Inflammation and Boils

Our bodies are prone to inflammation, which can lead to serious health issues such as cancer. Even the skin can be affected by inflammation, manifesting in various forms of abscesses and pimples. If a painful bump appears on the head, it is likely a boil. Boils are caused by infections in hair follicles and can usually be relieved with topical skin medications. Daily cleanliness can also help prevent the occurrence of boils. The primary pathogenic bacteria responsible for boils are Staphylococcus aureus, followed by Staphylococcus epidermidis and Streptococcus hemolyticus. Skin abrasions, erosions, and ulcers provide favorable conditions for bacteria to colonize, multiply, and infect the skin surface. Other predisposing factors include low immunity, excessive sebum secretion, malnutrition, anemia, diabetes, and long-term use of steroids.

Clinically, boils often occur in areas of the body that are subject to pressure and where sebum secretion is abundant, such as the head, face, neck, armpits, and buttocks. Initially, they manifest as inflammatory papules in the hair follicles, which gradually enlarge and become red, hard nodules with pain or tenderness. After 2-3 days, the nodules become inflamed, necrotic, and form abscesses with necrotic pus plugs. When the pus plug ruptures, pus, necrotic tissue, and the abscess resolve, leaving a scar that fades within 1-2 weeks.

The formation of boils is often accompanied by severe throbbing pain, especially if they occur in areas of dense skin tissue and high tension, such as the forehead or jaw. Some patients may also experience fever, headache, and other systemic symptoms. Boils on the face, especially those near the nostrils and upper lip, can be particularly dangerous due to the rich lymphatic and vascular networks in this area. Improper handling or squeezing can allow bacteria to enter the brain through the bloodstream, leading to serious complications.

Malnourished and immunocompromised individuals, especially children, may experience recurrent boils, making treatment more challenging. Diagnosis is based on the presence of follicular nodules, subsequent inflammation and necrosis, formation of pus plugs, and local pain. Boils should be differentiated from other conditions such as suppurative hidradenitis, cellulitis, and carbuncle.

The treatment principles for boils include systemic and local therapy. Systemic antibiotics may be prescribed for lesions located around the nose, nasal cavity, or external auditory canal; large or recurrent lesions; lesions surrounded by cellulitis; or when local treatment is ineffective. Early, adequate, and prolonged courses of effective antibiotics, such as beta-lactams, macrolides, lincomycins, and others, are commonly used. Antibiotic selection should be based on bacterial sensitivity testing. Local therapy involves the application of topical antibiotics such as 2% mupirocin ointment, 2% fusidic acid cream, or compound polymyxin B ointment. Warm compresses can be used to promote lesion maturation, drainage, and symptom relief. Other modalities such as ultraviolet, infrared, and ultrashort wave treatments can also be effective in reducing inflammation.