Complications of a boil
Boils are characterized as purulent infection of the soft tissue. Strictly speaking it is a purulent infection of the hair follicle. Unlike folliculitis, a simple inflammation of the hair follicle, the definition of boils includes the presence of pus.
The pus is cell waste and bacteria. It is typically whitish-yellow in color and has a greasy, firm consistency. Often there is also a central pus point on the surface of the furuncle.
The boil should not be expressed independently, but should be opened by a doctor. In case of recurring or refilling furuncles, a doctor should be consulted in any case. If necessary, the boil must be cut open by a doctor and the pus emptied.
This is also called a stab incision. Often antibiotics are then applied directly into the opened boil to ensure healing. The term blood poisoning is often used in the vernacular.
In medical terminology, this refers to sepsis. This is a deterioration of organ function due to the carry-over of bacteria into the blood. This infection can, for example, be a soft tissue infection, such as a boil.
Sepsis is a rare but life-threatening complication of furuncle. It can occur, for example, if the boil is expressed improperly. This can result in abscesses and as a consequence blood poisoning.
In principle, organ dysfunction can affect any organ, such as the lungs, the kidneys or the heart. In the case of blood poisoning, quick action must be taken, as it is a life-threatening clinical picture. Furuncles develop preferentially at some locations.
These include, for example, the thighs, armpits, face, but also the genital area. In professional circles one speaks of the anogenital region. This term describes the region immediately adjacent to the genitals and the anus.
There are many hair follicles, which can easily cause boils. The development of boils in the genital area is promoted by poor hygiene and skin lesions. The latter are caused in this region mainly by intimate shaving.
This can cause very small skin cracks and cuts, which promote the immigration of bacteria into the skin and hair follicles. As a result, painful boils develop in the intimate area. People who suffer from diseases that weaken the immune system, such as diabetes mellitus, more often develop boils and carbuncles in the genital area.
Furthermore, there is an increased risk of atopic dermatitis. Furuncles in the genital area can be treated analogous to furuncles on other parts of the body either with local measures, such as disinfecting compresses, topical or systemic antibiotics and an incision by a physician. To prevent boils in the genital area, good intimate hygiene and hygiene of underwear should be ensured.
Furthermore, the skin should be cleaned after shaving. Fresh blades should always be used for intimate shaving. Boils can also develop in the groin.They should not be confused with swollen lymph nodes, which are also frequently present in the groin.
Unlike boils, lymph nodes are not so superficially located, but are palpated under the skin as oval or round swellings. There is also no central pus point. In the groin, furuncles develop preferentially when there is heavy sweating, for example due to severe obesity, skin infections such as fungal diseases, or small wounds.
They are treated analogously to the general treatment of boils. This topic might also be of interest to you:
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A frequent place where boils occur is the buttocks. Here too, there are hair follicles that can become inflamed, which occurs relatively often due to the rather unhygienic conditions on the buttocks compared to other parts of the body.
Here, a boil usually manifests itself as a stabbing pain when sitting down or defecating. Other possible causes of this pain are anal venous thrombosis or a small tear in the skin (anal fissure). The therapy of the furuncle on the buttocks consists of anti-inflammatory ointments or an incision under local anesthesia by a doctor to remove the purulent content in the furuncle and prevent the inflammation from spreading.
The invasive therapy is preferable to the conservative one, as it is difficult to leave a boil on the buttocks alone and thus an ointment promises little success. Possibly the doctor will prescribe antibiotics as support. A boil on the face is probably the most unfavorable of the possible places where boils develop.
The problem in the face is that on the one hand the boil can be placed there by chewing and speaking with difficulty calmly and on the other hand constantly in the field of vision of other persons lies, which is extremely unpleasant for most humans. Surgical removal with a small incision can also leave a small but visible scar. However, this is only indicated if the boil is large and causes complications.
However, these complications should not be underestimated. Furuncles appearing in the face above the upper lip carry the danger that the bacteria that cause the inflammation will spread. Therefore any attempt to express a boil in the face itself should be avoided.
This will significantly increase the probability of spreading. The pathogens can migrate into the surrounding tissue and infiltrate the nearby facial veins. From there it is not far to the cerebral veins, the so-called sinuses.
There a cerebral sinus vein thrombosis can be triggered. This is a serious disease that can cause headaches or, in the worst case, a stroke. As already mentioned, this is possible, but a boil in the face is nevertheless initially harmless and usually disappears by itself.
If it persists over a longer period of time, therapy should be initiated by a doctor. As with all hairy parts of the body, boils can also appear on the nose. These nasal furuncles not only cause pain, but also cause suffering due to the always visible localization.
The nose is reddened and tense, a feeling of pressure can occur. The inflammation can spread to the entire nose, i.e. the wings and bridge of the nose and the bridge of the nose between the nostrils. The constant stress of chewing and speaking makes healing difficult.
A prolonged nasal furuncle should be treated medically, especially if the upper lip is also swollen. Patients who feel pressure in the corners of their eyes must see a doctor immediately. A rare but serious complication is cerebral venous thrombosis.
In this case, pathogens are carried from the nasal furuncle into the nearby veins of the face and can migrate into the cerebral veins. There they cause a thrombosis, a clotting of the blood, which can lead via nausea and headaches to clouding of consciousness and a serious illness of the brain. Therefore, one should never push on a boil on the nose.
