This kind of "red bag" is painful and swollen, and it is dangerous to squeeze it! Know these and go to the hospital less often

If we talk about the most painful skin problem, besides shingles, it is probably boils.

Boils are common skin infections that develop very quickly, some appear within hours, and some take a few days to develop. People who have had boils don't want to encounter them again.

Today, let’s talk in detail about what boils are and how to treat them using scientific methods.

What are boils?

Is it skin inflammation?

Some people may think that boils, as the name suggests, are boils that appear when the skin gets inflamed, but this is not the case in reality. Don't take it literally.

The so-called "getting angry" is an imprecise concept, and it is not the cause of boils.

In fact, the terms "boil" and "carbuncle" are not scientific names. The formal name is "boil" or "carbuncle".

It is a bacterial infection of the hair follicles and the area around them. As can be seen from the above definition, its lesions are located in the hair follicles and the area around them on the skin, and the basic factor causing the lesions is the infection caused by bacteria.

Next, let's take a look at its true appearance:

Figure 1. Typical carbuncle (cited from references)

It is not enough to just know these, we have also sorted out the important characteristics of boils:

The appearance is a skin lump that changes in size from small to large, and can be larger than 5 cm;

· It can occur in many parts of the body, especially the face, back of the neck, armpits, thighs, buttocks and other places that are prone to friction and sweating;

Almost always painful.

In addition to pain, there is also local redness, swelling and fever;

· It is hard and non-suppurative in the early stage, but tends to suppurate in the later stage, and some pus can be discharged naturally;

· It usually lasts from a few days to a few weeks before healing;

After healing, scars may remain.

So why are some people more susceptible to boils? This depends on the cause of the infection and the risk factors. If you have skin damage (such as scratches, bites, eczema, etc.), or close contact with other people with boils, or if you have poor health (such as diabetes, long-term use of immune-suppressing drugs), then you are more likely to get boils. However, even people with good health may occasionally get boils.

Don't get me wrong

These are not boils.

There are two other skin problems that are similar to boils, but not the same: folliculitis and carbuncle. These two problems can easily be mistaken for boils, and this is even very common.

Figure 2. Boils and similar skin problems (organized from reference materials)

The above is a microscopic diagram. It can be seen that folliculitis, furuncle and carbuncle have some similarities as well as some differences. We have used a table to sort out the comparisons between them.

Table 1. Comparison of boils and similar skin problems

Next, let’s take a look at the actual appearance of folliculitis and carbuncle.

Figure 3. Folliculitis Source: Reference [7]

Figure 4. Carbuncle Source: Reference [8]

If you are not sure what the painful lump is, do not seek treatment blindly. It is best to seek medical attention promptly and receive targeted treatment after the doctor's evaluation.

How to treat boils?

Many times, if you have a boil, you don't need to rush to the hospital. This is because mild boils can be treated at home without the need for a doctor. Here are some things you can do at home:

You can apply warm compresses with warm water three or four times a day for a few minutes each time;

If there is pus discharge, clean and disinfect it promptly;

Protect the area and cover it with a dressing;

Pay attention to hand hygiene and local skin hygiene;

If the pain is severe, you can take pain relievers such as acetaminophen or ibuprofen as needed.

In addition, be careful not to do the following things:

· Do not squeeze or rub the boils, and try not to drain the pus by yourself; · Do not share personal items such as towels with others during the illness; · Do not go swimming during the illness, as this may spread the pathogenic bacteria to others. If the condition is out of control and there are some of the following signs, it is recommended to seek professional advice from a doctor:

The pain from the boil is very severe and has not improved;

The boils continue to grow larger and worsen, and may even form carbuncles;

· Start to have a fever, with the temperature exceeding 37.3℃;

The boil is soft and contains pus, but it does not drain naturally;

· The carbuncle keeps recurring and I can’t find the cause.

After the doctor sees the patient, he will generally consider strengthening the treatment. One is whether to use antibiotics and how to use them, and the other is whether to make an incision to drain the pus. These treatments are helpful for recovery. Generally speaking, if there is a lot of pus but it is not discharged naturally, the doctor needs to help drain the pus artificially. The conventional way to drain the pus is to make a small incision on the surface of the boil, then disinfect the wound, and possibly put a sterile gauze strip in the wound to absorb and remove any residual pus. Since the use of antibiotics and the treatment of pus drainage are more professional and are issues that doctors need to consider, the details will not be expanded too much.

I don't want to have boils anymore.

You can do this

There is one bad news and one good news about prevention. The bad news is that boils can't always be effectively prevented because they sometimes occur by accident and cannot be predicted in advance. The good news is that there are some mainstream practices that can indeed reduce the risk of attacks and play a certain preventive role.

Based on medical consensus, the following measures may have a preventive effect:

Avoid close contact with people who have staphylococcal infections, boils, or carbuncles;

Pay attention to hand hygiene every day and learn the 7-step hand washing method, which helps prevent the spread of bacteria;

· Pay attention to protecting your skin, avoid frequent abrasion and scratching of the skin, and ensure the integrity of the skin;

Do not share personal items with others, such as towels, razors, and clothing;

If there are shared items, such as bed sheets and quilt covers, clean and air them (or dry them) regularly;

If you have chronic diseases or immune problems, seek medical attention and do not ignore them.

Summarize

Finally, let's make a summary and sort out the main content of this article. First of all, boils are not caused by getting angry. Don't be fooled by the name. It is medically called furuncle, which is a common problem caused by bacterial infection of hair follicles and surrounding skin. It usually appears as a lump on the skin, which may be accompanied by redness, swelling, pain and fever, and may heal within a few days to a few weeks.

In terms of treatment, if the boil is relatively mild, you can treat it at home by applying warm water, cleaning and disinfecting, and maintaining skin hygiene. However, if the condition is serious or shows signs of worsening, you should seek medical help. The most important response measures are antibiotics and drainage.

As for prevention, possible effective measures include avoiding skin damage, maintaining personal hygiene, and not sharing personal items with others, which can reduce the risk of recurrence.

References

[1]Overview:boilsandcarbuncles.https://www.ncbi.nlm.nih.gov/books/NBK513141/

[2]Boils&carbuncles.https://my.clevelandclinic.org/health/diseases/15153-boils-and-carbuncles

[3] Patient education: Boil. https://www.uptodate.com/contents/en/boil-the-basics

[4]Boilsandcarbuncles.https://www.mayoclinic.org/diseases-conditions/boils-and-carbuncles/symptoms-causes/syc-20353770

[5]Furunculosis.https://www.visualdx.com/visualdx/diagnosis/?moduleId=101&diagnosisId=52666

[6]Furunclesandcarbuncles.https://www.msdmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/furuncles-and-carbuncles

[7] https://www.mymed.com/

[8]https://www.healthline.com/health/carbuncle

Planning and production

Author: Tang Jiaoqing, MD, attending physician of dermatology

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital