This is a gross subject. I think I am getting a boil on my shoulder. I have never had one and don't know what to do about it. if anyone has any experiance with them let me know..

Buy some "Drawing Salve" and follow the directions.

I hope and pray each day that my ex mother-in-law awakes every morning with a boil where the sun don't shine.


284.

Hot compresses as often as you can stand 'em until it comes to a point and opens. Antibiotics don't do a thing until the abscess opens. Sometimes pain meds are necessary, in the event of a boil in the nether regions (apologies to 284LUVR's ex-MIL!!!)

But I gotta say, there is little in emergency medicine more satisfying than opening, draining, and packing a real nasty boil. Patients don't care for it much, of course...

Taint?

An ice-pick and a good pair of slip-joint pliers usually takes care of even the largest BOILS.

(OUTSIDE treatment is usually preferable to afterwards washing walls and ceilings.)

Up here they are treated just like you guys do with Snake Bites. Cut a X on the boil and have your best friend suck it out.

I guess you're doomed.

This brings up the case of the guy running down the hospital hallway, wearing a hospital gown, holding his crotch and screaming in pain, with a nurse close behind him, and a doctor following her yelling, "No, no, nurse. I said to prick his boil!"

Jeeze, 40 minutes and nobody has yet posted "Shave your junk and eat a can of frozen orange juice with a spoon"?

Shocked, I am.

John

Yep seen it s few times, some even shoot the goop (tech medical term) several feet if ya don't have a cover pad.

"Lord God, I've been bit by a tschzit snake!" (For those familiar with the works of Lewis Grizzard.)

I went to the doctor complaining my farts sounded like a small Japanese motorcycle.

"Interesting," he said, "Anything else?"

"Yes," I responded, "I also got a big boil on my butt."

"Right," said the doctor, "I'll just lance the boil and both your problems will be taken care of."

"How's that?" I inquired.

"Because abcess makes the Fart go Honda."

Quick!

Somebody page Leighton!

John

Man walks into the doctor's office and takes off his hat to reveal a frog sitting on top of his bald head. The doctor asks, "Can I help you?" The frog replies, "Yeah, can you take this wart off my ass?"

I lanced a REAL stinky one about 6 months ago that spray-painted the wall 12 feet away. Impressive!

OMG!! That pun is TLEE-worthy!!

i think boils must have been pretty common, back in the day, when folks worked around livestock such as cattle, hogs, etc.

not a recommendation but before that new-fangled antibiotic that was developed (discovered?) back in WWII, they'd use mustard and ginger poultices to draw it out. lancing it was common too. some kind of bacterial infection, sounds like?

penicillin was quite the miracle, wasn't it?

Had a couple in the Thirties. Medical "wisdom" in those days was "don't touch 'em," but disobedient experience proved that draining and disinfecting 'em was a better course all 'round. Complete draining called for some darn painful finger pressure but precluded further agony. (An Olympic-grade boil goes deep � isn't just a surface *&^%$#@! Think "bomb crater.")

Ugliest pus I ever saw! Hurt like the devil, too.

Had one on my knee and (another time) one on my arm. Bad enough. Auntie had one on her eyelid � hard to imagine a worse site. Even one on your butt could be lanced!

Get ya woman ta squeeze it.

They like doin' that chit,....

Don't ax me why.

Eyelid abscesses are classified as either chalazion or hordoleum. I used to know the difference. Now I just sent 'em all to an ophthalmologist and let him sort it out. Damn painful and tricky to lance, I'm told.

Two women? Here you go...

Warning you, it's not for the squeamish...

What does opera have to do with this?

Smartazz!

Happy New Year, Ken!

once upon a time my daughter was infected with what the doc calaled cat scratch fever. not pretty.

it was apparently a lymph glad under her left upper arm. tons of antibiotics ensured. i'm sure the old timers and mid-wives would have professed it to be a boil. anyways, it ruptured, and the puss ran out, and her arm shrank down to near normal size.

we were quite worried. she was our eldest, and a blue-eyed blonde.

ya can't just go tossing off young children to some disease like a boil, cat scratch fever or the military draft. there's more to it than that. i don't give a chit what cong. rangel might have to say.

If those girls in that video thought was bad, wait till they see a horse that jugs up and bust.

We just had a colt jug up, my dad squeezed it and the schit shot across the stall and splattered all over the place

I think that was a sebaceous cyst, not a boil. Regarding the video of the woman squeezing out all that stuff from the guy's back.

What causes these boils anyway? I've never had one myself. Isn't it just a big honkin pimple?

Make sure it's not staph. I had what I thought was a 'boil' that ended up being a staph infection, nasty [bleep], MRSA even more so.

Go to the local urgent care and get it lanced. That works wonders.

Ron

That looks like the mother of all sebaceous cysts, not a boil. If so, there's probably a coil of ingrown hair in there, about forty miles long.

yep shave and oj will do it every time

here is one from my buddy's old russian grandmother.
chew up a bunch of raisens and get them really gooey in your mouth. take gooey raisens mixed with saliva and put a gob on boil. hold in place with loose bandage. buddy swears by it. i have not tried it myself. good luck

here is one from my buddy's old russian grandmother.
chew up a bunch of raisens and get them really gooey in your mouth. take gooey raisens mixed with saliva and put a gob on boil. hold in place with loose bandage. buddy swears by it. i have not tried it myself. good luck

So that's how Russians make raisin pudding.

I had a pilonidal cyst once. Surgery and 5 weeks of open wound packing took care of it. Glad that's over.

5sdad
I sure am glad I wasn't drinking any thing when I read your response. That really give me a good belly laugh. Cheers NC Happy 2012

Only thing worse than having a boil lanced is not having it lanced.

