By Dr. Loretta Lanphier, ND, CN, HHP, CH

Boils can be painful and very annoying, but they are not really dangerous, are they? Well, not for the most part, but like any infection, they should be treated with respect. For otherwise healthy individuals, boils will usually run their course without any complications. But they can have some potentially serious side-effects in certain situations.

What Are Boils?

Boils are the result of bacterial infections that form under your skin when one or more of your hair follicles become inflamed. They generally form pustules, or pus-filled bumps, that grow in size until they rupture on their own and are thereby drained. On average, this process takes about two weeks, but some boils disappear in a few days, and some will occasionally last longer than a couple of weeks as well.Boilsare technically known as furuncles, and sometimes several furuncles come together to form a deeper, larger sore called a carbuncle that has several drainage points or “heads.”

Boils can occur on any one at any age, but they are more common in males than in females, and usually first appear in teens and young adults. They become less common as we age, but can occasionally be found in senior citizens. They appear most often on the hairiest parts of the skin, most typically on the face, armpits, thighs, buttocks, neck, and groin area. Often areas of the body that are susceptible to friction will develop boils. There are many suspected causes for boils, and folks with a compromised immune system or who have other skin problems such as acne are more susceptible to boils and carbuncles.

Boils first appear as red, tender bumps that are typically about ¼ inch across, and are slightly raised above the surface of the skin. They are usually painful to the touch, and as the area of inflammation grows, a pus-filled pimple forms that has a yellowish point or “head.” Most boils end up no larger than about one inch in diameter, but some can become as large as a golf ball. As they develop, they may become more painful for about 5-7 days before reaching a head.  Sometimes boils will continue to swell until they burst, and others will begin to recede back into the skin without rupturing. Once the boil is fully developed, and either bursts or begins to be reabsorbed, it generally takes about two weeks to completely run its course and disappear. Most boils will heal without leaving a mark, but larger ones can leave scars, especially if they rupture or are lanced by a health professional (or by yourself, which is not recommended, for reasons we will see in a moment). The majority of boils and carbuncles do not require treatment, other than to keep the area clean and being sure to avoid touching other body parts or other individuals after touching the boil, so as to prevent spreading the infection.

What Causes Boils?

Most boils are the result of an infection in one or more of your hair follicles. Follicles are shafts shaped like little tubes that are under your skin, from which individual strands of hair grow. The follicles become infected by a bacterium called Staphylococcus aureus, or staph for short. A certain amount of these bacteria are normally found on your skin and in the mucous membranes of your nose, throat, and sinus passages. But they can be very troublesome little buggers, and besides boils, they can be responsible for some serious illnesses such as pneumonia, meningitis, and endocarditis (inflammation of the lining of the heart). They can also cause food-borne illnesses, and are a source of many hospital-acquired infections.

Boils and carbuncles are actually the result of your immune system’s response to the staph infection in your follicle(s). Staph typically accesses the follicles through a break in the skin, and as soon as the infection is detected by the immune system, specialized white blood cells called neutrophils are dispatched to the scene. This response increases the inflammation and leads to the formation of pus, which is composed of neutrophils, bacteria cells, and dead skin cells.

Carbuncles are really clusters of boils that result in infections that can be more severe and go deeper into the skin than simple boils. Some carbuncle sufferers may also experience a low-grade fever and a sense of feeling mildly under the weather. Sometimes it is more difficult for carbuncles to heal, and they are more likely to spread to other parts of the body. Carbuncles are found most often in older men, and they usually manifest themselves on the thighs, shoulders, or back of the neck. They are also typically very painful and bothersome for many people.

