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  Boils, Abscesses, Carbuncles  
 
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Signs, symptoms and indicators | Contributing risk factors | Other conditions that may be present | Recommendations

 

Boils are infected, pus-filled swellings in the skin that are often located in or near hair follicles. They are most often found on the back of the neck and in other moist areas of the body like the armpits and groin, but may be anywhere on the body. Sometimes several boils form close together in a cluster. A carbuncle is formed when several boils merge to form a single deep abscess with several heads or drainage points. An abscess may be so deep that it may not surface for a long time. Boils and carbuncles are firm reddish swellings about 5-10 mm across that are slightly raised above the skin surface. They are sore to the touch. A boil usually has a visible central core of pus; a carbuncle is larger and has several visible heads. Boils occur most commonly on the face, back of the neck, buttocks, upper legs and groin area, armpits, and upper torso.

Carbuncles are less common than single boils; they are most likely to form at the back of the neck and with Males. Carbuncles can form in the same areas as boils, and may also form on the scalp, face, and buttocks. Furunculosis is a word that is sometimes used to refer to recurrent boils. Many patients have repeated episodes of furunculosis that are difficult to treat because their nasal passages carry colonies of Staphylococcus aureus. These bacterial colonies make it easy for the patient's skin to be reinfected.

A milder version of boils is folliculitis. This is an infection of hair follicles, usually with Staph bacteria. These often itch more than hurt. The appearance is similar to acne pustules.

A boil starts out suddenly as an itchy, red, painful lump. Usually within 24 hours, the lump fills with pus and takes on a round appearance with a yellow-white tip. There may be swelling around the boil as well as swelling of any lymph nodes near the boil. Lymph nodes are located in the neck, armpit, and groin area.

Boils and carbuncles are more likely to develop in those with:

  • Diabetes, especially when treated by injected insulin
  • Alcoholism or drug abuse
  • Poor personal hygiene
  • Crowded living arrangements
  • Jobs or hobbies that expose them to greasy or oily substances, especially petroleum products
  • Allergies or immune system disorders, including HIV infection
  • Family members with recurrent skin infections

Boils may take from 10 to 25 days to heal. In most cases, a boil will not heal until it bursts and drains. This can take as long as 5 to 7 days. A single boil can usually be cared for at home and does not require a trip to the doctor. Since releasing the pus in a boil can lead to more infection, puncturing it at home is not usually advised. If you do lance it, make sure to sterilize the surrounding area carefully before and after, washing the hands after touching the area.

If the boil bursts, apply an antibiotic ointment (like Bacitracin or Neosporin) or use Betadine to reduce the chance of infection. Keep the skin around it clean, and wash the hands carefully after touching the area.

You should see a doctor if:

  • a boil develops in a child or a sick or elderly person
  • a boil develops on the face near the eyes or nose
  • a boil becomes extremely large or painful
  • a cluster of boils form or you have an abscess
  • boils become increasingly common
  • red lines spread out from the center of the boil
  • the boil is extremely tender
  • fever and chills develop
  • lymph nodes begin to swell that are located in other areas of the body from where the original lymph node swelling occurred.
  • Medical treatment by a healthcare provider may include lancing or puncturing the boil to release the pressure and allow for drainage. Antibiotics may be prescribed to stop the infection.

    Practicing good hygiene habits minimizes the frequency of recurring boils and prevents the spread of infection. This includes not picking at boils, using clean towels after each bath or shower, and cleaning the skin with an antiseptic soap like Betadine.

    Hidradenitis Suppurativa is an uncommon disorder of unknown cause in which boil-like lumps develop in the groin and some times under the arms and under the breasts.
     

     
     

    Signs, symptoms & indicators of Boils, Abscesses, Carbuncles:
     
     
    Symptoms - Metabolic  Having a slight/having a moderate/having a high fever
     
     

    Risk factors for Boils, Abscesses, Carbuncles:
     
     
    Diet  Need for Dietary Improvement

    Nutrients

      Zinc Requirement
      Vitamin A Requirement
     The addition of zinc supplements and vitamin A to the diet is reported to be effective in treating boils.

      Iron Requirement

    Symptoms - Immune System

      Past boils/abscesses/carbuncles
     
     

    Boils, Abscesses, Carbuncles suggests the following may be present:
     
     
    Cell Salts  Cell Salt, Calc Sulf Need
      Cell Salt, Silica Need
     
     

    Recommendations for Boils, Abscesses, Carbuncles:
     
     
    Botanical  Goldenseal (Hydrastis canadensis)
     The application of a paste or poultice containing goldenseal (Hydrastis canadensis) root is recommended by naturopaths on the grounds that goldenseal helps to kill bacteria and reduce inflammation.

