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When a boil turns into an abscess (large collection of pus), it might need to opened, drained, cleaned and then packed in order for it to heal, called an incision and drainage. This might be done by an emergency medicine (EM) doctor or by a surgeon in the operating room (OR). This is a painful procedure so it is often done in the OR.
- Most simple boils can be treated at home. Ideally, the treatment should begin as soon as a boil is noticed. Early treatment may prevent later complications. The primary treatment for most boils is heat application, usually with hot soaks or hot packs. Hot soaks or hot packs are generally either hot towels or heated packs containing sodium acetate and water. The heated pack, which is purchased at a pharmacy or retail outlet, is placed in a microwave for a few minutes to retain enough heat for application to the affected site. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the site of infection.
- Soaking the abscess in a tub of hot water is often recommended by healthcare providers. This works well if the abscess is on the hand or lower arm. Soaking in hot water mixed with Epsom® salts can also be used. Make sure the water is hot, but not so hot that it burns the skin. In abscesses on the face and under the arms, hold a hot, wet wash cloth over the abscess. Soaking at least three to four times a day, 10-15 minutes each time, is recommended by healthcare providers.
Medical treatment: A doctor should be seen if the abscess or boil becomes extremely painful, very large, has not healed in two weeks, or is accompanied by a fever. Doctors should see individuals with frequent boils or those with red lines radiating from the boil, which may be a sign that the infection has entered the bloodstream. On occasion, and especially with larger boils, the larger boil will need to be drained or lanced by a healthcare provider. Frequently, these larger boils contain several pockets of pus that must be opened and drained.
Antibiotics: Antibiotics, such as amoxicillin (Amoxil®) and tetracycline (Vibramycin®), are often used to eliminate the bacterial infection.
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