What are the causes and treatments for boils on the body? Furuncle. An easy way to get rid
Chiriami is commonly called a skin disease of a purulent type, which is characterized by inflammation of the follicle (hair follicle) and surrounding tissues. This is a process of deep skin lesions with visible redness and purulent discharge, with pain.
The cause of the disease is damage by pathogenic microorganisms - staphylococci. The infection penetrates into the subcutaneous layers through microtraumas of the epithelium (cracks, cuts).
Causes of boils
The main cause of boils is a bacterial infection, which can develop against the background of various factors. These include: a significant decrease in immunity, hypothermia, failure to comply with personal hygiene rules, skin damage from chemicals, unhealthy diet, diseases of the digestive tract, metabolic disorders, use of certain medications, and changes in the climate of residence.
The risk of developing boils is much higher in people suffering from diabetes, other chronic diseases, with a lack of vitamins in the body and with a deficiency of ultraviolet radiation (climate specifics). Also in people with heavy physical exertion, lack of proper rest, and prolonged physical fatigue. Because of this, immunity decreases and the body becomes unprepared to cope with the attack of pathogenic microorganisms.
Symptoms of boils
There are three stages of development of chiriev:
Aggregation stage;
Stage of suppuration;
Complete healing stage.
Signs of the first stage of chiria are the appearance of a raised, hard infiltrate and significant redness, which are accompanied by sensations of pain. During the process of inflammation, a node is formed. After some time, the site of the lesion becomes denser, and its boundaries expand, affecting the healthy epithelium. The sensation of pain intensifies, swelling of the surrounding tissues is observed, and the inflammatory process increases.
After 2 - 3 days, the second stage of chiria maturation begins. The compaction takes the shape of a cone and can be up to 3 cm in diameter. A purulent core is formed at the base. The inflammatory focus is visible quite clearly. At this stage, the pain can be quite sharp, especially when moving or bending in the area of the abscess. The state of health worsens due to body temperature, which can rise to 38 ° C, and manifestations of intoxication are also possible.
Soon the suppuration spontaneously or deliberately opens and purulent discharge mixed with blood flows out. After removal of the necrotic rod from the base of the chiria, swelling and pain decrease. The temperature returns to normal, which makes you feel better. Healing occurs over the next 2-3 days with scarring. The color of the scar is initially bluish-red, but over time it changes color, becomes white and invisible. All three stages take an average of 8-10 days.
Diagnostics of chiriev
Diagnosis of boils should be carried out by a dermatologist. He determines the diagnosis based on the results of the examination and dermatoscopy of the affected area. To determine the causes of the appearance and type of the causative agent of the disease, various kinds of research are carried out. Bacterial cultures make it possible to establish the type of microorganisms that cause an infectious disease. Clinical analysis of blood and urine - determines the level of infection. A blood test for sugar, fluorography, ultrasound of the abdominal cavity, kidneys - possible violations of the work of other organs of the patient.
If a need arises as a result of the examination, the patient is referred for a consultation with other specialists. If a complication occurs, the doctor should prescribe additional examinations. Biological culture of blood for sterility with the determination of sensitivity to antibiotics is performed to prevent or diagnose sepsis in time.
Treatment of chiriev
Most often, the body is able to cope with a single boil on its own. Warming and squeezing them is categorically contraindicated, there is a possibility of an even greater spread of infection. To cope with chiria, at the initial stage, it can be treated with specially designed products, essential oils, which by their nature are antiseptics (tea tree oil), salicylic or camphor alcohol.
If chiri progresses, ichthyol is used for local treatment in the form of ointments that are applied to the focus of inflammation, bandaging is not recommended. This helps to speed up the breakthrough of chiria and helps to cleanse the purulent fluid that has managed to form inside. Also, in combination with local treatment, the doctor prescribes a course of antibiotics that speed up the process of eliminating the infection.
In the event that the size of the chiria is quite large or a breakthrough and rejection of the purulent core does not occur for a long time, surgical treatment is resorted to. Chiriy is opened with a scalpel to remove purulent formations and dead tissue. If necessary, drainage can be installed until the remaining suppuration is completely removed. After this, the wound is treated and a bandage is applied with ointments that have antibacterial properties. The dressings are changed until the wound is completely healed.
The opening of chiria should be carried out by a specialist, under appropriate conditions, using local anesthesia or freezing with chlorethylene. Surgery is also combined with a course of antibiotics to help the body cope with the infection. To prevent the recurrence of chiries, physiotherapeutic procedures are used. The patient should be under the supervision of a doctor until complete recovery.
Prevention of boils
In order to prevent chiria, you must follow the rules of hygiene and use antibacterial soap. Even the smallest skin injuries should always be treated with antiseptic agents, and then covered with a plaster or bandages until complete healing. Prevention also includes special care for oily skin, treatment with special products, protection from hypothermia and overheating of the skin.
It is not recommended to clean the ear canals with anything not intended for this purpose. Such cleaning can lead to skin trauma and the formation of chirium in the external auditory canal. It is recommended to eat food with sufficient amounts of vitamins. Good nutrition, timely treatment of chronic diseases, correction of metabolic processes, regular exercise, and a healthy lifestyle are the key to healthy skin.
Expert editor: Mochalov Pavel Alexandrovich| Doctor of Medicine general practitioner
Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".
Furuncle(syn. in everyday life - “ulcer”, “boil”) - this is a type staphyloderma(pustular inflammatory skin disease caused by staphylococcal microorganisms). It is characterized by the development of a purulent-inflammatory process in the hair follicle and surrounding tissue.
Furunculosis– a disease characterized by the appearance of a large number of boils on different parts of the skin.
Carbuncle– a disease in which several nearby hair follicles become inflamed. We can say that these are several boils combined into one. The disease has a more severe course.
Prevalence of boils
pyoderma* - a group of diseases that include boils - are quite widespread. They make up about 40% of other skin pathologies. Patients with boils make up from 4% to 17% of all patients treated in inpatient dermatological clinics.In recent years, the number of patients with boils of the face, especially the nose area, has been increasing.
*Pyoderma is a pustular skin disease. A general concept that unites a large number of different diseases. The two main types of pyoderma are staphyloderma (purulent processes caused by staphylococci) and streptoderma (caused by streptococci).
Anatomy of skin and hair follicles
Human skin is a special organ that covers almost the entire surface of the body. Its area in an adult is on average 1.5 - 2.5 meters. It consists of layers that are tightly connected to each other.Layers of skin:
- Epidermis- the outer layer of the skin. Consists of several layers of epithelial cells. The deepest layer is responsible for cell growth and reproduction. The outer layer, the horny layer, is represented by horny scales and performs a protective function.
- Dermis. It is located under the epidermis and fits tightly to it. Consists of connective tissue. It is the basis for the epidermis, contains blood vessels and nerves.
- Subcutaneous fat. Represented by adipose tissue.
Skin defense mechanisms
- Maintaining a certain level of acidity. The pH level of the skin ranges from 3 to 7. In such conditions, only microorganisms that are representatives of normal microflora can exist.
- Normal microflora. Microorganisms that are normally present on the surface of the skin prevent the proliferation of pathogens.
- Langerhans cell. These are specific immune cells that are found in the epidermis. They take part in providing immune protection, producing interferon And lysozyme– substances that destroy pathogenic microorganisms.
Structure of hair and hair follicle 
Hair– these are keratinized skin appendages. There can be up to 2 million hairs on the human body. hair structure:
- hair shaft- a thin part of the hair that protrudes above the surface of the skin.
- hair root- part of the hair located deep in the skin, in the hair follicle.
At the bottom of the hair follicle is its expanded part. It contains the hair follicle - the club-shaped expanded lower end of the hair. The hair follicle contains cells, the division of which ensures hair growth. A connective tissue papilla grows into the hair follicle and hair follicle. It contains blood vessels and nerves for nutrition and innervation of the hair.
In the upper part of the hair follicle, an expansion in the form of a funnel is also formed - its mouth. The duct of the sebaceous (any hair) and sweat (only hair located in certain areas of the body) gland flows into it.
Sebaceous glands draining into the mouth of the hair follicle
The sebaceous gland consists of an enlarged part, which is directly responsible for the secretion of sebum, and an excretory duct. Sebum has a complex structure. It has bactericidal properties - it can destroy pathogenic microorganisms that fall on the surface of the skin.
Sebum production in humans is mainly regulated by the adrenal glands and sex hormones. The more testosterone is present in the body, the more active the sebaceous glands work.
Sweat glands that secrete secretions at the mouth of the hair follicle
Only specific ducts flow into the mouths of hair follicles. apocrine sweat glands. The final part of the gland that secretes sweat is located deep in the dermis.Apocrine sweat glands are located in the armpits, around the nipples, genitals and anus.
Causes of boils and furunculosis
Who is staphylococcus?
Staphylococcus is a microorganism that is constantly present on the surface of the skin normally, and, at the same time, is capable of causing a wide variety of purulent infections, ranging from boils to severe blood poisoning - sepsis.How can the same bacteria be both harmless (and sometimes even beneficial) and very dangerous?
The fact is that there are different strains of staphylococci. Strain is a group within a species, like breeds in dogs.
Some strains are completely harmless to humans. Other conditionally pathogenic, that is, they are capable of causing infections only under reduced immunity and other special circumstances. Still others always cause illness if they enter the body.
Normally, 90% of staphylococci found on human skin are harmless strains. 10% are pathogenic, but there are so few of them that they are not capable of causing a purulent process. Boils and furunculosis develop in cases where this ratio changes greatly.
What skin features predispose to the development of boils?
- increased sweating: with constant sweat, the structure and protective properties of the skin are disrupted
- scratching and damage caused by other skin diseases and disorders
- frequent skin injuries: abrasions, scratches, abrasions - any infection easily penetrates through these defects
- constant contact of the skin with discharge from the nose and ears in case of chronic diseases: rhinitis, otitis, etc.
- skin contamination, lack of personal hygiene: most often, boils form on the back of the neck, as a lot of dirt and sweat accumulate here, and there is constant friction against the collar
- violations of skin protection as a result of occupational hazards: constant contact with lubricating oils, dust (coal, cement, lime, etc.), aggressive chemicals
Decreased immunity
The normal state of the body's immune forces prevents the penetration of any pathogenic microorganisms into the skin.Factors leading to decreased immune strength and furunculosis:
- severe chronic infectious and inflammatory diseases: tonsillitis, bronchitis, frequent pneumonia, rhinitis and sinusitis, otitis, etc.;
- diseases accompanied by decreased immunity: HIV;
- reception immunosuppressants(medicines intended specifically to suppress the immune system in autoimmune diseases), cytostatics(medicines to destroy tumor cells), the use of radiation therapy;
- hypothermia or overheating;
- insufficient and malnutrition, hypovitaminosis.
Hormonal disorders
Diabetes
Furunculosis can be considered a complication of long-term diabetes mellitus. The disease leads to disruption of blood flow in small vessels. As a result, the skin does not receive enough oxygen and nutrients. Dystrophic processes occur in it, and protective mechanisms decrease. Staphylococci penetrate hair follicles more easily.
Excessive adrenal function
The cortex (outer layer) of the adrenal glands secretes glucocorticoid hormones. They have many effects.