      Castor Oil

    Drug

      Antibiotics
     Antibiotics are usually prescribed to treat a bacterial infection, antifungal drugs to treat fungi, and antiamebic drugs to treat amebiasis. However, the lining of the abscess cavity tends to reduce the amount of drug that can penetrate the source of infection from the bloodstream.

    Boils often resolve by themselves, but severe or recurring cases require medical treatment. Options include lancing and draining the boil, and antibiotics. Some people have multiple or recurrent boils. In these cases antibiotics are taken by mouth for 10 or 14 days. Stubborn cases may require two oral antibiotics plus topical antibiotic ointments to eliminate the bacteria.

    Homeopathy

      Homeopathic Remedies / Vaccines
     Boils, carbuncles and other septic conditions can be effectively treated with homoeopathy. Suggested remedies include:

    Arsenicum album: Deeply infected boils with intensely burning pain and offensive discharge. Warmth and hot applications usually are soothing. The person may feel exhausted and ill, yet anxiety and discomfort also make them restless.

    Belladonna: Used in the early stages of inflammation, before much pus has formed. The area is red, hot, throbbing, and tender, often with intense or stabbing pains. Jarring or touch may increase discomfort. The person may also feel excitable or feverish.

    Calendula: Used as a topical application for boils and infected sores. It can be used in herbal form or in low dilution as a tincture, ointment, or compress. Taken internally, Calendula can help the body overcome infection.

    Echinacea angustifolia: People who need this remedy typically feel sickly, lethargic, achy, and chilly.

    Hepar sulphuris calcareum: When a boil is extremely tender and sensitive to touch, this remedy can be helpful. A splinter-like sticking pain is often felt. The boil may produce deep pockets of offensive pus or be slow to heal. This remedy is also indicated when boils seem to be spreading. A person who needs this remedy usually is vulnerable and touchy, with extreme sensitivity to cold.

    Mercurius solubilis: When boils are very sensitive with advanced development of pus. The person may have moist or greasy-looking skin, with swollen lymph nodes and offensive breath, and be very sensitive to changes in temperature. Warmth may aggravate the pain.

    Silica: Boils that form hard lumps and are slow to come to a head and slow to heal. If many boils form at once, or boils frequently recur, it is often very useful. People who need this remedy are sensitive and nervous, inclined toward colds and swollen glands, and easily fatigued.

    Tarentula cubensis: When a boil is sore and swollen with stinging, burning pain, and purplish or bluish discoloration of surrounding tissues. A person who needs this remedy may also have restless feet and difficulty sleeping.

    Mineral

      Zinc
     Zinc orally or topically may be effective for the treatment of boils and furuncles.

      Iron
     Sometimes recurrent boils are associated with low iron levels.

      Colloidal Silver

    Physical Medicine

      Hot Applications
     Apply warm, moist compresses for 20 minutes 4 times a day to encourage circulation and resolution. This will sometimes promote spontaneous drainage of the abscess which is important since the primary treatment of abscesses is to drain them. Take showers instead of baths (baths can spread infection) and keep the boil covered with a clean bandage.

    Surgery/Invasive

      Surgery
     Draining an abscess is done by making a cut in the lining and providing an escape route for the pus, either through a drainage tube or by leaving the cavity open to the skin. The area around the abscess will be numbed before draining. Most people feel immediately better after drainage. Many abscesses subside after drainage alone; others subside after drainage and antibiotic use.
     
     


    KEY
    Weak or unproven link
    Strong or generally accepted link
    May do some good
    Likely to help







    GLOSSARY

    Acne:  A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).

    Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

    Antiseptic:  Inhibiting growth of infectious organisms.

    Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

    Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

    Furunculosis:  Localized skin infection.

    HIV:  Abbreviation for human immunodeficiency virus, a retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).

    Immune System:  A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

    Insulin:  A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

    Lymph Nodes:  Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit and groin, but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Children’s nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's.

    Millimeter:  (mm): A metric unit of length equaling one thousandth of a meter, or one tenth of a centimeter. There are 25.4 millimeters in one inch.

    Vitamin A:  A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.

    Zinc:  An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.