Boil Treatment

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Boil

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Before you start a diagnosis, please read all of the information below.

A boil is an infection of a hair follicle. It occurs when bacteria (usually staphylococcus) multiply under the surface of the skin in a hair follicle. A boil looks like a small red lump on the skin that is tender. The surrounding skin may be swollen and inflamed. Pus fills the centre of the boil.

Small boils are common and will go away on their own without treatment. Larger boils will usually require treatment. Common places for boils include the neck, face, armpits, arms, and buttocks and around the back passage (anus).

Typically, after several days to a week, the boil will burst, and pus will discharge out. The pain tends to improve when the boil bursts. The infection in the surrounding skin will usually settle gradually over several days, but you may be left with a scar on the site.

A boil may need incision and drainage (a small cut is made by a doctor to let the pus drain).

Treatment commonly involves draining the pus and taking a course of antibiotics. They usually occur as a one-off in a healthy person. If you have recurring boils, you are advised to see your GP to have tests to check for an underlying cause.

Please see the 'Common Treatments' section below for further information.


Common Symptoms

You may experience some of the following symptoms:

  • a hard, tender, red lump surrounding a hair follicle
  • enlargement of the lump
  • pain
  • pus discharging from the lump
  • redness of the skin around the lump
  • may have a mild fever or feel tired and run down
Common Treatments

Speak to your pharmacist for advice on over-the-counter treatments that may help such as creams and painkillers.

Possible treatments we prescribe if clinically appropriate:


*Prices shown are cost price of the medication, taken from the British National Formulary 2018, and are given as a guideline. Pharmacies will add a dispensing fee to this which will vary considerably, so it is worthwhile phoning around to compare prices. The medication is paid for at your chosen pharmacy. 

Please click on the medication above to read the Patient Information Leaflet for important information about each drug. We use national prescribing guidelines to select which treatment would be most appropriate for your condition.

 

Risk factors for boils

The source of staphylococcal infection is usually from the nose or the genital area. It is thought that the infection is spread by the fingers and by clothing.

The following may increase the risk of developing boils:

  • if you have other skin conditions that may cause you to scratch and damage the skin such as eczema.
  • if you have an illness making you feel run down, tired or generally unwell. 
  • if you have a poor immunity.
  • diabetes.
  • if you are very overweight (obese).
  • if you are a carrier of staphylococcal bacteria.
Self-help

  • Use a warm flannel over the affected area for 30 minutes, three to four times a day. This may help the boil to burst and release the infection. If this occurs, then please use a sterile dressing over the wound to reduce the risk of the infection spreading.
  • Simple painkillers such as paracetamol or ibuprofen can help ease any discomfort. Please read the information leaflet contained with the medication or speak to a pharmacist to check that the medication is suitable for you.
  • Maintain good personal hygiene.
  • Wash your hands carefully after contact with the boil.
  • Wash and tumble dry underclothes, bed linen, and towels at a high temperature daily (if possible) to stop spreading the infection to other parts of their body, or to other people.
  • Use a separate towel and face cloth.
  • Try to wear loose-fitting, lightweight clothes.
  • Keep open wounds or grazes clean and covered with sterile gauze until they heal.
  • Change dressings frequently. Discard used gauze or dressings immediately. 
  • To avoid passing the infection on to others, do not participate in contact sports, or visit a swimming pool or gym until the boil has healed.
Information about flucloxacillin

The antibiotic Flucloxacillin can be used to treat a boil infection if you are not allergic to penicillins. Before you start treatment, always read the manufacturers leaflet contained with the medication. This contains more information and lists all the potential side effects.

The dose is to be taken four times a day, it is important that you space out the doses evenly during the day. Swallow the capsule with water, and take it on an empty stomach. This means an hour before food or 2 hours after food. 

Do not take Flucloxacillin if you are allergic to Penicillin.

Keep taking Flucloxacillin until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never give your medication to other people even if their condition appears to be the same as yours.

Possible side effects to flucloxacillin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then speak with your doctor or pharmacist. 

The most common ones for Flucloxacillin include:

  • feeling sick (nausea) or vomiting
  • diarrhoea
  • redness and itching in the mouth or genital area (thrush)
  • a skin rash
Information about clarithromycin

The antibiotic Clarithromycin can be used to treat a boil infection if you are allergic to penicillins. Before you start treatment always read the manufacturers leaflet contained with the medication, which contains more information and the potential side effects.

The dose is to be taken twice a day; it is important that you space out the doses evenly during the day. Swallow the tablet with water, and you can take Clarithromycin either before or after your meals.

Keep taking Clarithromycin until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never give your medication to other people even if their condition appears to be the same as yours.

