Boils

Staphylococcus aureus can spread from one part of the body to another, and from one person to another, via fingers, skin-to-skin contact, and contaminated clothing. Boils are most common in adolescents, and affect boys more often than girls. Sufferers of boils seldom have a problem with their immune system, although boils can be very florid when the immune system is abnormal.

What boils look like

A boil starts as a small itchy or tender spot that grows over a few days into a large red lump under the skin surface becoming increasingly painful and tender. Boils in the nose or ear can be particularly uncomfortable. At this stage it may come to a head and eventually burst through the surface of the skin, releasing its content of pus, or it may settle gradually without bursting. A healed boil tends to leave a red mark, which slowly goes, usually leaving a small scar. Boils may occur singly or in clusters.

Diagnosing boils

Boils They are usually straightforward to diagnose by their appearance. If a boil releases pus, this can be sent to the laboratory to establish the sensitivity of the bacteria to a range of antibiotics, in cases where boils keep appearing.

Boils can be cured.  Infections caused by Staphylococcus aureus settle with treatment. However the organism may linger on, or be picked up again from someone else, so that further infections can occur later.

The bacteria survive best in moist areas such as the nostrils, the armpits and the groin, and some people carry the Staphylococcus aureus at these sites on a long-term basis. If repeated infection occurs, it is wise to treat these areas to get rid of the germs persisting there. 

A single boil usually settles naturally, especially if the pus it contains discharges spontaneously. Sometimes your doctor may release the pus by cutting carefully into the boil (lancing it). 

This should only be done with sterile instruments once the boil has come to a head. An antibiotic cream or ointment can be used around the boil to stop others coming up nearby. Often an antibiotic is given by mouth as well, to make sure that the infection clears properly. 

It is sensible to seek medical advice if you are not sure of the diagnosis, or if the treatment you have tried seems not to be helping. Recurrent boils may be a sign of unrecognized diabetes, so this is another reason to see your doctor if the problem does not settle.

If boils keep coming back

Extra measures are needed to help break the cycle of infection and re-infection:


• • Areas where the bacteria tend to survive, such as the armpits, groin and scalp, should be cleaned with an antiseptic wash such as chlorhexidine (e.g. Hibiscrub) or iodine (e.g. Betadine), for a week or two. This treatment, however, may cause irritation, in which case it should be stopped.
    
  • An antiseptic can be used in the bath, perhaps in the form of a bath additive containing triclosan.
    
  • For those who still have the bacteria in their noses (nasal carriers), an antibiotic or antiseptic ointment (either
  • Bactroban or Fuscidin) should be applied to the inside of each nostril, four times a day for ten days. This usually eradicates the organism from the area. It may be worth treating the noses of family members who are also carrying it in the same way. Carriers are identified by taking swabs from the nose and sending them to the laboratory to see if
  • S.aureus is present.  
    
  • The hands and nails should be kept scrupulously clean. Avoid picking at any sores.
    
  • Clothing should be washed frequently, using a hot wash and hot tumble-dry if possible.

What you can do

• Follow the measures outlined above to reduce the spread of the germ around the body.
  
• Bath or shower daily, and keep your hands clean.
  
• Do you need to lose weight? Obesity encourages boils, as the bacteria survive most easily in folds of the skin. 
  
• Avoid activities that involve heavy perspiration and skin chafing, as they tend to aggravate the problem.
  
• Avoid contact sports, such as rugby and judo, until the boils have cleared.