Effects of glucocorticoids on boils:
- immunosuppression, decreased skin protection
- an increase in the production of sebum, which, accumulating on the skin and in the lumen of the sebaceous glands, turns into a breeding ground for pathogens
Testosterone and its analogues enhance the function of the sebaceous glands of the skin.
Stages of boil development
Usually the boil lasts no more than 10 days. After this, it usually goes away completely. There are 3 stages during a boil:| Stage | Characteristic |
| Infiltrative stage | Appears on the surface of the skin infiltrate– an area of swelling, redness and hardness. It is painful, gradually increases in size, reaching an average of 1 - 3 cm. The skin around the infiltrate also becomes swollen and painful. The tingling feeling bothers me. A characteristic feature: an infiltrate always forms around the hair, since staphylococci primarily affect the hair follicle and multiply inside it. At this stage of the boil, the phrase “boil is brewing” is often used in everyday life.  |
| Purulent-necrotic stage | It is observed 3 to 4 days after the first symptoms of a boil appear. A core consisting of pus and dead tissue appears in the center of the infiltrate. Its end protrudes above the surface of the skin in the form of an abscess. At a certain point in time, the thin layer of tissue covering the rod bursts, and pus and dead tissue come out. After this there is a significant improvement. All symptoms decrease: swelling and redness begin to subside, pain no longer bothers you. In common parlance, this condition is referred to by the phrase “the boil has broken through.”  |
| Healing stage | After the pus is rejected, the wound remaining at the site of the boil begins to heal. If the boil was small, then after healing there are no signs left on the skin. Large ulcers leave behind scars.  |
Symptoms of furunculosis
Manifestations of furunculosis depend on the stage of the process, the location of the boil, and the state of the body’s immune forces.Areas of the body where boils are most common:
- face: nose, nasolabial triangle(the area of skin between the nose and upper lip), ear area
- back of the neck: in this case, the fact that the skin of the neck constantly experiences friction in contact with the collar plays a certain role
- forearms
- buttocks and thighs
Symptoms of a boil on the face 
The face is one of the favorite places to localize a boil, since the skin on the face most often has increased oil content and there is a large number of sebaceous glands. The most common boils are the nose, upper lip, and ear canal area. Characteristic symptoms and complaints of patients with nasal boils:
- the boil quickly becomes noticeable, since even with small sizes it leads to a cosmetic defect
- there is severe pain
- pain in the area of the boil intensifies during movements of facial muscles, shaving, washing;
- Facial boils, more often than in other places, are accompanied by increased body temperature and general malaise
- headaches are noted
- small boils resemble blackheads (pimples); attempts to squeeze them out are accompanied by severe pain.
The veins of the facial area are connected to the veins of the skull. When trying to squeeze out a boil on the face, carelessly pressing on it, the work of facial muscles, or a decrease in immunity, the infection can penetrate into the venous bed and lead to the development of thrombophlebitis - inflammation of the walls of the veins with the formation of blood clots. The face becomes swollen, acquires a bluish coloration, and is painful to touch. The general condition of the patient is severely disturbed, body temperature rises to 40⁰C.
Further, the infection can spread into the cranial cavity, leading to meningitis(inflammation of the meninges), meningoencephalitis(inflammation of the meninges and brain matter), sepsis(generalized inflammation).
There is a rule in purulent surgery: boils on the face that are located above the upper lip should be treated with the utmost caution.
Symptoms of a boil under the armpit
Boils in the armpit are relatively uncommon. Another disease is more common here - hidradenitis– purulent inflammation of the sweat gland.In general, a boil in the axillary region is accompanied by the same symptoms as boils in other locations. An increase in pain is noted during movements in the shoulder joints, careless touches and pressure on the boil.
Symptoms of a boil in the groin area and on the lower limb 
In the groin area, boils and hidradenitis may occur. A boil in the groin manifests itself with typical symptoms and goes through typical stages. Conditions that may complicate a boil in the groin area and lower limb:
- Regional lymphadenitis. Inflammation of the lymph nodes located in the area of the boil. It appears as a painful lump under the skin. With a boil in the groin, the inguinal lymph nodes are most often affected.
- Regional lymphangitis. Inflammation of the lymphatic vessel located next to the boil. It appears as a painful cord under the skin. Lymphangitis is often combined with lymphadenitis.
Symptoms of a boil in the genital area
Among the boils that arise in the genital area, the furuncle of the labia majora has the greatest specificity. Most often, its development is associated with bartholinitis– purulent staphylococcal inflammation of the Bartholin glands located in the thickness of the labia majora. Normally, their function is associated with the release of a special lubricant.A furuncle of the labia majora is accompanied by swelling, redness, and severe pain.
Symptoms of a boil in the buttocks and back of the thigh
The largest boils are usually found in the area of the buttocks and thighs. They are accompanied by the most severe symptoms.
Furunculosis 
Furunculosis– a disease that is characterized by the appearance of a large number of boils on different parts of the body or in a limited area (most often on the buttocks, thighs). Furunculosis is also called constant recurrence, when after the healing of boils new ones constantly appear. Types of furunculosis, depending on the severity of the process:
- acute furunculosis: there are many boils on the skin at the same time
- chronic furunculosis: sequential appearance of boils, when some disappear while others appear - this form of the disease usually lasts for a very long time
- disseminated(common) furunculosis: boils are found throughout the body;
- localized(limited) furunculosis: all boils are concentrated in only one limited area.
Causes of furunculosis
The causes of individual boils and furunculosis are described above. Furunculosis almost always occurs against the background of decreased immunity.Symptoms of furunculosis
Furunculosis is accompanied by the same symptoms as a single boil. Each element sequentially goes through three stages of development. But with furunculosis, signs of a violation of the general condition are more pronounced. Malaise and elevated body temperature are noted.Complications of furunculosis
Complications with furunculosis are relatively common.The most common complications of furunculosis:
- lymphadenitis- inflammation of nearby lymph nodes;
- lymphangitis– inflammation of nearby lymphatic vessels;
- sepsis, or, in common parlance - blood poisoning - a severe generalized infectious process;
- meningitis and meningoencephalitis – inflammation of the meninges and brain substance when infection penetrates into the cranial cavity (if the skin of the face and head is affected);
- arthritis – inflammation in the joints (with skin lesions in the joint area);
- glomerulonephritis – inflammatory kidney disease.
Treatment of furunculosis
When should you see a doctor to open a boil?
In most cases, uncomplicated boils do not require surgical treatment. Conservative techniques are used.Treatment methods for uncomplicated boils at the infiltration stage:
- wiping the skin in the area of the abscess with an antiseptic solution, most often with ordinary medical alcohol
- frequent hand washing with soap and antiseptics
- cauterization of the boil itself with iodine solution (5%)
- applying dry heat to the boil (under no circumstances apply compresses to the area of the boil: this helps loosen the abscess and spread it to surrounding tissues)
- UHF therapy
- laser therapy
Treatment methods for uncomplicated boils at the stage of formation of the rod
When the abscess has already formed, you need to help ensure that its opening occurs as quickly as possible.What is important to remember:
- only a doctor after an examination can say exactly what stage the boil is at and whether it is ready to burst
- In no case should you try to squeeze out the abscess yourself: any pressure on the boil can cause it to begin to spread to surrounding tissues
- The doctor applies a bandage with several salicylic acid crystals to the skin in the area of the boil. After some time, they corrode the cover of the boil and contribute to the release of the purulent-necrotic core.
- The doctor removes the purulent-necrotic rod using a thin clamp. This is done very carefully, avoiding pressing on the boil.
When is surgical treatment indicated for a boil?
One of the complications of the boil is subcutaneous abscess(abscess). It is formed when pus spreads into the subcutaneous fatty tissue. Subcutaneous abscess must be opened. Such patients are treated in a hospital setting.Is it possible to squeeze out a boil?
Doing this is strictly prohibited. During extrusion, pus spreads into the surrounding tissues, venous and lymphatic vessels. This can lead to severe complications.It is especially dangerous to squeeze boils on the face.
When should you start taking antibiotics for a boil?
For uncomplicated boils, antibiotic therapy and other general treatments are not prescribed.Conditions for which antibiotic therapy is indicated:
- complications of boils: lymphadenitis, lymphangitis, thrombophlebitis, etc.
- boils located in the facial area
- boils that occur against the background of other serious diseases: diabetes, severe infections, HIV, etc.
| Name | Application |
Penicillins:
| Antibiotics from the penicillin group are the oldest. Many of them are still effective against staphylococci and other microorganisms. Penicillins are broad-spectrum antibacterial drugs. |
Cephalosporins:
| Usually more effective than penicillins. These antibiotics are prescribed most often, as they have a relatively low cost with a pronounced effect. Available in the form of powders for dilution and injection. |
| Gentamicin | It is a fairly powerful antibacterial drug, but has a number of contraindications. Under no circumstances should it be used by children or pregnant women. Available in the form of tablets, injection solutions and ointments. Local forms (ointments) have fewer contraindications. |
| Tetracycline | Broad-spectrum antibiotic. Effective against many types of microorganisms. It can be used for general (in tablets) and local (in the form of an ointment) therapy of boils. |
| Levomycetin | Powerful antibiotic. It is used topically for boils, in the form of an ointment (see below). |
Attention! Self-medication with antibiotics for boils is often ineffective and can lead to negative consequences. These medications must be prescribed by a doctor.
In addition to the use of antibiotics, such general treatment methods as UV therapy and anti-inflammatory drugs are used.
What to do if boils appear frequently? Treatment of furunculosis.
If a large number of boils appear on the body at once, or they occur very often, then this condition is called furunculosis.Self-medication of furunculosis most often does not bring any effect. Improper treatment can lead to further spread of the process and serious complications. To prescribe the correct therapy, you must consult a doctor.
Treatment methods for furunculosis :
| Method | Description |
| UV therapy | Ultraviolet radiation has an antibacterial effect and promotes tissue regeneration. |
| Laser therapy | Effects of laser radiation:
|
| T-activin | Immunostimulant, promotes the formation and activation of leukocytes - immune cells. Treatment with T-activin is carried out under the strict supervision of a physician. |
| Antistaphylococcal immunoglobulin | Immunoglobulins are antibodies that protect the body from foreign antigens. For furunculosis, antibodies produced against staphylococci are used. Treatment is carried out under the strict supervision of a doctor. |
| Interferon | |
| Antibiotics | See above “Antibiotics that are used to treat boils” |
| Rinoleukin | A drug that stimulates the body's general defenses. |
What to do if the boil opens on its own, but a lot of pus flows out of it?
After the boil has opened, it must be washed with hydrogen peroxide and a clean bandage applied. After this, wash your hands thoroughly. Contact your doctor at the clinic as soon as possible.Traditional methods of treating boils
Attention: Improper self-medication can lead to the spread of the purulent process and the development of severe complications. Therefore, before using any traditional methods for treating boils, be sure to consult your doctor.Coniferous baths for boils
Substances that pine and spruce needles contain:
- phytoncides– destroy pathogenic microorganisms
- vitamin C– is an antioxidant, protects cells from damage, increases protective functions
- tannins– tone the skin and close skin pores.
Treatment of boils with aloe leaves
This method is used for ripening boils ( in the stage of infiltration and purulent-necrotic stage) in order to accelerate its breakthrough and rejection of the purulent-necrotic rod.
