses that form
under the armpits and often in the groin area. These areas are a result of
local inflammation of the hair follicles. This form of skin inflammation is
difficult to treat with antibiotics alone and typically requires a surgical
procedure to remove the involved hair follicles in order to stop the skin
inflammation.
Boil Type: Pilonidal Cyst
A
pilonidal cyst is a unique kind of abscess that occurs in or above the crease
of the buttocks. Pilonidal cysts often begin as tiny areas of inflammation in
the base of the area of skin from which hair grows (the hair follicle). With
irritation from direct pressure, over time the inflamed area enlarges to become
a firm, painful, tender nodule making it difficult to sit without discomfort.
These frequently form after long trips that involve prolonged sitting.
Boil Type: Sty
A
sty (also spelled stye) is a tender, painful red bump located at the base of an
eyelash or under or inside the eyelid. A sty results from a localized
inflammation of the glands or a hair follicle of the eyelid. A sty is sometimes
confused with a chalazion, a lump on the inner portion of the upper or lower
eyelid, but a chalazion is usually painless and caused by obstruction and
inflammation of an oil gland, not an infection.
Anyone
can develop a boil. However, people with certain illnesses or medications that
impair the body's immune system are more likely to develop boils. Among the
illnesses that can be associated with impaired immune systems are diabetes and kidney failure. Diseases, such
as hypogammaglobulinemia, that are associated with deficiencies in the normal
immune system, can increase the tendency to develop boils. Many medications can
suppress the normal immune system and increase the risk of developing boils.
These medications include cortisone medications (prednisone and prednisolone)
and medications used for cancer chemotherapy.
What Is the Treatment for a Boil?
Most
simple boils can be treated at home. Ideally, the treatment should begin as
soon as a boil is noticed since early treatment may prevent later
complications. The primary treatment for most boils is heat application,
usually with hot soaks or hot packs. 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. Do not pop the boil
with a needle. This usually results in making the infection worse.
Should Boils Be Drained?
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 is
noted in the boil), it can be ready to drain. Once drained, pain relief can be
dramatic. Most small boils, such as those that form around hairs, drain on
their own with soaking and/or heat application. On occasion, and especially
with larger boils, the larger boil will need to be drained or
"lanced" by a health-care practitioner. Frequently, these larger
boils contain several pockets of pus that must be opened and drained.
Should Boils Be Treated With Antibiotics?
Antibiotics
are often used to eliminate the accompanying bacterial infection. Especially if
there is an infection of the surrounding skin, the doctor often prescribes
antibiotics. However, antibiotics are not needed in every situation. In fact,
antibiotics have difficulty penetrating the outer wall of an abscess and often
will not cure an abscess without additional surgical drainage. In most cases,
incising and draining the boil is sufficient to cure the infection.
When Should I Seek Medical Attention?
You
should call your doctor and seek medical attention if:
·
the boil is located on your face,
near your spine, or near your anus;
·
a boil is getting larger;
·
the pain is severe;
·
you have a fever;
·
the skin around the boil turns red
or red streaks appear;
·
you have a heart murmur, diabetes,
any problem with your immune system, or use immune-suppressing drugs (for
example, corticosteroids or chemotherapy) and you develop a boil;
·
the boil has not improved after five
to seven days of home treatment;
·
you get many boils over several
months.
What Can Be Done to Prevent Boils (Abscesses)?
Good
hygiene and the regular use of antibacterial soaps can help to prevent bacteria
from building up on the skin. This can reduce the chance for hair follicles to
become infected and prevent the formation of boils. Your health-care
practitioner may recommend special cleansers such as Hibiclens to further
reduce the bacteria on the skin.
What Can Be Done to Prevent More Serious Boils and Abscesses?
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Pilonidal
cysts can be prevented by avoiding continuous direct pressure or irritation of
the buttock area when a local hair follicle becomes inflamed. Regular soap and
hot water cleaning and drying can be helpful. For acne and hidradenitis
suppurativa, antibiotics used as anti-inflammatory agents may be required on a
long-term basis to prevent recurrent abscess formation. Finally, surgery may
occasionally be needed, especially for hidradenitis suppurativa or pilonidal
cysts that recur. For pilonidal cysts, surgically removing the outer shell of
the cyst is important to clear the boil. For hidradenitis suppurativa,
extensive involvement can require plastic surgery.
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