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BOILS TREATMENTS |
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Patient and family education Patient education is an important part of the treatment of boils and carbuncles. Patients need to be warned against picking at or squeezing boils because of the danger of spreading the infection into other parts of the skin or bloodstream. It is especially important to avoid squeezing boils around the mouth or nose because infections in these areas can be carried to the brain. Patients should also be advised about keeping the skin clean, washing their hands carefully before and after touching the boil or carbuncle, avoiding the use of greasy cosmetics or creams, and keeping their towels and washcloths separate from those of other family members. Some doctors may recommend an antiseptic soap or gel for washing the infected areas. If the patient has had several episodes of furunculosis, the doctor may examine family members or close contacts to see if they are carriers of S. aureus. In many cases they also need treatment for boils or carbuncles. Skin infections and reinfections involving small groups or clusters of people are being reported more frequently in the United States. Medications Boils are usually treated with application of antibiotic creams--usually clindamycin or polymyxin--following the application of hot compresses. The compresses help the infection to come to a head and drain. Carbuncles and furunculosis are usually treated with oral antibiotics as well as antibiotic creams or ointments. The specific medications that are given are usually dicloxacillin (Dynapen) or cephalexin (Keflex). Erythromycin may be given to patients who are allergic to penicillin. The usual course of oral antibiotics is 5-10 days; however, patients with recurrent furunculosis may be given oral antibiotics for longer periods. Furunculosis is treated with a combination of dicloxacillin and rifampin (Rifadin). Patients with bacterial colonies in their nasal passages are often given mupirocin (Bactroban) to apply directly to the lining of the nose. Surgical treatment Boils and carbuncles that are very large, or that are not draining, may be opened with a sterile needle or surgical knife to allow the pus to drain. The doctor will usually give the patient a local anesthetic if a knife is used; surgical treatment of boils is painful and usually leaves noticeable scars. Alternative treatment Naturopathic therapy Naturopathic practitioners usually recommend changes in the patient's diet as well as applying herbal poultices to the infected area. The addition of zinc supplements and vitamin A to the diet is reported to be effective in treating boils. The application of a paste or poultice containing goldenseal (Hydrastis canadensis) root is recommended by naturopaths on the grounds that goldenseal helps to kill bacteria and reduce inflammation. Homeopathy Homeopaths maintain that taking the proper homeopathic medication in the first stages of a boil or carbuncle will bring about early resolution of the infection and prevent pus formation. The most likely choices are Belladonna or Hepar sulphuris. If the boil has already formed, Mercurius vivus or Silica may be recommended to bring the pus to a head. Western herbal therapies A variety of herbal remedies can be applied topically to boils to fight infection. These include essential oils of bergamot (Citrus bergamia), chamomile (Matricaria recutita), lavender (Lavandula officinalis), and sage (Salvia officinalis), as well as tea tree oil (Melaleuca spp.). Herbalists also recommend washing the skin with a mixture of goldenseal and witch hazel. To fight the inflammation associated with boils, herbalists suggest marsh mallow (Althaea officinalis) ointment, tinctures (herbal solutions made with alcohol) of blue flag (Iris versicolor) or myrrh (Commiphora molmol), and slippery elm (Ulmus fulva) made into a poultice. |
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