Aloe is a houseplant that is often grown in pots. It has succulent leaves. To speed up the breakthrough of the boil, their juice is used. The aloe leaf is cut and applied with a cut to the abscess, fixing it with an adhesive plaster. So you need to walk constantly, replacing the aloe leaf 1 - 2 times a day.
Preparation of ointment for boils
Ingredients:
- beeswax – 100 grams
- unrefined vegetable oil – 500 ml
- spruce sulfur – small amount
- lower part of the onion – 10 pieces
Mode of application: Periodically lubricate the areas where boils occur.
Treatment of boils with garlic
Substances contained in garlic:
- phytoncides – destroy pathogenic microorganisms;
- adaptogens – tone living organs and tissues, help increase defenses.
Method 2. Grate a clove of garlic. Apply to the boil and secure with adhesive tape. Walk like this for a day until the abscess matures and breaks through.
Ointments for furunculosis
For furunculosis, ointments containing antibacterial drugs are mainly used.| Gentamicin | Description: Ointment in tubes, from 15 to 80 g. Gentamicin is an antibiotic that is effective against many types of infections, including staphylococcal. Mode of application: Apply to the location of boils 2 – 3 times a day. Usually the course of treatment lasts 7–14 days. |
| Tetracycline | Description: Tetracycline is a broad-spectrum antibiotic. Effective against many types of microorganisms, including staphylococci. Available in tubes of 100 g. Method of application 1. Apply a small amount of ointment to the areas Method of application 2. Apply bandages with tetracycline ointment. Change every 12 – 24 hours. |
| Levomycetin | Description. Levomycetin is a powerful antibiotic that has a pronounced effect in purulent processes. Available for local cutaneous use for furunculosis in the form of liniment (a thick mass like an ointment). Sold in tubes of 25 and 30 g, in cans of 25 and 60 g. Mode of application: Make bandages with chloramphenicol liniment, change once a day. |
| Levomekol | Active substances:
Mode of application: Soak a sterile gauze pad with ointment and apply it to the wound. Put on a bandage. Perform dressings daily. |
| Sintomycin | Description. Syntomycin is an antibiotic, which in its chemical structure is very similar to chloramphenicol. Also available in the form of liniment, in 25 g jars. Mode of application. Apply liniment to the area where the boil is located. Put a bandage on top. Perform dressings daily. |
| Dimexide | Description. A medication belonging to the group of non-steroidal anti-inflammatory drugs (NSAIDs). Eliminates inflammation and pain. Mode of application: Moisten a sterile gauze pad with dimexide. Apply to the location of the boil and apply a bandage. Do dressings daily. |
The effectiveness of ichthyol ointment in the treatment of furunculosis
Ichthyol ointment is an ointment prepared on the basis of the active component ichthyol. It has anti-inflammatory, antiseptic and analgesic effects. Ichthyol ointment is widely used in the treatment of boils.
The antibacterial properties of ichthyol ointment apply to all strains of streptococci and staphylococci.
The pronounced analgesic and anti-inflammatory effect of ichthyol ointment appears several hours after its application to the surface of the boil.
Method of using ichthyol ointment for furunculosis
The required amount of ichthyol ointment is applied to the surface of the boil so that it covers the abscess in the form of a cake. Place a cotton swab on top and stick it with an adhesive plaster. The tampon should be changed every 8 hours. After about a day there is improvement.The effectiveness of Vishnevsky ointment in the treatment of furunculosis 
Vishnevsky ointment(full name - balsamic liniment according to Vishnevsky) is a combined drug with a complex composition and several active components. Basic steps: disinfectant, irritant. Vishnevsky ointment destroys many types of pathogens. By irritating the skin, it stimulates tissue regeneration. With a boil, Vishnevsky’s ointment helps soften the walls of the abscess and allow it to penetrate deep into the tissue. This creates a threat of development of a subcutaneous abscess - an abscess. Therefore, the use of Vishnevsky ointment for boils is not practiced.
Why does a boil occur and how does it manifest itself in a pregnant woman?
Pregnancy is a condition during which the expectant mother often remains defenseless against many ailments and microbes.Reasons for development
Basically the same as in other patients: an infection gets into the skin in the presence of certain predisposing factors - for example, friction of clothing, foci of chronic infection, endocrine diseases and others.However the expectant mother is at risk two additional factors:
- Under the influence of hormones that are produced during pregnancy, physiological decrease in immune activity future mother. Thanks to such hormonal changes, the pregnant woman’s immune system “does not see” the fetus - a “stranger” to her own body. This condition is necessary to maintain pregnancy so that the mother’s immune system does not reject the fetus.
- When carrying a future mother provides the fetus nutrients, minerals and vitamins. Therefore, they need additional input from outside. However, if this does not happen, then the pregnant woman’s immune system activity decreases even more.
Symptoms
In its development, the boil usually goes through all the stages typical of it. That's why local signs the diseases are the same as in other patients: a dense red tubercle appears, a rod forms, a boil opens (either independently or surgically), the wound heals.However, taking into account the hormonal changes in the body of the expectant mother general symptoms The diseases are sometimes somewhat more pronounced: body temperature often rises, general malaise and headache appear.
Why is a boil dangerous during pregnancy?
Microbes can harm both the expectant mother and the baby.For mother
A weakened immune system sometimes causes Bacteria are more easily carried in the bloodstream to other areas of the skin and organs, causing the development of furunculosis or complications (meningitis, lymphadenitis, sepsis and others).For the fetus
There is a high risk of infection of the membranes and fetus. Moreover, the consequences depend on the duration of pregnancy.In the first trimester
The formation of internal organs is disrupted, which leads to the formation of congenital malformations: heart, kidneys and others. Moreover, they are often incompatible with life, so a miscarriage occurs.
In the second trimester
- Intrauterine infection of the fetus mainly manifests itself after birth. When the lungs are damaged, pneumonia or pleurisy develops, the heart - carditis, the meninges - meningitis and others.
- When the membranes become infected, fetoplacental insufficiency develops (a syndrome in which all functions of the placenta are disrupted). As a result, the fetus experiences oxygen starvation, its growth and development are delayed, and the risk of premature birth increases.
- There is a high probability of developing mastitis in the mother after the birth of the child.
What are the causes of chronic furunculosis?
Common factors contribute to the formation of the disease:- Severe disturbances in the functioning of all parts of the immune system - for example, with HIV infection, congenital immunodeficiency.
- At taking medications to treat tumors- cytostatics that disrupt the division and development of all cells in the body, including tumor cells.
- For autoimmune diseases(psoriatic arthritis, rheumatoid arthritis, systemic lupus erythematosus) drugs are used that suppress the activity of the immune system (Arava, Methotrexate, Metypred).
- Diseases of the gastrointestinal tract: chronic gastroduodenitis, chronic cholecystitis, erosive bulbitis and others.
- Disturbance of normal intestinal microflora with a predominance of coccal forms, which include Staphylococcus aureus.
- The presence of foci of chronic infection. Most often - ENT organs: tonsillitis (tonsillitis), sinusitis, pharyngitis and others.
- Endocrine diseases, causing disturbances in carbohydrate metabolism (diabetes mellitus), the production of hormones by the thyroid gland (thyroiditis) and sex glands (hypogonadism, amenorrhea).
- The presence of allergic diseases or a tendency to allergic reactions: bronchial asthma, allergy to house dust and others. Because in these cases the functioning of the immune system is also impaired.
What are the symptoms of chronic furunculosis?
Most often, the disease occurs in a relapsing form - when, after a period of imaginary well-being (remission), signs of the disease reappear.The course and manifestations of the disease are determined by the degrees of severity
What are the causes of boils in children?
Due to the characteristics of the body, the disease occurs somewhat more often in children than in adults.The main “culprit” of the boil is Staphylococcus aureus. However, normally its reproduction is restrained by the immune system. Whereas with the combined influence of certain local and general factors, the disease develops.
Local factors
- Constant rubbing of clothes or minor skin injuries(abrasions, abrasions, scratches), which is not uncommon in children.
- Allergic diseases such as atopic dermatitis. There is dry skin, erosions and peeling appear on the skin, the child scratches the skin due to itching, and the functioning of the immune system is disrupted.
- Close contact with contaminated objects- for example while playing outside or in the sandbox.
- Features of the structure of the skin: Children have a thin upper (horny) layer of skin, it has a well-developed network of capillaries and blood supply. Therefore, any microbes enter the skin easily, and then quickly spread through the blood or lymph flow to other areas.
- Non-compliance with personal hygiene leads to children introducing bacteria into a wound or abrasion with unwashed palms.
General factors
- Presence in the body foci of chronic infection, in which colonies of staphylococci live (isolated cluster). From them, through the blood and/or lymph flow, bacteria are spread to all organs and tissues, including the skin. The leading diseases are from the ENT organs: chronic tonsillitis, sinusitis (sinusitis, frontal sinusitis).
- Imperfect immune system, which matures in the process of growing up. Therefore, microbes easily penetrate the body without encountering obstacles on their way.
- Endocrine disorders. In children and adolescents, as a rule, hormonal instability of the body plays a large role in the occurrence of boils.
Under the influence of sex hormones, the work of the sebaceous glands is disrupted. Increased production of sebum begins, which leads to blockage of the outlet (mouth) of the sebaceous glands of the hair follicle (sac). In such conditions, the infection is easier to join. In addition, sebum is an excellent breeding ground for staphylococci.
However, often other endocrine diseases contribute to the development of furunculosis in adolescents and children - for example, diabetes mellitus or dysfunction of the thyroid gland. - Gastrointestinal diseases: gastritis, colitis, ulcers and others. Digestion of food is disrupted, as is the supply of microelements and vitamins to the body. In addition, Staphylococcus aureus may be present in the intestines.
- Anemia, lack of vitamins and nutrients, physical or emotional stress, anorexia in adolescents(decreased appetite, deliberate refusal to eat) lead to disruption of the immune system.
- The intensive work of the sweat and sebaceous glands is due to immaturity of thermoregulation processes in children under seven years of age. As a result, sweat and sebum quickly accumulate on the surface of the skin. According to research, under such conditions, local immunity decreases, and the protective function of the skin decreases by 17 times.
- Helminthiasis reduce the activity of the immune system, which is quite common in children.
What are the symptoms of boils in children?
A boil can develop on any area of the skin where hair is present, since the disease affects the hair follicles and the adjacent sebaceous gland.Whereas a boil never forms on the skin of the palms and soles, since there is no hair in these areas.
There are two forms of the disease:
- A large single abscess appears on a limited area of skin. In this case, with timely and adequate treatment, recovery usually occurs within 8-10 days.
- Furunculosis develops: Many boils appear on the skin. The disease can be acute or chronic in its course.
Single boil in children
A large abscess appears, which in its development goes through the same stages as in adults.However In children there are some differences in the course of the disease:
- As a rule, several symptoms are more pronounced intoxication: The body temperature rises to high levels (38-39°C), general malaise appears, the child refuses to eat, and complains of a headache.
- Despite the rapid course of the disease, usually cure in children occurs in a shorter time than in adults. In addition, a chronic process develops less often.
