Boils are the volcanoes of the human body. They pop up like popocatepetl and erupt like Etna, cascade like Kilauea and leave a crater akin to Krakatau (east of Java). At no time are they as fine-looking as Fuji.
The hard biological facts of a boil are these: Staphylococcus bacteria invade through a break in the skin and infect a blocked oil gland or hair follicle. The body's immune system sends in white blood cells to kill the invaders; the battle (inflammation) produces debris (pus). A pus-filled abscess begins to grow beneath the skin surface, rising up red with pain. Sometimes the body reabsorbs the boil; other times the boil swells to an eruption, drains, and subsides.
|The Boiling points of Trouble|
If bacteria from a boil get into the bloodstream, they can cause blood poisoning. It can be dangerous to squeeze a boil around your lips or nose because the infection can be carried to the brain. Other danger zones are the armpits, groin, and the breast of a nursing woman.
If the boil is extremely tender or under thick skin like that on the back, or if the boil victim is very young or old or sick, have a doctor treat it, says Rodney Basler, M.D. If there are any red lines radiating from it, or if you feel any general body symptoms like fever and chills or swelling of lymph nodes, he adds, see a doctor because the infection may have spread. Diabetics are especially prone to such dangerous boils, Adrian Connolly, M.D., says, and may need a course of antibiotics. Sometimes recurrent boils can be symptoms of more serious diseases.
Boils are painful and unsightly. Sometimes they leave scars. Occasionally they can even be dangerous. But for the most part, you can treat most of them safely at home. Here's how.
Bring things to a head. "A warm compress is the very best thing you can do for a boil," says Rodney Basler, M.D., a dermatologist and assistant professor at the University of Nebraska College of Medicine. "It will come to a head, drain, and heal a lot faster."
At the first sign of a boil, place a compress-it can be just a warm, wet washcloth-over the boil for 20 to 30 minutes three or four times a day. Change it a few times during each session to keep it warm. "It's not uncommon for this to take five to seven days" until the boil breaks on its own, Dr. Basler says.
Spend extra time in Compress City. "It's important to continue the warm compresses for three days after the boil opens," Dr. Basler says. "You have to drain all that pus out of the tissues." You may also want to bandage it to keep it clean, "but it's not critical. A bandage is mainly to keep the drainage off your clothes."
|The Alternate Route: Folk Remedies from the Kitchen|
Food is for more than eating. Folklore has it that home remedies for boils are as close as your vegetable bin. All the following, recommended by Michael Blate, founder of the G-Jo Institute in Hollywood, Florida, are variations of the warm washcloth compress described in the beginning of the chapter. They should be changed every few hours.
Go on the attack. When the boil has come to a pus-filled head, and if it's a small boil with no sign of spreading infection, Dr. Basler says, "it's certainly acceptable to sterilize a needle with a flame and make a small nick in the head. It's okay to squeeze it."
Doctors often worry that squeezing can drive the infection deeper into the skin, thus spreading it through the lymph system, Dr. Basler says, "but in reality that rarely happens. In the office we just squeeze the dickens out of them." Letting the boil break on its own can create "more of a mess," he says, because it often breaks while you're sleeping. If only the citizens of pompeii had been able to poke a hole in Vesuvius.
Use antiseptic if you want. It's not really necessary to treat an opened boil with an antiseptic. "It's of almost no value, because the infection is localized," Dr. Basler says. "The important thing is to keep it draining." But Adrian Connolly, M.D., clinical assistant professor at the University of Medicine and Dentistry of New Jersey, recommends an OTC antibiotic ointment like Bacitracin Steril or Neosporin as insurance against infection.
Lead staph to slaughter. If you're prone to boils, you may be able to lessen their frequency, Dr. Connolly says. "I don't think you can totally prevent them, but you can clean your skin with an antiseptic soap like Betadine," which will help keep the staph population down. Another prevention tip: Boils are usually cysts that have become infected. "Monkeying with a cyst is the surest way to get a boil," Dr. Basler says. Leave cysts alone, or have them excised by a doctor.
Don't spread it around. When a boil is draining, keep the skin around it clean, Dr. Connolly says. Take showers instead of baths to reduce the rare chance of spreading the infection to other parts of the body. After treating a boil, wash your hands well before preparing food because staph bacteria can cause food poisoning.
Try the old-timers' special. Varro E. Tyler, ph.D., professor of pharmacognosy at purdue University, mentions such folk remedies as poultices of warm milk and bread, burdock leaves, or the mud of a wasp's nest (which he agrees could be a little risky if the wasps aren't at work or on vacation). Any of these are applied as compresses to bring the boil to a head and are probably as effective as a warm, wet washcloth, Dr. Tyler says.
panel of Advisors
Rodney Basler, M.D., is a dermatologist and assistant professor of internal medicine at the University of Nebraska College of Medicine in Lincoln.
Michael Blate is founder and executive director of the G-Jo Institute of Hollywood, Florida, a national health organization that promotes acupressure and oriental traditional medicine.
Adrian Connolly, M.D., is clinical assistant professor of medicine at the University of Medicine and Dentistry of New Jersey in Newark.
Varro E. Tyler, ph.D., is professor of pharmacognosy at purdue University in West Lafayette, Indiana, and author of The Honest Herbal. He also serves as a prevention magazine adviser.
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