What is a boil?
A boil (also called a furuncle) is a deep form ofbacterialfolliculitis(我nfectionof ahairfollicle).
What are the clinical features of a boil?
Boils present as one or more tender red spots, lumps orpustules. Careful inspection reveals that the boil is centred on a hair follicle. A boil is a deep form of bacterialfolliculitis; superficial folliculitis is sometimes present at the same time.Staphylococcus aureuscan be cultured from the skinlesions.
If there are multiple heads, thelesion我s called a carbuncle. Large boils formabscesses, defined as an accumulation ofpuswithin a cavity.Cellulitismay also occur, ie, infection of the surrounding tissues, and this may causefeverand illness.
Why do boils occur?
Most people with boils are otherwise healthy and have good personal hygiene. They do however carryStaphylococcus aureuson the surface of their skin (staphylococcalcarrierstate). Why this occurs is usually not known, but it is estimated that 10–20% of the population are staphylococcalcarriers.
Staphylococcus aureus我s most commonly carried in the nostrils, armpits, between the legs and in thecleft在臀部之间。它可能是转移到另外一些er sites from the nostrils via the fingernails.
Tiny nicks or grazes or something rubbing against the skin can innoculate thebacteria我nto the wall of a hair follicle which is a weak point in the skin's defences. Once innoculated, the bacteria cause a boil which goes on to run its usual course of about 10 days.
Although most people with boils are otherwise healthy, boils are sometimes related to immune deficiency,anaemia, diabetes, smoking or我ron deficiency.
What is the treatment for a boil?
Medical treatment of boils
Treatment of boils depends on their severity. Your doctor may give you specific advice and medical treatment, some are listed below:
- Antisepticorantibacterial soap我n your daily bath or shower for a week then twice weekly for several weeks. The cleanser may cause a little dryness.
- Use a hand sanitiser regularly to reduce the chance of reinfecting yourself or others with contaminated hands.
- Antiseptic or antibioticointmentorgelto apply to the inside of the nostrils.
- Wipe the entire skin surface daily for a week with 70% isopropyl alcohol in water (this will make the skin dry).
- Apply atopicalantiseptic such as povidone我odineor chlorhexidinecreamto the boils and cover with a square of gauze.
- Your doctor may prescribe an oralantibiotic(usually thepenicillinantibiotic flucloxacillin), sometimes for several weeks.
- Other members of the family with boils should also follow a skin cleansing regime. Your doctor may also advise the family to apply topical antibiotic to their nostrils in case they areStaphylococcus aureuscarriers as well.
- If the boils fail to clear up, a swab should be taken for microbiologicalculture, in case ofmethicillin (meticillin) resistant staphylococci.
- Sometimes, special antibiotics may be prescribed on the recommendation of a specialist, includingfusidic acid,clindamycin,rifampicinand cephalosporins.
General measures to prevent boils
- Consult your doctor about your general health.
- If you are overweight, try to reduce your weight; take regular exercise.
- Follow a balanced healthy diet with meat, plenty of fruit and vegetables.
- Avoid smoking.
- Wash your whole body once a day withsoap or cleanserand water. Wash your hands several times daily or use antiseptichand rubs.
- Don't share your flannel or towel with other family members.
- Maintain a clean handkerchief and don't pick your nose!
- Change your underclothes and night attire regularly.
- Consider modifying leisure activities that cause sweating and friction from clothing, such as squash and jogging.
- If you are我ron deficient, a course of iron tablets may help reduce infection.
- 1000 mg of vitamin C each day has also been advocated to improve deficientneutrophilfunction.