- Furuncle in children of wounded age(up to three years) is most often located in places that are difficult to access for treatment - for example, at the base of the nasal passages.
Whereas preschoolers and junior schoolchildren boils are mainly located on the nose (clips, back and base of the nasal passages), forehead, cheeks and chin.
In other areas of the skin, boils develop less frequently. - Due to the location of boils, as well as abundant and good blood supply to the skin, there is high risk of infection from the primary focus with the development of acute furunculosis or complications (sepsis, thrombosis of the cavernous veins and others).
Furunculosis in children
Ulcers can appear either in the form of separate clusters on a certain area of the skin or spread to other areas.Acute furunculosis in children
There are several boils on the skin that appear almost simultaneously. Therefore, they are at the same stage of development.
In this case, as a rule, the child’s general condition is sharply disturbed: he becomes lethargic and refuses to eat, his body temperature rises to high levels and is difficult to lower.
In this case, the course of the disease usually resembles a severe infectious process. Moreover, the general trend is as follows: the younger the child, the more severe the disease.
Chronic furunculosis in children
Typically, boils are at different stages of development: at the same time, red bumps, ulcers, and wounds can be seen on the skin after the pus is rejected.
However, most often the disease occurs in a relapsing form: periods of exacerbation alternate with periods of apparent well-being (remission).
The general condition of the child is usually disturbed when new boils appear, resembling the acute course of the disease.
How to treat chronic furunculosis?
This task is quite difficult, since numerous factors lead to its development. Therefore, an integrated approach is required.Basic principles
1.
Local and general treatment is carried out depending on the stage of development of the boil and the complications that have developed. At the compaction stage - local treatment with antiseptics, ultraviolet radiation, applications with antibacterial ointments. At the stage of rod formation, if necessary, the boils are opened, drained, treated with antiseptic solutions, and bandaged with antibacterial ointments are applied. When indicated, antibiotics are prescribed taking into account the sensitivity of the microbe to them. 
2.
Impact on the underlying disease
It is carried out at any stage of development of furunculosis: treatment of foci of chronic infection, diseases of the gastrointestinal tract, endocrine diseases (for example, diabetes) and others. Therapy is carried out by specialized specialists: ENT doctor, endocrinologist, gastroenterologist and others. 
3.
Improving immune system function
An immunologist prescribes medications depending on the type of immune system disorder and the stage of the disease. With timely treatment, chronic furunculosis is cured in 80% of cases within 1-2 months of treatment.
How to increase immunity during furunculosis?
Immunostimulating drugs are prescribed as part of complex treatment.During an exacerbation
| A drug | Mechanism of action | Directions for use and duration |
Polyoxidonium |
| Intramuscularly 6-12 mg once a day. In tablets for resorption under the tongue 2-3 times a day, half an hour before meals. The dose for adolescents is 12 mg, for adults 12-24 mg. The course is 6-12 days, and sometimes longer. |
Galavit |
| Daily for adults and children over 12 years old - 100 mg, for children under 12 years old - 50 mg. The drug can be taken in injections, suppositories or tablets. Course - 15 days. |
| Myelopid |
| 3-6 mg intramuscularly daily or every other day. Course - 3-5 injections. |
| Immunoglobulin class G preparations: Octagam, Gabriglobin, Intraglobin (used when Galavit is ineffective) | Compensate for the deficiency of class G immunoglobulins (IgG), which provide long-term immunity against pathogens of many infections. Moreover, for each microbe or virus in the body, its own IgG is produced. | Drugs are administered intravenously only in a hospital setting. The dosage and duration of treatment depend on the specific drug used and the course of the disease. |
During remission- during the period when there are no symptoms of the disease
| A drug | Indications | Dosage and administration |
| Polyoxidonium | Discussed above | Discussed above |
| Galavit | Discussed above | Discussed above |
| Lycopid |
| Dissolve under the tongue half an hour before meals. The dosage depends on the severity of the disease and age. The duration of treatment is about 10 days. If necessary, longer. |
Drugs of the future: Neogen and Seramil
Medicines are not yet widely used. However, according to recent studies, their use has reliably established positive changes in the functioning of the immune system.
When using Neogen in remission:
1. The number and ratio of T- and B-lymphocytes are normalized.
2. The activity of phagocytes against Staphylococcus aureus increases.
3. The level of CD4 cells normalizes .
Treatment regimen: daily administration of 1 ml of a 0.01% solution intramuscularly. Course - 10 injections.
When using Seramil at the stage of remission and / or exacerbation:
1. The level of B-lymphocytes is normalized.
2. The content of CD8 lymphocytes, the cells of the immune system, which normally complete the body’s immune response when the “stranger” has already been destroyed, decreases. However, with an excess of CD8 lymphocytes, the immune system completes its work much earlier, before it can cope with the microbe or virus. Therefore, it does not fulfill its main function - protective.
Treatment regimen: intramuscular administration of 5 mg of the drug. Course - 5 injections.
How to treat a boil for pregnant women?
The difficulty is that during pregnancy most drugs are prohibited for use because they have a negative effect on the fetus.Local treatment
Tactics depend on the stage of development of the boil, which is no different from the treatment of other patients.However, in this case, only drugs are used approved for use during pregnancy:
- Antiseptics- drugs that prevent or suppress the growth of bacteria - Betadine (only up to 12 weeks of pregnancy), Chlorhexidine.
- Ointments- Levomekol, Ichthyol, Synthomycin.
General treatment
Antibiotics are prescribed that are approved for use during pregnancy, taking into account the period: penicillins (Amoxiclav, Ampicillin), cephalosporins (Cefazolin, Ceftriaxone, Suprax, Cefepime), macrolides (Erythromycin, Rovamycin, Vilprafen).However, antibiotics are only used in case of emergency:
- When complications develop - for example, lymphadenitis (inflammation of the lymph nodes), lymphangitis (inflammation of the lymphatic vessels) and others.
- If the boil is located in a dangerous place: face, neck, scalp.
- With acute or chronic furunculosis.
- In the presence of common diseases - for example, diabetes mellitus, HIV infection, pyelonephritis and others.
Treatment of foci of chronic infection
The most common “place of residence” of Staphylococcus aureus is the pharynx and nasopharynx. The microbe is detected by sowing from the nasopharynx.Local processing
1.
Antiseptic solutions are used, which are approved for use during pregnancy and also inhibit the growth and reproduction of Staphylococcus aureus.
- Alcohol solution used for gargling. Before use, it is diluted as follows: one teaspoon per 200 ml of warm water.
- Oil solution the pharynx, back wall of the pharynx, tonsils are treated and the nasal cavity is instilled.
- Spray The mouth, throat and nose are irrigated.
2. Used staphylococcal bacteriophage which is safe for the fetus:
- The nasopharynx is irrigated: two or three pipettes of the solution are inserted into each nasal passage. Anything that gets into your throat should be swallowed.
- Then you should leave a cotton swab soaked in the bacteriophage in the cavity of each nostril for 5-7 minutes.
Moreover, both drugs are also good because they carriage of staphylococcus in the intestines they can be used internally.
How to protect the fetus from infection?
Sometimes carried out immunization with staphylococcal toxoid at 32, 34 and 36 weeks of pregnancy. To do this, 0.5 ml of the drug is injected subcutaneously at the angle of the scapula.What vitamins should I take for furunculosis?
Vitamins A and E improve skin nutrition and wound healing, promote cell renewal, and participate in protein synthesis.Vitamin C increases the body's resistance to infections, improving the functioning of the immune system.
B vitamins normalize the functioning of the stomach, intestines, liver, endocrine glands (for example, thyroid), nervous system, participate in protein synthesis and other processes.
It is not difficult to compensate for the deficiency of such a number of vitamins at the same time. Since the modern pharmaceutical industry offers a large selection combination vitamin preparations, also containing minerals such as iron, calcium and others. For example Vitrum, Multi-Tabs, Centrum. 
However, practice proves that it is still better take vitamins separately, in small courses.
For example, drugs with B vitamins- brewer's yeast, Milgamma, Neurobex, Tricortin and others. You can also compensate for the deficiency of B vitamins by taking biologically active supplements - for example, Mega B Complex, B vitamins - dietary supplement "Tiens".
Vitamin C or ascorbic acid available in tablets or dragees with similar names.
How is a boil treated for diabetes?
In compliance with key principles: local treatment, prescription of immunostimulants, vitamins and other drugs.However, in diabetes mellitus the main emphasis is on normalizing metabolism and carbohydrates: diet therapy (discussed in the section below) and prescription of medications.
Type II diabetes mellitus (non-insulin dependent)
Insulin is produced. However, cell receptors (proteins with which the substance binds to penetrate inside) in organs and tissues either do not respond to it or their sensitivity is reduced. Therefore, the flow of glucose into cells is impaired.Two groups of medicines are prescribed:
- Drugs that increase the sensitivity of cell receptors to insulin and reduce the absorption of glucose from the intestine: Glucophage, Metformin.
- Drugs that stimulate pancreatic cells to synthesize insulin - for example Gliclazide, Diabepharm, Maninil and others.
Type I diabetes mellitus (insulin dependent)
The pancreas either does not synthesize insulin or produces it in insufficient quantities. In this case, replacement therapy is prescribed with the selection of an individual dose.There are insulins that have different effects in duration: short, medium and long.
Ideally, the patient should receive long-term and/or intermediate insulins throughout the day. In this way, a dosed supply of insulin into the body is achieved, which imitates the normal functioning of the pancreas.
While short-acting insulins are usually used only when necessary: for example, before eating a large meal or a small dose of alcohol.
However, unfortunately, such treatment is quite expensive. Therefore, patients often “sit” on short-acting insulin for many years, which aggravates the course of diabetes mellitus and leads to the development of complications.
Diet therapy during treatment is aimed at improving the functioning of the immune system, normalizing metabolism, fighting infection and accelerating the recovery of the skin. Moreover, such a diet resembles nutrition for diabetes, but correction is still required.
1. Simple carbohydrates: sugar and sweets, pasta, cakes, pastries, alcohol, watermelon, banana, grapes and others. They contain carbohydrates (glucose), which are instantly absorbed into the blood from the intestines. We need carbohydrates in moderation as a universal source of energy for all processes occurring in the body.
However, when there is an excess of them in the body, completely different mechanisms are triggered, which lead to metabolic disorders, which impairs the functioning of the immune system. In addition, glucose entering the tissues from the blood is an excellent nutrient medium for Staphylococcus aureus.
2. Undesirable fried, salty, sour and spicy dishes. Because their consumption disrupts the functioning of the gastrointestinal tract.
As a result, the absorption of vitamins, microelements and nutrients, which are necessary for the full functioning of the immune system and the body as a whole, is reduced. In addition, with such a diet, the number of beneficial bacteria in the intestines decreases, which leads to increased growth of pathogens.
3. Extractives, which go into solution when cooking meat, fish, vegetables and mushrooms (broth). Because they increase the production of gastric and intestinal juices, stimulating digestion, increasing the load on the gastrointestinal tract.
In addition, they are quickly absorbed into the blood and increase the load on the liver and have an irritating effect on the skin.
4. You should avoid foods that are known to cause an allergic reaction: chocolate, citrus fruits, products containing preservatives and/or dyes, eggs and others .