Possible side effects to clarithromycin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then contact us, or speak with your doctor or pharmacist. 

The most common ones (occur in about 1 in 10 people) for Clarithromycin include:

  • feeling sick (nausea) or vomiting
  • diarrhoea
  • redness and itching in the mouth or vagina (thrush)
  • tooth or tongue discolouration, and changes in the way things taste or smell. This will settle once you finish treatment.
  • a headache
Who should not take Clarithromycin

It is important that you tell your doctor in your assessment of all the medical conditions you have, and all the medications you take. Failure to do so can lead to problems with any treatment you are prescribed. Always read the patient leaflet before you take any medication. 

The following groups of people should not take Clarithromycin:

  • those allergic to clarithromycin or macrolide antibiotics
  • those with QT prolongation or ventricular cardiac arrhythmia, including torsades de pointe
  • those with heart disease
  • those with hypokalaemia (low potassium)
  • those with problems with the way your liver works
  • pregnant women or if breastfeeding 

The following medications can interact with Clarithromycin:

  • Statin for lowering cholesterol: you should stop your statin while you are taking Clarithromycin.
  • Colchicine used for gout: clarithromycin should not be taken if you are also taking colchicine. 
  • Warfarin: Clarithromycin can increase the bleeding risk
  • Ergotamine or dihydroergotamine used for migraines: Clarithromycin must not be taken with them
  • Sildenafil, tadalafil or vardenafil: Clarithromycin can increase the levels of the erectile dysfunction (ED) medication in the body. Consider reducing the dose of the ED medication while taking Clarithromycin. 
Allergic reactions to medication

An itchy rash, swollen face or mouth, or difficulty in breathing, may be signs that you are allergic to the antibiotic. 

Please note that i-GP DOES NOT TREAT Medical Emergencies. For Medical Emergencies please call 999.

If you develop a sudden onset of any of the symptoms below then you must STOP the medication immediately and seek urgent medical advice. This could be from your GP, Out of Hours Service, Urgent Care Centre or NHS 111. Call an ambulance using 999 or go to A&E if the symptoms are severe.

  • Wheeze
  • Difficulty in Breathing
  • Swelling of the eyelids, face or lips
  • A rash particularly if affecting your entire body
Complications

Complications of boils are uncommon, however, it is important to be aware of them. There is a small risk that some bacteria from the boil may spread in the bloodstream to cause serious infections of the bone, brain or other parts of the body. 

When to seek further medical advice

Please note that i-GP DOES NOT TREAT Medical Emergencies. For Medical Emergencies please call 999.

If you develop any of the following symptoms, then it is important to seek medical advice as soon as possible:

  • If you develop a persistent high fever (high temperature) which can cause shivers.
  • If the pain becomes worse.
  • If you feel increasingly unwell (this may include nausea and vomiting).
  • If you develop spreading redness affecting your skin around the site of your boil.
  • If you develop any painful, red and hot joints near to the boil.

If you develop any of the following symptoms, then you must seek urgent medical advice immediately (from your GP, Out of Hours Service, Urgent care centre, NHS 111). Call an ambulance using 999 or go to A&E if the symptoms are severe.

  • drowsiness or confusion
  • difficulty in breathing or shortness of breath
  • a severe headache
  • if you develop redness, swelling and warmth around the eye
  • if you are unable to look at bright lights (photophobia)
  • chest pain
  • persistent vomiting
  • neck stiffness
  • non-blanching rash
Help finding NHS services near you

In an emergency call 999 for immediate help for life-threatening conditions.

During working hours you can contact your GP surgery for help or call NHS 111. Alternatively, the following links can help you find Urgent Care Centres or Out of Hours care near you:


England 

Website: NHS Choices or telephone NHS 111


Wales

Website: NHS Direct Wales or telephone NHS Direct Wales on 0845 46 47 or the new 111 Wales Service for Swansea Neath Bridgend & Carmarthen


Scotland

Website: NHS Inform  or call NHS 111


Northern Ireland

Website: Health and Social Care

The contact telephone numbers for out of hours GP services in your area can be found here: NI Direct Government Services

Antibiotic Guardianship

Antibiotics should be used responsibly and only when really necessary. Overuse and misuse of antibiotics can lead to antibiotic resistance. This is where the antibiotic becomes less effective at treating certain types of bacterial infection, so they do not work when needed. 

Antibiotics should be taken as prescribed, and it is important to complete the full course, this can reduce the chance of the bacteria developing an immunity to that antibiotic. It is important not to share antibiotics, and always take unused medication to your local pharmacy for disposal.

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