Boils: Causes, Symptoms & Treatment

A boil is an infection of a hair follicle. Boils occur frequently and are independent of age, physical condition or gender in their development. In many cases, they heal without further treatment, but their symptoms can be relieved. Only in more severe cases do boils require medical treatment.

What is a boil?

Boils occur when bacteria or fungi find their way into the hair follicle located in the skin. Mostly affected are the regions where there is increased sweating or friction from clothing. Staphylococci particularly often trigger the infection. It not only affects the hair follicle, but also spreads to the surrounding tissue in the course of the disease. The region around the infected hair follicle fills with fluid as the infection progresses, and the typical swelling of a boil appears. The skin over the boil is taut and feels hot because of the inflammation. Multiple boils may occur close together or merge into one another. This local clustering is called a carbuncle.

Causes

The cause of the formation of a boil is found in damage to the hair follicle. This may be due to injury or may occur in areas of the body that are particularly exposed, such as skin folds or the lower back. The damage allows bacteria from the skin surface to penetrate deeper and cause the boil by infecting the hair follicle. Lack of personal hygiene is also a cause that promotes the formation of a boil. Pressure points with damage to the upper layer of the skin or chafing in the groin due to clothing are also known to be a factor in the development of boils.

Symptoms and course

A boil is usually a harmless but often very painful local inflammation at a hair follicle. A painful, highly tense reddish lump develops at the affected skin site, ranging in size from 0.5 to two centimeters. In the center of the inflammation, tissue death occurs, which is also called necrosis. Within the furuncle pus is formed, which creates the strong feeling of tension. After a certain time, the plug of pus empties and the boil regresses. Typical local symptoms of a boil include severe pain, redness, hyperthermia at the affected area, and swelling. Other general symptoms occur only in rare cases. These are fatigue, exhaustion and general physical weakness. Boils can occur on the face, ear, anus or pubic area. The additional symptoms that occur are often also dependent on the location of the boil. Boils in the facial area cause greater discomfort. Especially if they occur on the lip or nose, complications can arise. Thus, the development of life-threatening sepsis is possible. Facial furuncles can also cause inflammation of the eye socket. Furthermore, there is a risk of developing meningitis or a clot in the brain. In severely immunocompromised patients, lymphadenitis may also occur.

Complications

Various complications are possible in the course of a furuncle. This risk is particularly present when a carbuncle forms from multiple furuncles. In such cases, there is often pronounced general discomfort. In addition, lymphangitis may also occur, in which the lymphatic channels become inflamed and the lymph nodes swell. Sepsis (blood poisoning) is a particularly serious complication of boils. In this case, the bacteria responsible for the boil enter the body’s bloodstream. However, the effects of the boil depend largely on its location. For example, a nasal furuncle can have life-threatening consequences if the triggering staphylococcal bacteria are transported with the venous blood into the bloodstream of the head. At this point, there is a risk that the germs will cause phlebitis, meningitis or cerebral sinus vein thrombosis. Likewise, diseases of the orbit are within the realm of possibility. In medicine, this is referred to as orbital naphlegmosis. Because of the threat of sequelae, the patient must never press his fingers against a boil on his face or nose.Thus, the pus accumulations filled with staphylococci can reach neighboring veins and cause life-threatening complications in the brain. However, if it is a boil with a favorable course, dangerous sequelae are rarely to be feared.

When should you go to the doctor?

If a painful swelling is noticed on the skin, it is possibly a boil. This usually heals on its own and does not require medical attention. A doctor should be consulted if the inflamed hair follicle does not open on its own or breaks open inward. If the boil becomes infected, medical advice is also required. A spread of the infection to the surrounding tissue must be clarified before serious complications such as secondary infections or sepsis develop. If, in addition to the accumulation of pus, other symptoms such as fever or chills occur, a visit to the doctor is recommended. A reddish stripe leading from the boil towards the heart indicates blood poisoning, which must be treated immediately. It is best to take the affected person to a hospital immediately. People who suffer from boils or abscesses more frequently should talk to a dermatologist. It is possible that the complaints are based on a serious disease that must be clarified and treated.

Treatment and therapy

Boils in the head area should always be treated by a doctor. Initially, antibiotic ointments are used to limit the infection locally. In addition, it is possible to use traction ointments to accelerate the development of the boil. It will open and the fluids can drain. Special attention must be paid to hygiene, because the contents of a furuncle are highly infectious. Heat helps with smaller boils, which also causes the boil to open and drain. A boil is only opened prematurely if it is particularly painful or does not open on its own. This is done by a medical procedure under local anesthesia followed by wound care. In the majority of cases, however, the course of the disease is without complications and the boil opens by itself without further intervention. The open wound is disinfected and the boil heals in a few days.

Prevention

Boils can be prevented primarily by careful personal hygiene. Since another trigger for boils is tight clothing, underwear with leg cuffs that are too tight should be avoided. Especially in the body folds on the thighs and under the armpits, friction leads to skin damage, which facilitates the penetration of bacteria and fungi and causes a boil.

Aftercare

A single boil does not require follow-up care if it has healed completely. It is usually a hair follicle infection. If changes in size or degree of inflammation are evident on the supposed boil, it could be a carbuncle – a fusion of several individual boils – or a fistula. In this case, a visit to the doctor is advised. If there was furunculosis with extensive furuncle infestation, the situation is different. In this case, a search must be made for the causes that can be eliminated. These are often related to an unsuitable diet. Boils are often found in the intimate area. They form, for example, at the pressing edges where the panty closures are located. Those who are prone to boils after intimate shaving should better refrain from it. Boils can cover the buttocks. They are then difficult to treat yourself. However, a change in diet to a more wholesome and nutrient-rich diet can work wonders. It is best to closely monitor the healing process of a boil. For aftercare, an antiseptic healing ointment can be applied to a healing boil. Constrictive clothing should be avoided in the future. The diet should be low in fat and high in vitamins. Dietary fiber is essential to relieve the intestinal system. The presence of many fats or waste products from unhealthy food can promote boil formation. Therefore, some changes in the previous lifestyle are conceivable in the aftercare phase.

This is what you can do yourself

Under no circumstances manipulate the afflicted area in any way or even squeeze out the boil. Improper handling of boils can cause the microorganisms that cause inflammation to enter the bloodstream. Therefore, the inflamed area should be left completely alone.In addition to medical treatment, boils or abscesses can be alleviated by air or sun baths. The corresponding area is freed from textiles and exposed to daylight or the outside air. Hot compresses, for example with chamomile decoction, also relieve the pain associated with boils. A chamomile bath has an equally soothing effect. This can be done as a partial bath (only the affected area) or as a full bath. It should be noted that the bath water is not too hot. In no case should be experimented with creams containing fat or tinctures containing alcohol, this could lead to aggravation of inflammation. Antiseptic teas, fresh ginger and turmeric can also be soothing and beneficial when used internally. Alcohol, nicotine and caffeine, on the other hand, should be avoided, as should over-seasoned and especially spicy foods. An alkaline diet promotes healing. Here, steamed vegetables should be in the foreground and little salted. A meat-heavy diet can have a counterproductive effect. Boils are local inflammations, they are not transmissible. Those affected can therefore still socialize as they please and also go about their daily lives. However, stress and great exertion should be avoided.