1. With a high content of easily digestible proteins: boiled meat and egg white (if you are not allergic to them), lactic acid products (cottage cheese). Proteins are the building material for our tissues, which is important for the full functioning of the immune system and the body as a whole. 2. Vegetable fats(sunflower, olive oil). They have a high content of vitamins A and E, which improve wound healing, weaken allergic reactions and increase the body's resistance to infections.
3. Animal fats(butter) is better to limit, but not completely exclude from the diet.
4. Fresh vegetables and fruits- sources of vitamins and microelements that are necessary for the functioning of the immune system and wound healing. In addition, they improve the functioning of the digestive system.
5. If there are no problems with the gastrointestinal tract, you can use legume dishes(beans, peas). They contain a lot of plant proteins, vitamins (A, B, C and group B), minerals (magnesium, calcium, sodium).
6. Dried fruits(raisins, dried apricots, prunes, figs) replace sweets and are sources of vitamins and microelements (potassium, vitamin A, groups B and C). They also contain fiber, which improves the functioning of the digestive tract.
7. Porridge is useful(oatmeal, buckwheat, pearl barley, millet), which contain a lot of vitamins, minerals and amino acids (building blocks for protein).
8. Spices. Previously, it was believed that their use should be limited or eliminated in case of furunculosis. However, studies were conducted at the Chita State Medical Academy that proved that some spices can suppress the growth and reproduction of Staphylococcus aureus in the intestines. These include turmeric, red pepper, mustard and cloves.
9. You can replace sugar sorbitol or xylitol. Moreover, xylitol is preferable because it also regulates the metabolism of fats and carbohydrates.
You can also use natural sweetener- stevia and extract from its leaves. In addition to adding sweetness to dishes, it also has a lot of useful properties: it normalizes the metabolism of fats and carbohydrates, contains vitamins (B1, B2, C, precursors of vitamin A), and lowers cholesterol in the blood.
The resulting acute inflammatory process affecting the hair follicle, sebaceous gland and connective tissue is called a boil. The main source of the disease is considered to be Staphylococcus aureus.
The causes of the development of inflammation can be both disorders of the autoimmune system and a number of diseases that precede the development of the process:
How many days does it take for a boil to mature? The estimated time is about a week, from the moment of infection to the beginning of the separation of purulent contents. The complete healing process takes place over a period of about 2 weeks. If the boil does not go away for more than 10 days, you need to seek medical help.
What can I do to make the abscess break faster? In order for the boil to ripen faster, without taking a long period, different types of therapies will help speed up the process. If the allotted time has passed and the boil does not open, you need the help of a surgeon.
Can a boil last a long time? Why does it take so long? The process of ripening of an abscess goes through several stages:
- Infiltration – counted from the moment the infection penetrates the layers of the dermis. Initially it manifests itself as hyperemia with swelling and pain, without definite boundaries. At the site of injury, itching, pain when pressed, and local pulsation are felt. Swelling depends on the number of blood vessels passing through the affected areas. The development time of the stage is about 4 days, with a gradual transition to the secondary stage. During this period, enlarged lymph nodes are detected.
- Maturation is indicated by the appearance of a purulent core. The boundaries of the lesion are clearly marked, the head of the rod is clearly visible. The secondary maturation time is 4 days, then there is a gradual decrease in the level of inflammation. The result of the stage is a mature boil. Pus begins to come out.
- Autopsy - after a week, the formation is opened independently (breakthrough of the boil), with the removal of purulent contents and gradual cleansing of the wound surface. Over time (after it bursts), after the final cleaning of the wound, self-healing of the tissue occurs, with the formation of a scar. Traces of necrotic changes practically do not disappear - the skin becomes hard, with a slight bluish tint.
How long can a boil take to heal? With the normal development of the disease, the entire process (with breakthrough) will take from 10 to 14 days; if you use auxiliary therapy, the cure will take about a week. It all depends on the general condition of the body and the functioning of the immune system.
Complications when a boil occurs can arise from attempts to independently squeeze out the abscess - the process may further spread through the tissues and purulent bacteria enter the bloodstream.
If he doesn't mature
If the maturation of the head of the boil at the first stage lasts for more than four days, you should seek professional help. Postponing a visit to the doctor can result in:
- critical temperature levels;
- spread of the inflammatory process;
- abscesses;
- vascular thrombosis;
- meningitis;
- sepsis, etc.
When contacting a medical institution, a diagnosis will be made to determine the causative agent (the root cause), based on the results of which symptomatic treatment will be prescribed. If the boil does not break out, be sure to inform your doctor.
How to speed up maturation
What to do if the boil does not ripen? First you need to make an adjustment:
- nutrition - remove sweet, fried, salty, spicy, smoked foods from the daily diet;
- take vitamins, minerals and dietary supplements (yeast);
- normalize the amount of water consumed - up to 2 liters per day;
- practice body hygiene at least once every 24 hours.
Drug therapy
What if the boil does not ripen? The process of boil maturation can be accelerated by:
- ultraviolet irradiation - prescribed to increase immunity and destroy harmful microorganisms, regenerate damaged cells, improve oxygen supply;
- thermal effect - to accelerate the removal of purulent contents from the wound;
- wiping the skin around the abscess with antiseptic drugs - hydrogen peroxide, boric alcohol, iodine, salicylic acid;
- applying applications containing ointments - "Ichthyol", "Vishnevsky", "Tetracycline", "Erythromycin" - to accelerate the process of ripening of the boil;
- applying dressings with antibiotics - used after the opening of the abscess (after the rod has come out), to stop the spread of the inflammatory process and disinfect dead tissue.
If within 7 days the patient understands that the boil does not want to open (break through), the duration of the process is longer, then he needs to consult a surgeon.
Surgical procedures
If the boil does not go away for a long time, despite conservative treatment, then they resort to the help of a surgeon. The doctor performs local anesthesia and opens the growth with a scalpel. After opening, the wound surface is cleaned of pus, the necrotic core and dead tissue are removed.
A drainage is inserted into the wound for five days, after which it is removed (on the 5th day). The surgical field is covered with a bandage with an antiseptic solution, additionally moistened with antibiotic ointment. At the same time, a course of antibiotic therapy, vitamins and immunomodulators is prescribed.
The secondary method is to remove the boil with a laser - to speed up the healing process, the abscess is burned out with a laser, along with the necrotic contents. The entire treatment period takes place in one procedure and takes no more than half an hour. This manipulation is considered the most modern and safe, not leaving ugly scars after healing.
What to do at home
To make the boil open faster, the affected area can be lubricated with folk remedies:
- applying to the affected surface of aloe leaves, cabbage, grated beets;
- anoint the affected area with aloe juice;
- treatment with a baked onion - after baking, it should be cut in half and applied to the sore spot, etc.
After how many days can treatment be done with folk remedies? From the very beginning, from the moment redness appears on the skin. When opening a formation, these methods are not recommended. The disease should go away within 7 days.
If a boil develops on the face, then home therapy is not suitable - in order to avoid an unsightly scar, it is better to seek medical help. Boils break through the skin, purulent masses come out, and after healing the tissues become scarred. The face cannot be covered with clothes, and such scars do not decorate anyone.
Preventive actions
- Maintain hygiene standards at all times;
- avoid damaging the leather surface with synthetic or rough clothing;
- use products that reduce sweating;
- Check your blood sugar levels periodically
- carry out seasonal vitamin therapy;
- normalize the daily routine;
- avoid constant stressful situations;
- to cure colds in time, without translating them into chronic forms;
- for any damage to the dermis (scratches, splinters, small cuts), treat with special antiseptic preparations;
- reduce the use of antibacterial soap.
To prevent the development of complications with existing furunculosis, there are separate rules of conduct:
- it is forbidden to heat the site of inflammation with heating pads, hot objects;
- for the period of the acute phase, it is necessary to refuse to take baths and visit saunas;
- constantly take a shower - at least once a day;
- do not touch the affected area, do not comb;
- If additional foci of formation appear, seek qualified help.
Summarizing
After we have dealt with the main stages of the ripening of boils, it remains to understand what the danger is of opening an immature abscess on your own. Some patients try to squeeze out an interfering pimple to speed up the maturation process.
It is categorically not recommended to do this - breaking through inside, the pus will fall on the surrounding tissues and into the bloodstream. Self-medication in this case threatens necrosis of surrounding tissues and blood sepsis. Without timely treatment, sepsis will lead to the death of the patient.
How dangerous is treatment at home? A ripening boil can burst both outward and inward. The opened abscess will slowly melt the necrotic core, simultaneously melting the adjacent tissues. What should be done in this case? Urgently seek help from your local clinic.
A furuncle is an inflammatory disease of the hair bulb (follicle), accompanied by the formation of a large amount of pus and necrosis (death) of the tissue of the bulb itself, the adjacent sebaceous gland and the surrounding connective tissue base of the skin. The popular name for this disease is boil or abscess. It is caused by pyogenic microorganisms, most often bacteria of the St. aureus (Staphylococcus aureus).
The disease can also be caused by other common microorganisms, for example, epidermal and saprophytic staphylococci, as well as group A beta-hemolytic streptococcus.
Causes
Staphylococcus aureus is part of the normal microflora in many people, without causing disease. However, under certain conditions, it penetrates the skin and begins to multiply in it, causing inflammation.
Causes of boils:
- skin contamination, especially with petroleum products, machine oil;
- scratches, abrasions, scratches, other damage, including microscopic (for example, from metal shavings or shaving);
- increased sweating associated with illness or caused by exposure to a warm, humid environment;
- presence of suspended cement, coal, mineral dust in the air;
- excessive secretion of sebum, which is also observed in adolescents during puberty;
- diabetes mellitus, which inhibits the activity of skin immune cells;
- lack of vitamins or protein;
- immunodeficiency of various origins - both congenital and acquired under the influence of drugs (immunosuppressants, cytostatics) or viral infection (human immunodeficiency virus).
Hypothermia, stress, lack of sleep and other nonspecific factors that deplete the body's defenses contribute to the occurrence of a boil.
External manifestations of a boil
It can be located on any area of the skin where there is hair or hair follicles. However, its most common location is on the face, neck, occipital region, back, lower back, buttocks and thighs, as well as on the back of the hand.
What does a boil look like: in its course it goes through certain stages associated with the development of the process of purulent inflammation.
Stages of the disease:
- infiltration;
- formation of a purulent-necrotic core;
- opening;
- cleansing, healing.
At the very beginning, a pustule - a small bubble - appears at the mouth of the hair follicle. Then a vaguely limited swelling and thickening of the skin (infiltrate) appears, having a bright red color and raised above the surface of the skin in the form of a small cone. A painful nodule forms in the thickness of the infiltrate. Over the course of several days, the compaction grows, the redness spreads to the surrounding tissues, and in the outbreak itself the skin becomes purple in color.
For a single process, the symptoms of intoxication are uncharacteristic, the patient’s well-being does not suffer, and the body temperature does not rise.
After 3-4 days, the tissues in the center of the cone die off, that is, necrosis occurs. Dead tissues, immune cells, and bacteria form pus, which forms a rod that has a greenish color. At the same time, a softening (fluctuation) forms at the top of the boil, and then it opens. This is how the formed necrotic core becomes visible.