The therapy consists of immobilization and possibly an antibiotic therapy. In case of a large nasal furuncle and complications, surgical removal is possible. A boil in the ear causes severe ear pain.
It is a special form of inflammation of the ear canal, also called otitis externa, in which small hair follicles are inflamed. Due to its location, the ear canal can become narrowed, so that patients complain of hearing loss. In addition, a boil in the ear may be noticed in the purulent discharge.
The treatment of ear boils is done through a small incision under local anesthesia, followed by pressure relief and removal.Afterwards the boil usually heals within a few days. Antiseptic and antibiotic ointments or ear drops can also be used to support and prevent the bacteria from spreading. As a sign of an inflammation in the ear, as it is also a boil, pain when pulling the earlobe and with light pressure from outside on the ear canal can be interpreted.
Complications are rare due to the quick diagnosis and treatment. A common localization for boils is the nuchal region. The term nuchal refers to the region below the hairline at the neck.
There is also a high density of hair follicles and sweat glands, so that boils can easily develop there. They can be felt as painful, hard knots in the neck. The pain manifests itself as throbbing and stabbing and can be localized exactly.
The furuncle in the neck should not be expressed, even if it is perceived as very disturbing in everyday life. It should be treated by a doctor and, if necessary, pricked and emptied. The armpit is one of the most frequent localizations for the development of furuncles.
There are various reasons for this. On the one hand, there are often many hair follicles in the armpit, so that follicular inflammation and furuncles can easily develop there, and on the other hand there is a high level of perspiration in the armpit. The warm and humid climate in the armpit promotes the reproduction of bacteria or fungi.
Especially with poor hygiene, boils can unfortunately develop there quickly. In addition, there is a high level of friction in the armpit, which means that even small injuries, which often occur when shaving the armpit, heal poorly. Boils in the armpit manifest themselves as painful, hard swellings, which often contain a central pus point.
Boils are less common on the finger, but are in principle also possible there. However, they should not be confused with other purulent infections of the fingers and nail fold. These include, for example, nail bed inflammation.
This purulent inflammation affects the tissue surrounding the nail, but not the hair follicles. As a rule, this is opened surgically and the pus is drained. Boils are not found on the finger near the nail, but mostly below the knuckles, where the hair is also located.
On the fingers it is particularly difficult not to strain the boil, as the hands are indispensable in daily use. Nevertheless, one should try not to strain the boil. The boil on the upper shcnekel is a bacterial inflammation in the area of the thigh.
The thigh is a “popular” place for a boil. It can be felt as a warmed, reddened, painful knot on the thigh. Often the neighboring tissue is also affected.
The causes of a furuncle on the thigh are of various origins. The most common cause, however, is injuries to the hairy skin of the thigh. Since boils always heal with scarring and sometimes have serious consequences, it is best not to let them develop in the first place.
However, active prophylaxis is only possible to a limited extent, since the causes of boils are not always known. In principle, it can be said that general measures for good personal hygiene help to prevent the development of furuncles, but also many other skin infections. These include frequent washing and disinfection of the hands, regular changing of towels and bed linen or disinfection of the skin after shaving.
All these points are especially important when the boil has burst open, as it is then infectious and transmission to other parts of the body must be avoided. Furthermore, one should counteract the occurrence of complications by not trying to express boils yourself. In addition, care should be taken not to wear too tight-fitting, rubbing clothing.
Diabetics should also make sure that their blood sugar levels are always well adjusted, also in view of the danger of boils. The duration of a furuncle differs depending on the person and location, as well as the nature of the furuncle. In most cases, furuncles develop as a subacute to acute event.
This means that the furuncle develops over a few hours to days. Usually the furuncle is relatively small at the beginning and then fills with pus over a few days. The healing of a boil, however, can take several weeks.
However, this also depends on the applied therapy and the nature of the furuncle. Through a stab incision, i.e. the cutting open of a furuncle, immediate relief can usually be achieved, since the purulent contents are emptied immediately.In contrast, treatment with traction ointments and disinfectant solutions applied topically leads to slower healing, but saves an incision. All in all, one can therefore speak of a duration of days to a few weeks.
Most boils are uncomplicated and show a favorable course. After some time they burst open and heal on their own, but the formation of a small scar cannot be avoided. In order to prevent the transfer of the bacteria to other parts of the body, it is important to maintain a high level of hygiene.
Only rarely do boils occur repeatedly and/or in batches or fuse together (carbuncles), which then leads to more severe symptoms and requires more extensive treatment. Although complications do not occur frequently, they should be taken seriously because of their severity. On the one hand, there is the possibility that the lymph channels of the skin become inflamed when the pathogens colonize them (lymphangitis) and the lymph nodes swell.
In the worst case, this can lead to the life-threatening clinical picture of blood poisoning. Further complications occur mainly when the boils are located in the upper part of the face. Between the masticatory muscles in the deep facial region lies the venous pterygoid plexus, which forms a link between the veins of the face and the sinus cavernosus inside the skull; the veins of the orbit can also communicate with it. Consequently, there is a possibility that the germs may eventually reach the orbitaphlegm or even the brain via the skin veins, where they may cause a cerebral venous thrombosis or meningitis, both of which can be fatal.
