Learning how to manage recurrent boils involves exploring the reasons for repeated infections with staphylococcus aureus, preventive steps to be taken and treatment of the furunculosis with topical and systemic antibiotics.
Furunculosis or recurrent boils can be a problem for individuals because of lost working days, treatment costs and risk of associated complications. The management of recurrent boils includes general measures and specific measures.
General Measures in the Treatment of Recurrent Boils
Learning how to avoid recurrent boils coupled with the following measures form the backbone of the management of recurrent boils:
- Give special attention to personal hygiene. Take a bath after outdoor trips. If you have a boil, take care not to contaminate surfaces or re-inoculate skin from carrier sites like the nasal opening. Wash hands well with soap and water after touching the body folds or nose.
- Eat a balanced diet. Avoid spicy, hot, fast foods and sweets.
- Reduce weight if you are obese.
- Control diabetes.
- Avoid long term corticosteroids with alternative medications in illnesses requiring these.
- During a visit to a hospital or clinic, take care not to touch the railings, and other surfaces as far as possible. Wash yourself thoroughly after a visit. Many hospitals have in-house protocols for the control of spread of MRSA within the premises.
- Treat boils early so as to avoid transfer to other members of the family and other sites within the body
- Screen family members for carrier state
Specific Measures in the Treatment of Recurrent Boils
- Managing the Carrier State of Staphylococcus aureus. This involves finding and managing the specific causes for the carrier state, application of topical antibiotics to the anterior nares (nasal opening) and body folds like perineum, arm pits etc.
- Boils resistant to treatment should have the pus collected for culture and sensitivity test and appropriate antibiotics instituted.
- Mild boils can be treated at home with spirit swab and simple puncture with a sterile needle and application of antibiotic creams. How long and how far can boils be treated at home is worth detailed discussion.
- Incision and drainage or lancing is the only required treatment for uncomplicated first appearance boil. In recurrent cases, however, this should be accompanied by oral antibiotics.
- In most cases of deep boils, incision and drainage of the pus, followed by daily absorbent glycerin magnesium sulfate dressing for a couple of days with proper antibiotic coverage is the treatment of choice.
- Deep boils and carbuncles should never be manipulated (pressed hard or squeezed) if you are not on suitable antibiotics. This can cause the spread of infection to the blood stream (septicemia) and other organs causing life threatening complications.
- Emergence of MRSA and other resistant strains have drastically altered the antibiotic choices in the treatment of boils.
- Boils are usually treated with flucloxacillin or other penicillinase resistant antibiotics.
- Treatment of MRSA involves use of glycopeptides group of antibiotics like vancomycin and teicoplanin. Some strains are becoming resistant to these agents also. Alternatives used in such cases are quinupritin/dalfopristin and linezolid.
Thus given proper care, recurrent boils can be managed well and further recurrence stopped.
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Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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