The opened boil releases a large amount of pus, often mixed with blood. Within 2-3 days of this process, the necrotic rod comes out of the wound (rejected). At the same time, the swelling and pain of the surrounding tissues decreases quite quickly. In its place, a deep wound or ulcer remains, bleeding moderately for some time. It quickly fills with granulation tissue and heals with the formation of a scar within 2-3 days.
How long does it take for a boil to mature?
The entire described cycle takes 8-10 days, half of which is occupied by the process of infiltration and formation of a purulent-necrotic core, and the second half by the opening, cleansing and healing of the abscess.
Special forms of boils and their consequences
There are some types of boils that require special attention from doctors. These include ulcers located on the nose, under the eyes on the cheeks, in the area of the nasolabial folds and upper lip. This localization is characterized by severe pain when talking, chewing, and facial movements. Patients are often bothered by headaches, a feeling of weakness, and fever. Only after opening the boil does the patient’s well-being improve.
Furuncle on the face
Dangerous of developing severe complications. In this anatomical area, a network of lymphatic and venous vessels is developed, into which pathogenic microorganisms enter from the source of inflammation. The inflammatory process also begins there - thrombophlebitis. With the flow of venous blood, the infection enters the venous sinuses (extensions) of the dura mater. Thrombosis of the sinuses occurs, and purulent meningitis occurs - inflammation of the meninges.
This complication is accompanied by rapidly increasing swelling of the face, in which compacted painful veins can be felt, fever, and deterioration of the general condition. Subsequently, vision and consciousness are impaired, and stiffness of the neck muscles appears. If medical assistance is not provided at this time, the patient may die.
Abscess boil
A condition in which purulent inflammation spreads to the surrounding skin with its necrosis and the formation of extensive ulcers - abscesses. The process is accompanied by a deterioration in general condition, fever, thinning of the skin, and the appearance of foci of fluctuation under the skin. Such inflammation is also fraught with the development of complications.
Why is a boil dangerous? In severe cases of the process, usually found in patients with diabetes, the following complications may develop:
- (multiple ulcers);
- lymphangitis and lymphadenitis (inflammation of the lymphatic vessels and nodes);
- thrombophlebitis (blockage and inflammation of the veins);
- phlegmon and abscess of soft tissues (extensive purulent fusion);
- sepsis and metastatic abscesses (microbes enter the blood and form purulent foci in other organs).
Without medical intervention, such diseases can lead to sepsis (blood poisoning) and an unfavorable outcome.
Diagnostics
Recognizing a boil is usually easy. The doctor must distinguish it from hidradenitis (inflammation of the sweat glands), folliculitis (superficial pustules on the skin), erythema nodosum (painful nodes under the skin), lesions due to tuberculosis, actinomycosis, deep trichophytosis, anthrax.
With recurring boils, it is necessary to sow the contents on a nutrient medium and find out which microbe causes the disease and which antibiotic it is sensitive to. In a patient, they seek to identify a focus of chronic infection - a source of bacteria. It can be chronic tonsillitis, sinusitis, dental caries. Be sure to check your blood sugar levels.
With the development of complications, additional diagnostics are carried out - blood and urine cultures for sterility, ultrasound, magnetic resonance imaging of the liver, kidneys, brain and other organs to determine the localization of metastatic purulent foci.
How to get rid of a boil
Which doctor should I contact? If the boil is at the stage of infiltration, that is, the abscess has not yet opened, you can contact a dermatologist who will prescribe local and systemic treatment. If the boil is already mature, its stem is visible, or it has already come out with pus, you need to contact a surgeon to treat the wound. If you are not sure about choosing a doctor, the right thing to do would be to contact a surgeon at the clinic at your place of residence. He will advise how to treat a boil at any stage.
If the abscess is on a limb, it should be kept at rest. For this purpose, a plaster cast or plastic splint is sometimes applied.
Local therapy
Local treatment of a boil involves, first of all, thorough antimicrobial treatment of the surrounding skin. It is wiped with 70% ethyl alcohol or 2% salicylic alcohol. If the process has just begun, you can try to stop it by lubricating the site of infiltration with tincture of iodine or an alcohol solution of brilliant green. Dry heat can still be used at this stage. Rubbing the surface of the skin with Dimexide solution gives a good effect. There is no need to use compresses with it, like any other wet dressings, which only impair blood supply and cause additional damage (maceration) to the skin.
At the same time, physiotherapeutic procedures can be prescribed to cause regression of the boil. It must be remembered that the time during which the developing infiltrate can be warmed up is very short (2-3 days), so such procedures should be carried out only as prescribed by a doctor and under his daily supervision. If this is not possible, it is better to refrain from thermal procedures until the wound is cleansed of pus.
Pure ichthyol or Ichthyol ointment is applied directly to the infiltrated area. This medicine has an anti-inflammatory effect, relieves pain, and has a local irritant effect. Ichthyol drawing ointment is a popular remedy for boils, in some cases helping to get rid of them before an abscess forms. Pure ichthyol can also be used, but it is almost impossible to find on sale. However, many medical institutions have this remedy, and surgeons perform dressings with it.
There are methods according to which the developing boil is injected with a solution of novocaine mixed with antibiotics or electrophoresis of antibacterial drugs is performed. These medications are prescribed by your doctor. Below we will mention which antibiotics to take for boils.
If a purulent-necrotic core has already begun to form, but the boil does not mature, to accelerate its formation, salicylic sodium or salicylic acid was applied to the center of the infiltrate in the past and fixed with a dry sterile bandage. Nowadays these means are practically not used. Instead, ointment with ichthyol is used. Dressings with ichthyol or Ichthyol ointment should be carried out 2 times a day until the abscess is opened.
Opening a boil
The opening of the abscess occurs independently. After the formed purulent core has separated from the surrounding inflammatory infiltrate, it can be carefully removed with tweezers. It is better to entrust this manipulation to a surgeon who will carry it out under sterile conditions and show how to apply a bandage.
After removing the rod, the wound is washed with solutions of disinfectants, for example, hydrogen peroxide or Furacilin. In order to prepare a solution of Furacilin, you need to dissolve two tablets of the drug in a glass of water. For quick and complete dissolution, water with added tablets can be boiled and then cooled.
A bandage moistened with hypertonic sodium chloride solution is applied to the wound. To prepare such a solution at home, you need to dissolve a tablespoon of salt in 100 ml of water, boil, and cool. You need to moisten gauze pads in this solution and apply them to the wound 3-4 times a day for 30-40 minutes, and then cover the damage with a dry bandage, securing it with an adhesive plaster if necessary.
When the wound is completely cleared of pus, there will be no white or gray plaque, blood and other secretions in it, ointment dressings can be applied, changing them daily or every other day. Most often, Levomekol is used for this purpose. This is an ointment available in tubes of 40 grams and jars of 100 grams. It contains the antibiotic chloramphenicol (levomycetin) and the wound healing agent methyluracil. Levomecol is impregnated with gauze napkins and the healing boil is covered with them, covered with a dry bandage from above and fixed with adhesive tape if necessary. You can use other products containing antibiotics: Baneocin, Bactroban. In order not to form a scar, a protracted wound can be treated with Panthenol.
Healing
During healing, physiotherapy is prescribed: Sollux, ultraviolet irradiation, UHF therapy. Is it possible to heat a boil when treating it at home? Yes, it is possible if the cavity is cleared of pus, the wound is healing, the redness is decreasing, and there is no pain around the injury. Use dry heat, for example, heating with bags of salt. Thermal procedures, their type and duration must be agreed upon with the attending physician in order to prevent an exacerbation of the infection.
If a lump remains after the boil, you need to consult a doctor - perhaps an encapsulated source of infection remains under the skin - the so-called internal boil. From a medical point of view, this term itself is not entirely correct, since sooner or later any abscess must burst, and the abscess has no other way out than on the surface of the skin. However, if this does not happen for a long time, the boil is removed using a small skin incision with a scalpel.
Is it possible to squeeze out a boil? No, you can't do this. If the smallest blood vessels are damaged, which is inevitable with mechanical impact on the abscess, dangerous microbes will certainly enter the blood. This can lead to serious complications: blood poisoning, the formation of ulcers in the kidneys, brain, other organs, and even death.
Home treatment and antibiotic therapy
Home therapy is carried out in most uncomplicated cases. Usually the patient goes to the clinic to see the surgeon only for dressings and for a follow-up examination after recovery. Only patients with facial boils are hospitalized. They are prescribed bed rest and are prohibited from talking or chewing solid food.
For facial boils, systemic antibacterial therapy is prescribed. The most commonly prescribed are protected aminopenicillins (Amoxiclav) or cephalosporins (Cefalexin and others). If they are intolerant, macrolides (Clarithromycin, Azithromycin), tetracyclines (Doxycycline), fluoroquinolones (Ofloxacin) and other stronger antibiotics can be used.
However, the higher the activity of the antibiotic, the more likely its undesirable effects, and also the higher the likelihood that the patient will develop drug resistance of microorganisms in the future. Therefore, the choice of antibacterial drug should be made by a doctor. You can use both tablets and preparations in the form of an injection solution. This depends on the pharmaceutical characteristics of each antibiotic - some act faster and more effectively after absorption in the gastrointestinal tract.
At the same time, anti-inflammatory drugs are prescribed, which also have an analgesic effect. They can also be taken when treating a boil at home to relieve pain (Nurofen, Paracetamol).
Vaccination, vitamins and immunostimulants
To treat staphylococcal infections in children from 6 months of age and in adults, a therapeutic staphylococcal vaccine (staphylococcal antiphagin) is prescribed. In addition to curing boils, this medicine causes the formation of immunity against infection caused by staphylococcus. It is especially indicated for recurrent boils and widespread furunculosis. The staphylococcal vaccine has quite a few contraindications, mainly diseases of the liver, kidneys, endocrine glands and allergic diseases, as well as pregnancy and lactation.
Multivitamins are prescribed, especially C, E, A, which have a beneficial effect on the immune system and the protective properties of the skin. Immunostimulants are used, in particular Lykopid. It can be prescribed to children over 1 year of age. Lykopid is contraindicated during pregnancy, lactation, severe autoimmune thyroiditis and other allergic diseases.
Complex liquid pyobacteriophage is applied topically, a drug that destroys bacteria. It is used in the form of lotions and irrigations after opening the boil. This medicine not only speeds up healing and fights infection, but also prevents the development of complications.
Surgical removal of a boil
It is carried out when there is a threat of infection spreading and the formation of purulent complications - an abscess or phlegmon of the skin. Under local anesthesia, the skin over the lesion is incised, the affected tissue is removed, and the cavity is thoroughly cleaned. If the wound is small, it can heal on its own; for more extensive damage, stitches are applied. In the postoperative period, antibiotics, pyobacteriophage, anti-inflammatory drugs, vitamins, and immunostimulants are prescribed.
Prevention
Preventive measures for boils can be divided into two groups: primary (prevention of the appearance of ulcers) and secondary (prevention of complications).