Boils can afflict any one, and most all of us have had or will have a bout with boils during our lifetimes. However, there are certain risk factors that make it more likely for an individual to get a boil or carbuncle. These include:

  • Compromised immune system:  Most healthy people have a pretty good resistance to staph and other antigens, especially on the surface of the skin. However, when a person’s immune system is not working up to par due to certain illnesses, their risk is increased for all infections, including those leading to boils. Diabetes increases this risk in a two-fold manner. Diabetes is a disease that weakens the immune system. In addition, if a diabetic has to inject insulin, this provides small holes in the skin that staph germs can take advantage of to enter and infect the follicles. Other common immune system disorders that can increase the incidence of boils are lupus and HIV / AIDS.
  • Allergies:  Statistics show that some folks who suffer from allergies of various kinds are also more likely to get boils and carbuncles. This may be because allergies and immune system response are linked closely in many ways.
  • Other skin conditions:  Any skin disorder that leaves the skin in a less than healthy condition can result in a greater number of boils. Examples include psoriasis, acne, and dermatitis.
  • Certain medications:  Some drugs suppress the immune system, and therefore increase the risk for boils. These include drugs for chemotherapy, and long-term use of some medicines such as prednisone or other corticosteroids.
  • Tight clothing:  Clothes that are tight or chafing can cause breaks in the skin or encourage perspiration that can irritate the skin and weaken its protective barrier. These factors make it easier for the staph to penetrate and infect follicles.
  • Certain skin-care products:  Greasy potions such as petroleum jelly, some skin creams or lotions, and cosmetics can cause blockage of hair follicles, and make them more susceptible to staph infections. Various occupations or hobbies can also expose the skin to petroleum products such as motor oil or gasoline, and irritate the skin and block follicles in the same manner.
  • Drug abuse:  Alcoholics and drug addicts are also at greater risk for boils. This can be for several different reasons, mostly having to do with a weakened immune system and/or needle punctures in persons who inject drugs.
  • Poor personal hygiene:  This can weaken the skin and the immune system, and becomes more of a problem in very crowded living conditions.

Are There Any Possible Complications of Boils or Carbuncles?

Yes there are, and some of them can be quite serious. The most common ones include:

  • Septicemia:  Commonly known as blood poisoning, this condition can occur when a staph infection that started as a boil or carbuncle spreads into your bloodstream and begins to travel throughout the body. Signs to be aware of that may indicate blood poisoning are:
    1. A fever that quickly spikes
    2. Chills
    3. Increased heart rate
    4. Feeling suddenly very ill
    5. Swollen lymph nodes
    6. Red lines radiating outward from the boil or carbuncle
    7. Blood poisoning is a very critical condition, and can quickly lead to shock and death if not treated. Signs of shock include:
      1. Falling blood pressure
      2. Falling body temperature
      3. Mental confusion and disorientation
      4. Bleeding into the skin and abnormal blood clotting.
  • Methicillin-resistant Staphylococcus aureus (MRSA):  This is becoming an increasingly problematic situation that involves strains of staph that have developed a resistance to many of the commonly used antibiotics, including penicillin. MRSA is difficult to treat, is very contagious, and can spread quickly in certain environments. It is often found in gyms where equipment, showers, and towels are shared. It can also become a big problem in institutions or in crowded living quarters, such as in prisons, military barracks, or locker rooms. It can even spread to kids in daycare and school environments. This is why so many people are concerned about the overuse of antibiotics to treat bacterial infections of all kinds. Many strains are becoming immune to these drugs.
  • It is not wise to squeeze of puncture boils on your own, as it is very easy to spread the staph infection to other parts of your body by doing so. There have actually been reported cases of fatalities in folks who “popped” a boil near the mouth or nose and enabled the infection to spread to the brain. If a boil or carbuncle becomes especially large or troublesome, it is best to have a health practitioner lance it for you in a sterile atmosphere. If you do choose to do it yourself, be extremely careful that you know what you are doing. Staph infections can be very aggressive and dangerous in some cases, and they’re nothing to play around with.

What’s the Best Way to Self-treat Boils?

  • Tea Tree Oil (Melaleucca Oil) is one of the best treatments for boils and carbuncles. It has antiseptic and healing properties, and it can help soothe and lessen pain as well.
  • Warm compresses can also be helpful to soothe and encourage healing. If you soak them in salt water, they will also help the boil to rupture and drain more quickly.
  • Increasing your intake of Vitamin C, zinc, and beta-carotene when you have a boil will also help your body to remedy the situation better and faster as well.

Patience is the best policy when it comes to dealing with boils and carbuncles. Just take care of yourself, keep the wound clean, and don’t spread the infection around by inappropriately touching it or other body parts. Most boils are nothing to worry about, and will disappear just as mysteriously as they showed up when their time is done.

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