Boil - Treatment

Treatment

A small boil may burst and drain on its own without any assistance. In some instances, however, draining can be encouraged by application of a cloth soaked in warm salt water. Washing and covering the furuncle with antibiotic cream or antiseptic tea tree oil and a bandage also promotes healing. Furuncles should never be squeezed or lanced without the oversight of a medical practitioner because it may spread the infection.

Furuncles at risk of leading to serious complications should be incised and drained by a medical practitioner. These include furuncles that are unusually large, last longer than two weeks, or are located in the middle of the face or near the spine. Fever and chills are signs of sepsis that require immediate treatment.

Antibiotic therapy is advisable for large or recurrent boils or those that occur in sensitive areas (such as around or in the nostrils or in the ear). Staphylococcus aureus has the ability to acquire antimicrobial resistance easily, making treatment difficult. Knowledge of the antimicrobial resistance of S. aureus is important in the selection of antimicrobials for treatment. Poor personal hygiene being common, the role of nasal S. aureus carrier may differ from communities with good hygienic practices. Staphylococcus aureus re-infection may result from contact with infected family members, contaminated fomites, or from other extra-nasal sites. This raises a suggestion to treat household contacts and close contacts if recurrence persists, because it is likely that one or more contacts are asymptomatic carriers of S. aureus. In addition to the increase in the cost of treatment in poor countries, the possibility of developing drug resistance must be considered. The most important independent predictor of recurrence is a positive family history. Boils are spread among individuals by touching or bursting a boil. Furunculosis is a common disease, particularly with deficient hygiene. A large number of S. aureus organisms are frequently present on the sheets and underclothing of patients with furunculosis and may cause re-infection of patients and infection of other members of the family. The role of iron deficiency anemia in recurrent furunculosis was demonstrated, all patients were free from recurrence during the six months follow-up period after iron supplementation. A variety of host factors, such as abnormal neutrophil chemotaxis, deficient intra-cellular killing, and immuno-deficient states are of importance in a minority of patients with recurrent furunculosis. Health education about sound personal hygiene and correction of anemia should be mandatory in management of furunculosis. It was found that recurrence was significantly associated with poor personal hygiene. A previous study reported that MRSA infection was significantly associated with poor personal hygiene. It was reported that frequent hand and body washing with water and antimicrobial soap solution decreases staphylococcus skin colonization. Previous use of antibiotics is associated with a high risk of recurrence. This may be due to the development of resistance to the antibiotics used. An associated skin disease favors recurrence. This may be attributed to the persistent colonization of abnormal skin with S. aureus strains, such as is the case in patients with atopic dermatitis.