To prevent a person from developing boils, he must follow simple rules:
- observe the rules of personal hygiene - wash your hands, body, hair on time;
- do not use soap with antibacterial components (triclosan), which kill beneficial microflora that inhibits the development of pathogenic bacteria;
- when working in dusty rooms, use personal protective equipment, avoid rubbing the skin with a collar, belt and other parts of clothing;
- limit skin contact with petroleum products and machine oils;
- use antiperspirants and wash more often if you sweat excessively;
- for patients with diabetes, keep blood sugar levels under control;
- avoid fasting, hypovitaminosis, constant stress and overwork, normalize sleep;
- eliminate foci of chronic infection in the body, get rid of the carriage of bacteria in the nasopharynx;
- In case of wounds or damage to the skin, treat them with antiseptic agents as quickly as possible, wipe the skin around the wound with tincture of iodine or brilliant green, apply Baneocin ointment and a dry bandage.
If the boil has already appeared, you must:
- touch it as little as possible;
- keep the surrounding skin clean;
- ensure rest of the limb;
- consult a doctor.
Furuncle and carbuncle are manifestations of deep staphyloderma. The diseases are characterized by purulent-necrotic inflammation localized in the hair follicle and surrounding tissues. Inflammation is always limited due to the development of granulation tissue. The appearance of several boils at the same time or the sequential appearance of one boil after another is called furunculosis.
When several hair follicles are involved in the inflammatory process and inflammation spreads into the subcutaneous fatty tissue, a carbuncle develops. The most dangerous is the localization of inflammatory elements on the head, face, nose and upper lip. Treatment of boils and carbuncles should be strictly individual. In mild forms of boils, symptomatic therapy is sufficient. For moderate forms of boils and carbuncles, surgical treatment is used.
Rice. 1. Furuncle and carbuncle - a manifestation of deep staphyloderma.
Furuncle
A furuncle (in the old days called a “boil”) is a complication of staphylococcal folliculitis (purulent inflammation of the hair follicle). Not only the pilosebaceous sac, but also the surrounding tissues are involved in the inflammatory process. Acute purulent-necrotic inflammation ends with the rejection of molten (purulent) masses with the formation of scar tissue.
Rice. 2. With a boil (picture on the left), not only the pilosebaceous sac, but also the surrounding tissue is involved in the inflammatory process. With a carbuncle, the inflammatory process involves several hair follicles (picture on the right).
Reasons for the development of a boil
The cause of the development of the boil is white and Staphylococcus aureus.
Rice. 3. In the photo of staphylococci: white (left) and golden (right).
Contribute to the development of the disease:
- damage to the skin (scratching and abrasions);
- increased secretion of sweat and sebaceous glands;
- the use of warm compresses and poultices during the initial period of infection;
- sudden hypothermia or overheating of the body;
- consuming large amounts of carbohydrates and diabetes mellitus create favorable conditions for the development of infection (carbohydrates are a good breeding ground for pyogenic microbes);
- malnutrition (insufficient amounts of proteins, fats, carbohydrates, vitamins and microelements), immunosuppressive diseases (AIDS, cancer, etc.), severe somatic pathology and long-term use of corticosteroids and immunosuppressants lead to decreased immunity;
Rice. 4. In the photo on the left is inflammation of the upper part of the follicle (ostiofolliculitis), on the right is inflammation of the entire follicle (folliculitis). Diseases often precede the development of boils.
Clinical picture of a boil
Boils develop on those areas of the skin where hair grows - on the face, neck (back surface), forearms, thighs, lower back and buttocks.
A boil on the face, nose, head and upper lip is the most dangerous location. Thrombophlebitis of the facial veins, the development of purulent meningitis and septicemia are serious complications of the disease.
The general condition of the patient remains satisfactory with single boils. Furunculosis and multiple boils are often accompanied by fever, malaise and headache. In severe cases, lymphangitis and lymphadenitis develop (enlargement of regional lymph nodes).
Rice. 5. The photo shows a boil on the eyelids.
Rice. 6. The photo shows a boil on the neck and leg.
Symptoms and signs of a boil
- begins to develop with ostiofolliculitis. Small, pinhead-sized pustules form at the mouths of hair follicles.
- Next, the inflammatory process spreads to 2/3 of the follicle (folliculitis develops).
- With deep folliculitis, inflammation affects the entire follicle.
- With boils, inflammation spreads beyond the follicle. In this case, redness appears around the inflamed follicle, which over time acquires a purplish-blue color, swelling and soreness, often of a pulsating nature. The infiltrate can reach the size of a walnut or more. The boil can be single. Sometimes several boils develop at the same time.
- Over time, a necrotic core with a pustule on top appears in the center. There is purulent melting of tissue around the necrotic core.
When the pustule is opened, thick gray-green pus is released and a necrotic core is visible. - After cleansing, the wound looks like an ulcer with crater-shaped edges. The formed cavity is quickly filled with granulations.
- The defect heals with a scar.
The duration of the disease is 1 - 2 weeks or more.
Rice. 7. The photo shows a boil on the buttock and finger.
Rice. 8. In the photo there is a boil on the ear (on the left) and a boil on the nose (on the right).
Complications of a boil
- Particularly dangerous is the localization of the boil on the face, lips and nose due to the risk of developing purulent thrombophlebitis of the facial veins, inflammation of the meninges (purulent meningitis), sepsis and septicemia.
- Inflammation of the lymphatic vessels (lymphangitis) and lymph nodes.
Traumatization and squeezing out boils are triggers for the development of a malignant boil
Rice. 9. In the photo, a boil on the face is the most dangerous location.
Rice. 10. The photo shows a boil on the nose.
Rice. 11. The photo shows a boil on the lip.
Furunculosis
In recent years, there has been an increase in skin diseases of a viral and bacterial nature. Chronic recurrent furunculosis is one of them.
What is furunculosis
Furunculosis is an infectious disease characterized by the appearance of several boils simultaneously or the appearance of one boil after another. Furunculosis can be limited or widespread.
- With acute furunculosis, several boils appear and develop simultaneously.
- In chronic furunculosis, boils appear one after another. Upon examination, you can see inflammatory infiltrates at different stages of development. The disease drags on for weeks, months and years. Tolerance to the therapy with antibacterial drugs is noted. Furunculosis complicates the course of many skin diseases.
Rice. 12. In the photo there are several boils on the neck and back.
Causes of furunculosis
The main cause of furunculosis is Staphylococcus aureus. It causes disease in 60-97% of patients. In other cases, the cause of the disease is epidermal staphylococci, group A and B streptococci and other types of bacteria.
Recently, more and more staphylococci resistant to a number of antibiotics have been sown from lesions, about 90% of which are staphylococci resistant to penicillin and ampicillin, about 19% to erythromycin.
The presence of Staphylococcus aureus on the skin and weakened immunity are the main factors in the development of furunculosis.
- The presence of foci of chronic infection in patients with furunculosis is recorded in 75 - 90% of cases. The most common pathologies are the ENT organs (tonsillitis, sinusitis and pharyngitis) and the gastrointestinal tract (chronic gastroduodenitis and cholecystitis). Dysbacteriosis contributes to the development of furunculosis.
- In 40% of cases, patients with furunculosis have diseases of the thyroid gland, gonads and diabetes mellitus.
- Consumption of large amounts of carbohydrates and diabetes mellitus contribute to the development of furunculosis. An increased amount of sugar in the blood is a good breeding ground for staphylococci.
- In 39% of cases, the patient’s body is sensitized to different types of allergens.
- The development of furunculosis is caused by a violation of carbohydrate, fat and protein metabolism and the development of hypo- and avitaminosis. Furunculosis often occurs in weakened, exhausted patients suffering from severe somatic pathology. Anemia, chronic diseases of the gastrointestinal tract, immunodeficiency conditions (HIV infection and oncology) are the main ones.
- Constant physical and mental stress contributes to the development of furunculosis.
Rice. 13. In the photo there is furunculosis. Numerous boils at different stages of development.
Immune status disorders in furunculosis
The human immune system is designed to protect the body when in contact with infectious agents. The causative agents of furunculosis cause a whole “cascade” of protective reactions, most of which are disrupted during the disease.
- Up to 70% of patients with chronic furunculosis have impaired phagocytosis (capture, absorption and destruction of pathogenic microorganisms).
- A low level of iron in the blood serum causes a decrease in the processes of killing (destruction) of pathogenic microorganisms.
- In the blood of 43% of patients with chronic furunculosis, a decrease in the level of T and B lymphocytes is recorded.
- In the blood of 60% of patients with chronic furunculosis, there is a decrease in the level of immunoglobulins (IgG and IgM).
Severity of furunculosis
Mild severity furunculosis is characterized by the presence of single boils. The inflammatory reaction is moderate. Relapses occur 1-2 times a year. There are no signs of intoxication. Peripheral lymph nodes enlarge during exacerbations. Indicators of immune status in this category of patients in 70% of cases remain within normal limits.
Moderate severity Furunculosis is characterized by the presence of single large boils or multiple boils. The inflammatory reaction proceeds rapidly. Relapses occur up to 3 times a year. During exacerbations, inflammation of the lymphatic vessels and lymph nodes is noted. Often the disease occurs with symptoms of intoxication. Violations of the cellular and humoral immunity are noted.
Severe severity The disease is characterized by the presence of multiple boils with a continuously relapsing course. The disease is accompanied by severe intoxication. Patients experience weakness, malaise, headache, fever and sweating. Violations of the cellular and humoral immunity are significant.
Rice. 14. In the photo there is furunculosis.
Complications of furunculosis
The penetration of bacteria into the blood causes bacteremia, which is a serious complication of furunculosis. Bacteria settle in the internal organs, causing endocarditis, osteomyelitis, pneumonia, meningitis, kidney inflammation, etc. Septic shock often ends in the death of the patient. With furunculosis, lymphatic vessels and lymph nodes are often affected.
Differential diagnosis of furunculosis
To prescribe adequate treatment for furunculosis, the method of differential diagnosis should be used with diseases such as pseudofurunculosis, hidradenitis,
Rice. 15. The photo shows multiple abscesses in children (Finger's pseudofurunculosis). The disease occurs mainly in children under 1 year of age. The disease causes pustules and multiple abscesses associated with the child's eccrine sweat glands. When an abscess is opened, liquid pus is released. There is no necrotic core.
Rice. 16. In the photo, hidradenitis is an inflammation of the apocrine sweat glands. The armpits, pubis and perineum are common locations of the disease. When abscesses open, thick, creamy pus is released. There is no necrotic core.
Carbuncle
When several hair follicles are involved in the inflammatory process and inflammation spreads into the subcutaneous fatty tissue, a carbuncle develops. The name carbuncle comes from the Latin carbo - coal. In Rus', the disease was called ognevik or uglevik.
The localization of the process and the stages of development of the carbuncle are similar to those of a boil. Golden and white staphylococci are the main culprits of the disease. Failures in the functioning of the immune system contribute to the development of carbuncles, which occurs in patients with severe somatic pathology, diabetes mellitus, obesity, hypovitaminosis and hypothermia.
Rice. 17. With a boil (photo on the left), one pustule forms on the surface of the infiltrate, with a carbuncle - several (photo on the right).
Rice. 18. The photo shows carbuncles on the chin and neck in the collar area.
Signs and symptoms of carbuncle
The disease occurs with severe symptoms of intoxication: chills, elevated body temperature, weakness, loss of appetite and headaches; vomiting and loss of consciousness are less common.
Local symptoms:
- Initially, the skin over the affected surface becomes purplish-red. There is severe pain.
