How are boils treated?

Photo of a man with a painful boil at the back of his neck
PantherMedia / Wavebreakmedia ltd

Boils are generally treated by a doctor. When the boil is “ready,” the doctor can make a small cut to allow the pus to drain and the wound to heal. Antibiotics are used in certain situations, for instance if the person has a weakened or a fever. People who try to squeeze boils themselves increase the risk of the spreading inside their body and leading to complications.

A boil (furuncle) is a bacterial skin that looks a bit like a very big pus-filled pimple. It starts off as a noticeable swelling that then becomes filled with pus. Boils are often very painful.

Sometimes they drain on their own, and go away without causing any problems. But medical treatment may be needed, particularly for big boils.

If someone gets boils often, it could be a sign that they have a medical condition that has weakened their , increasing the risk of infections. It is then important to find out what that medical condition is, and treat both the underlying condition and the boils.

Illustration: Different types of hair follicle infections – as described in the article

Different types of hair follicle infections

Compresses and ointments

When a boil first appears, the pus-filled space inside the swollen bump (abscess) hasn’t yet fully developed. In this phase, doctors usually recommend applying a warm, moist, antiseptic compress (a cloth pad held in place by a bandage) or a special ointment that draws (pulls) pus out of the boil. This kind of ointment is also known as “drawing salve.” It typically contains a drug called ammonium bituminosulfonate, also known as Ichthyol. The compress and ointment are meant to speed up the development of the abscess inside the boil, so that it can drain and heal on its own later on – or be cut open and drained by a doctor.

Cutting and draining

The cutting and draining of boils is a standard treatment, particularly for large boils. It is usually an outpatient procedure (no need to stay overnight in a hospital). Before piercing the skin covering the boil, the doctor numbs the area around the inflammation with a local anesthetic or by cooling it.

Sometimes one or more strips of gauze or silicone are placed inside the open wound. These help to remove any remaining pus and fluid from the wound, keeping it clean and allowing the tissue to gradually recover. The strips are usually replaced every day, for instance by a family doctor.

In many cases, the wound is also cleansed with a sterile saline (salt) solution. Doctors sometimes use antiseptic solutions, ointments or dressings too. The wound generally isn’t sewn shut – it gradually closes up on its own. This is known as open wound healing or healing by secondary intention. While the wound is still open, a compress or plaster are used to protect it from dirt and germs.

Treatment for more severe cases

The above-mentioned treatments are usually enough, but sometimes other measures are needed – for instance, if the boil is on the face or if several boils have merged, forming a carbuncle.

Keeping still

If you have a boil on your face, it’s important to keep the infected area still. This is because movement and pressure can increase the risk of spreading to the brain through the bloodstream. So you should try to avoid using your face muscles. In other words: Don’t talk, and only eat liquid or mushy food that doesn’t have to be chewed, if possible. Bed rest is also recommended.

Antibiotics

If complications arise or are likely, are taken as tablets or a liquid, or given in the form of an infusion (IV drip) or injection. When used in this way, they travel around the whole body in the bloodstream. This type of treatment is called systemic antibiotic therapy. It is usually only needed

  • if the boil is on your face, particularly on your nose or upper lip,
  • if you have several boils (furunculosis) or a carbuncle,
  • if the starts spreading through the lymph vessels,
  • if you have symptoms such as a fever, high pulse rate, low blood pressure and rapid breathing – or if blood tests suggest that the is spreading in the body.

Doctors usually prescribe an antibiotic that is effective in the treatment of boils, which are nearly always caused by the same type of .

In rare cases, samples of pus are taken and analyzed in a laboratory to find out exactly which type of is causing the . This is done, for instance, if the normal treatment approach doesn’t seem to be working, if it’s thought that the person may have blood poisoning (sepsis), or if there’s a risk that the are resistant to a lot of . Once doctors know which strain of is causing the , they can use the type of antibiotic that is most likely to work.

Fahimi J, Singh A, Frazee BW. The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis. CJEM 2015; 17(4): 420-432.

Gesenhues S, Gesenhues A, Weltermann B. Praxisleitfaden Allgemeinmedizin. Bad Wörishofen: Urban und Fischer; 2017.

Moll I. Duale Reihe Dermatologie. Stuttgart: Thieme; 2016.

Singer AJ, Thode HC Jr. Systemic antibiotics after incision and drainage of simple abscesses: a meta-analysis. Emerg Med J 2014; 31(7): 576-578.

Sterry W. Kurzlehrbuch Dermatologie. Stuttgart: Thieme; 2011.

Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59(2): e10-52.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Created on June 14, 2018
Next planned update: 2021

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.