Boils: Causes, treatment and home remedies

Boils begin as tender, swollen areas, which are pinkish to red in colour, erupting on a firm area of the skin. It soon progresses to a cyst-like swelling filled with pus or fluids. At this point, it becomes immensely painful with the pain gradually diminishing after the drainage of the boil. Depending on the severity and size, boils may drain on their own or may require an incision. Following symptoms may be observed:

• Redness over a small area of the skin, usually in hairy areas, which rub against each other like thighs, buttocks, neck, armpits or even the face
• Pea-sized swelling, sometimes larger
• Tenderness to touch
• Pain
• Having a white or yellow coloured head in the centre
• Presence of pus or fluids
• Quickly spreading swelling
• Redness of the surrounding area
• Rarely, itching
• If the size of the boil is large, you may experience additional symptoms like fever, fatigue and malaise
• They spread to the surrounding area causing more boils to develop and may even spread from person to person.

You may also note that the swelling may occur due to a single infected hair follicle or multiple. It is called furuncle in case one hair follicle is affected and carbuncle in case of the latter.

Boils are most commonly caused due to S. aureus, which is a normal inhabitant of the skin. The bacteria causes infections upon gaining entry through damaged or broken skin; the latter usually occurring due to excessive friction in the aforementioned areas.

Having a poor hygiene is a significant risk factor for the development of boils since it provides a suitable medium for the entry of S. aureus. The presence of sweat and dead skin cells further provides a hostable environment.

Additionally, poor nutrition increases your susceptibility to boils due to a naturally diminished immune response of the body.

Diabetes is yet another risk factor due to immunosuppression.

Certain skin conditions such as eczema also increase the risk of boils since they damage the skin, making it more susceptible.

Boils can be prevented by taking the following measures:

• Maintaining proper hygiene
• Avoidance of nutritional deficiencies by consuming a balanced diet
• Taking a shower each day and scrubbing to prevent the accumulation of dead skin cells
• Keep your hands, clothing, bedding, linen and other objects clean
• Avoiding to share personal items like razor, towel, clothes, etc

If you already have boils, you can prevent it from spreading to surrounding areas by taking the following measures:

• Washing hands with an antibacterial soap after touching the boil
• Washing clothes and beddings in warm water
• Use a separate towel for the area affected with boils
• Avoiding unnecessary touching or squeezing of the boil
• Being careful while cleaning and dressing the boil
• Keeping the boil covered until it heals
• Regularly changing the dressing of the boil
• Disposing of used dressing with utmost care
• Taking a proper diet and adequate rest (this will help in a quicker recovery) 

Boils can be self-managed, however, larger ones necessitate a doctor’s visit. Mostly, boils can be successfully managed at home without any serious complications. Here is how you can do it:

• Application of a warm cloth to the site of the boil for a duration of 10 minutes- this will speed up the process of healing. Application of a warm cloth raises the temperature of the surrounding area, which improves perfusion or blood flow of the site, allowing it to heal better and quicker. Warm, moist compress will help to aid the drainage of the boil.
• Once the boil has already burst open, the symptoms of swelling, pain and redness will gradually diminish. Covering the area with a dressing or a sterile gauze is still essential to avoid the spread of infection.
• If you experience intense pain, over-the-counter medications like ibuprofen may help. If you have a fever, you may also take paracetamol for relief. However, it is best to visit your doctor in these cases.
• Use of an antibiotic cream is recommended for dressing. This may also be applied to nasal membranes since S. aureus usually inhabits this area. Over-the-counter antibiotic creams may be used for topical application.
• It is important to note that you must not cut open the area by yourself if the size of your boil is large. You should also not use pins or other items to assist in the drainage of fluids since this can lead to severe spreading of the infection.
• Antibiotic coverage is often prescribed for the management of boils. But, you should not consume them on your own since it holds the risk of antibiotic resistance and future infections.
• If the boil is large, your doctor will form an incision (cut) on the area of the swelling to facilitate drainage. This may or may not be performed under the effects of local anaesthesia (numbs pain and sensations in a small area where it is injected). The wound is then disinfected and dressed.

You may require to visit a doctor for the treatment of boils if:

• The boil is severely painful
• The size of the boil is too large
• Boils are recurring
• Boils last for more than 2 weeks
• Fever and other additional symptoms are present
• The boil is present on the face or the area of the spine

There are several ways in which you can manage a boil at home if warm compress fails to cure. This section will explore the best of these remedies.