- After a few days, several pustules appear on the surface of the skin.
- The thinned skin breaks out in several places and resembles a “sieve.” Thick pus oozes from the holes.
- When the carbuncle is opened, an ulcerative surface with purulent discharge and several necrotic rods is exposed.
- After the rods are rejected, a deep wound (ulcer) with a dirty gray bottom is exposed. The edges of the wound are undermined. Ulcer healing is slow. In its place, a deep star-shaped retracted scar forms.
Smear microscopy confirms the diagnosis. Culture of pus allows you to identify the pathogen and determine its resistance to antibiotics. The disease lasts from 2 to 4 weeks or more.
Rice. 19. The photo shows a carbuncle. Superficial pustules and multi-chamber abscesses are visible, on the surface of which there are numerous holes resembling a “sieve” through which pus is released.
Differential diagnosis of carbuncles
At the beginning of the disease, the picture of the carbuncle is similar to that of phlegmon. Sometimes the necrotic crust of the carbuncle makes it look like an anthrax carbuncle.
Rice. 20. In the photo on the left there is phlegmon. The disease develops as a result of the spread of infection from affected areas into the deep layers of the skin, fiber and connective tissue. With a carbuncle (photo on the right), the inflammatory process is limited. Pustules will appear on the surface of the skin, and when the abscess is opened, necrotic rods will be exposed.
Rice. 21. An anthrax ulcer has raised edges and a dark bottom (photo on the left). After opening the carbuncle, an ulcerative surface with purulent discharge and several necrotic rods is exposed. The edges of the ulcer are undermined and crater-shaped (photo on the right).
Laboratory diagnosis of boils and carbuncles
Rice. 22. Microscopy (Gram stain) reveals gram-positive cocci (often staphylococci). They are arranged in clusters resembling “bunches of grapes” (photo on the left). Colonies of pathogens are visible in the photo on the right. Cultures of pus can identify not only staphylococci, but also determine their sensitivity to antibiotics.
Treatment of boils, furunculosis and carbuncle
Treatment of boils and carbuncles should be strictly individual. In mild forms of boils, symptomatic therapy is sufficient. For moderate forms of boils and carbuncles, surgical treatment is used. Antibiotics and pathogenetic therapy agents speed up recovery. Treatment of furunculosis includes the use of specific and nonspecific agents that increase the body's defenses, treatment of concomitant diseases, sanitation of foci of chronic infection and dietary nutrition.
Rice. 23. In the photo there is a boil (on the left) and a carbuncle (on the right).
Local treatment of boils
Treatment of boils during maturation
- At the beginning of treatment, the hair in the area of inflammation is cut with scissors.
- In the period before the spontaneous opening of the boil, the skin around them is treated twice a day with a solution of 70% ethyl alcohol.
- Keratoplasty agents are used to ripen the boil. Drugs in this group have the property of drying out tissues. By taking away water, they help slow down the processes of fermentation and decay in deep inflammatory infiltrates. The use of 20% Ichthyol ointment or pure Ichthyol is indicated. An “ichthyol cake” is applied to the affected surface twice a day (the applied ointment is covered with a thin layer of cotton wool). The procedure is carried out until the boil opens.
- During the period of boil maturation, physiotherapy (UHF therapy, dry heat) is indicated.
- Antibiotic therapy is used in the case of boils located on the face (nose, lips, nasolabial triangle), inflammation of the lymphatic vessels, lymph nodes and deteriorating general health.
- For severe pain, novocaine blockades are used.
Rice. 24. A boil can open at any time.
Treatment of boils and carbuncles using surgical techniques
The purpose of surgery for boils and carbuncles is to open the abscess and ensure a good outflow of purulent-inflammatory exudate. After opening, the abscesses are washed with antiseptic solutions and drained. Drainage ensures unimpeded drainage of pus. For significant defects, sutures are applied.
Enzymes are widely used in the treatment of boils and carbuncles. They break down peptide bonds in protein molecules and their breakdown products, thereby accelerating the cleansing of purulent wounds.
When treating boils and carbuncles, only surgical treatment is used.
Rice. 25. The photo shows a carbuncle. The opening of the abscess is made in the form of a cross-shaped incision.
Rice. 26. Surgical opening of a carbuncle on the chin.
- If necessary, the pustule can be opened with a sterile needle.
- Used to disinfect surrounding tissues 2% salicylic alcohol, furacillin, 3% alcohol iodine solution or 3% hydrogen peroxide solution. The skin around the boil is rubbed in the direction from the periphery to the center of the formed ulcer.
- To treat an opened pustule, it is recommended to use 2% alcohol solutions of aniline dyes: fucorcin, brilliant green, gentian violet, methylene blue,),2 - 5% alcohol solution of iodine, antiseptic solution "Sangviritrin" or antimicrobial agent "Eucalimin".
- Promotes the separation of purulent contents from the wound. Ichthyola And Sodium chloride solution hypertonic. Ichthyol is applied to the area around the ulcer formed after opening. And the ulcer itself is covered with a gauze napkin soaked hypertonic sodium chloride solution.
- If it is difficult to reject a purulent-necrotic rod, a good effect is obtained from using: 1% trypsin solution, chymopsin or chymotrypsin with novocaine or isotonic sodium chloride solution.
- After rejection of the purulent-necrotic rod, the use of ointments with antibiotics is indicated: Fucidin. Fucicort, Bacroban, Heliomycin, Lincomycin, Tetracycline, Iruksol, Synthomycin emulsion. A good effect is achieved by using ointments such as Lincomycin or Levomycetin along with 30% or 70% dimexide solution.
- Effective use of turundas with antimicrobial ointments Levomikol,Levosin or Tomicide.
- After opening the abscess, the use of ultraviolet radiation is indicated.
- Accelerates tissue regeneration Iruksol ointment, Curiosin solution, Ichthyol ointment And Levomikol.
Rice. 27. When treating boils and carbuncles, drainage ensures unimpeded drainage of pus.
Rice. 28. For severe pain, novocaine blockades are used in the treatment of boils.
Treatment of boils and carbuncles with antibiotics
Antibiotics for boils and carbuncles speed up recovery. The basis of treatment of the disease is surgical treatment.
Antibiotic therapy is used in the case of boils located on the face (nose, lips, nasolabial triangle), inflammation of the lymphatic vessels, lymph nodes and deteriorating general health. The risk of developing bacteremia is an absolute indication for antibiotics. This applies primarily to patients with reduced immunity.
- Antibiotics of the penicillin group ( Cloxacillin).
- B-lactam antibiotics ( Dicloxacillin, Amoxicillin-clavulanate).
- Macrolides ( Azithromycin, Clarithromycin, Josamycin, Vilprafen, Klacid).
- Tetracyclines ( Unidox-solutab, Doxycycline hydrochloride, Vibramycin).
- Cephalosporins ( Zinnat, Cephalosporin).
- Other antibiotics (Lincomycin, Azithromycin, Clindamycin, Rifampin).
When treating strains of Staphylococcus aureus resistant to methicillin, it is recommended to use Minomycin, Trimethoprim/sulfamethoxazole, Ciprofloxacin or Vancomycin.
Rice. 29. The photo shows the stages of cleansing the ulcer of a opened carbuncle.
Features of the treatment of boils
Features of the treatment of boils and carbuncles located on the face
If boils are located on the face (nose area, lips or nasolabial triangle), with inflammation of the lymphatic vessels and lymph nodes, or deteriorating general health, patients are hospitalized. They are prescribed bed rest, restriction of facial mobility is recommended, and antibiotics are prescribed. With this arrangement of abscesses, there is a high risk of complications in the form of meningitis and sepsis. The administration of heparin will prevent the formation of blood clots in the facial veins.
Rice. 30. The photo shows a boil. On the left is the marking of the surgical field. On the right is a cross-shaped incision.
Features of the treatment of multiple boils
Patients with multiple boils require antibiotic and immunotherapy, treatment of concomitant diseases and sanitation of foci of chronic infection.
- Patients' nutrition should be complete and regular. Restriction of carbohydrates and salt is recommended. Alcohol should be completely avoided.
- For specific treatment, antistaphylococcal drugs are used, which are represented by antistaphylococcal immunoglobulin, antistaphylococcal plasma, staphylococcal toxoid and staphylococcal bacteriophage.
- In addition to specific methods of treating staphylococcal infection, autohemotherapy, the introduction of protein blood substitutes, pyrogenal, prodigiosan, methyluracil and splenin are indicated. Vitamins and immunomodulators are prescribed. To stimulate immunity in children and adults, the use of herbal preparations - echinacea ( Immunal), ginseng ( Ginseng tincture, drugs in the form of tablets and capsules) and Schisandra chinensis.
- In the treatment of multiple boils, suberythemal doses of ultraviolet rays, electrophoresis with drugs, the use of a helium-neon laser, and UHF currents are indicated.
Features of the treatment of furunculosis
- Treatment of furunculosis includes the use of specific and non-specific methods of increasing immunity, treatment of concomitant diseases, rehabilitation of foci of chronic infection and dietary nutrition.
- Antibiotics for furunculosis are used until all foci of inflammation are completely healed. If necessary, maintenance antibiotic treatment is prescribed for several months.
- It is recommended to take a shower and use soap and gel with antiseptics: foaming solution Povidone-iodine or Benzoyl peroxide.
- A good effect in the treatment of staphylococcal infections is the application of ointments with the antibiotic mupirocin to the affected areas of the skin: Bactroban, Bonderm, Supirocin.
- From the methods of physiotherapy, suberythemal doses of ultraviolet rays, electrophoresis with drugs and the use of a helium-neon laser are shown. To accelerate the maturation of abscesses and their spontaneous opening, the use of UHF currents is shown.
Features of carbuncle treatment
- Treatment of carbuncle is carried out in a hospital setting.
- When the carbuncle is localized on the face, bed rest and restriction of facial mobility (eating solid food, talking, etc.) are prescribed, antibiotics are prescribed.
- If necessary, detoxification therapy is carried out: the introduction of polyglucin or hemodez, blood transfusion.
- With the ineffectiveness of the use of conservative methods of treatment (increase in the phenomena of intoxication and tissue necrosis) within 2-3 days, the carbuncle is opened surgically, followed by drainage of the purulent cavity. Dressings are carried out twice a day.
Rice. 31. The photo shows a carbuncle. The process of cleaning a wound.
Preventing the spread of infection
- It is strictly forbidden to wash damaged skin.
- The nails on the hands should be cut short, and before carrying out medical procedures, they should be treated with a 2% alcohol solution of iodine.
- Before treatment, the hair located in the lesion should be cut, but not shaved.
- Healthy skin around the lesions is treated with a 1-2% alcohol solution of salicylic acid or an aqueous solution of potassium permanganate.
- It is forbidden to squeeze out pustules.
- The use of compresses is prohibited.
Prevention of recurrence of boils and carbuncles
- Elimination of carriage of Staphylococcus aureus. Identification and treatment of foci of chronic infection.
- The use of soap and gels with antiseptics when washing hands and taking a shower.
- The use of ointment with mupirocin (laid in the nose) will help eliminate staphylococci from the nasal mucosa.
- Adequate treatment of diabetes mellitus as a predisposing factor in the development of the disease.