Then the pain, and infection, can go on and on.

Hope this helps!!

Steve

Oh, no! I started out this new year with a clean mind and a clear conscience. Then I made the mistake of reading the comments to Hubert's question. Although I've tried my best to resist, here goes my contribution. Eye bleach, white noise, and videos of lambs being slaughtered will be available after reading the following:

For Halloween the little boy filled his mouth with mayonnaise and smeared ketchup over his face. Each house he visited they would ask him what he was supposed to be.

He would squeeze his cheeks, spitting out mayonnaise, and say, "I'm a boil."

(This year is shot! Maybe my resolve to be good will last a little longer in 2013.)

I would hate to be the best friend of 284LUVR ex MIL.

Had one on my neck when I was about 18. It started like an inflamed pimple, or ingrown hair, and just kept growing (up inside my hairline). The thing just kept growing, and getting more tender, until the day I had ENOUGH. Grabbing it between my thumb and 2 fingers, I squeezed until it broke open - mucho pain, and INSTANT relief (ever heard the phrase "That hurts so good)? I was facing away from a stock trailer, and the stuff splattered over about a 3 foot circle from 18 inches! My only regret was, I put up with the damm thing for so long!
Lance it!
Mark

We used Mashed Potatoes,.....

GTC

WHOA, did you get skunked on the KOTY award, or something, ....?

Get you ass over to yer' BONG and STFU, Space alien.

GTC

Doc, I went to my family doctor for a abcess. A little local anesthetic, a little cutting, and lots of expressing. Took about forty minutes. Medicare paid him...13 dollars.

Saw this in a Clint Eastwood movie. He's caught this bad guy and is goingto take him to jail. Guy claims he can't ride his horse
'cause he can't sit down. Clint straps him across his saddle, pulls down his pants, cuts the boil open, then drinks most of the whisky out of a bottle then lights the rest of the whisky to create a vaccum, slaps it on the open boil. Suction pulls the core out with a loud "thunk". They always take that part out when they show that movie on TV.

Had one on my inner thigh about a week ago, got home from work and the pain was intolerable. Lanced it with my Spyderco after washing it good in alcohol. Made the mistake of squeezing it while standing over the bathroom rug. I owe mama a new rug, when that thing let loose the blood and puss went flying. Better to do it in the shower stall or bathtub, would have made cleaning it up easier.

This 300 lb woman had a boil on her Taint. she went to the DR and he lanced it and started sucking it out, she suddenly let a big fart, he Jumped back and said what are you trying to do make me sick?

284 could earn some points there.

Yep, this can get pretty gross!

Nice!

The future of America's healthcare.

For a meth addict she seemed to know what she was doing.

This one is a slower one but a testimonial for the anesthetic properties of beer, the importance of sharp surgical instruments, and an audience of your peers...
http://www.youtube.com/watch?v=FusrI6ae0dw

Embed anyone?

When coke bottles were good heavy glass, the trick was to heat the empty bottle, place it over the boil, and let it cool. The vac. would suck the junk out.

Jim if you will keep Mentholatum heaped on it...it will draw out the puss,alieve some of the pain and/or bring it to a head.Use a large bandaid or or Gauze pad to keep it on a night while you sleep. My brother gets them often and says thet are as painful as anything he's ever had. powdr

Couldn't agree more. MRSA moves fast and both can kill you. I have treated both and they are not fun. Clindamycin is a good start in killing the staph or MRSA and then come the joys of packing and unpacking the abscess for the next 2 weeks.

MRSA!

P and M were going to come see me in ICU after they'd done some shopping at Lowe's. But something tickled P's mind as they approached Lowe's � "Go see Ken now," so they reversed the order of their schedule.

In my room, P found me unresponsive � unconscious, gasping, dying. He notified the nurse who sat at a monitor outside. "Dr Howell is unresponsive." "Oh, he's all right," she said, unperturbed. "He was checked only thirty minutes ago."

P went down the hall, to the nurses' station, where several people were talking. "Who's in charge here?" "I am," a man (doctor) said. P told him "Dr Howell, in room 123, is unresponsive."

The doctor, alarmed, rushed to my room, and before long, I was on a gurney on my way to ER, where I lay in a coma for several days.

Thus began my long affair with MRSA, souvenir of recent grammatical surgery, and we danced a while. It'd be a long time, a lot of antibiotics, and months in a couple of nursing homes before we broke-off the affair.

MRSA is a good reason NOT to use anti-bacterial soaps. On the one hand, bacteria can become immune to the anti-biotic in the soaps and on the other hand, anti-bacterial soaps are non-specific, killing pretty much all bacteria, even beneficial bacteria. Because there are no competing bacteria left, you are wide open to complete colonization by whatever bacteria you come in contact with next.

That's not a "boil", or furuncle. It's a huge sebaceous cyst.

The "surgeon" here isn't doing him any favors by opening and draining it, really. The shell of the cyst needs to be excised, which in this case is going to be a fairly lengthy procedure because the damn thing is so big. Now that she's drained the cyst he'll need to let it heal up for a few weeks before excision can be attempted. It's a LOT easier to remove the cyst when it's chock-full of gunk.

MRSA (and other antibiotic-resistant bacteria) is thought to be a result of the unregulated use of antibiotics by agriculture. Using antibacterial soaps isn't a real strong contributor to the problem, but you're right, it's best to use regular soap for most of your cleaning needs. We're seeing a lot more MRSA in tattoo infections in the past 5 years or so, FWIW.

Likely not a "boil" but a epidermoid cyst. See your doctor. There are various treatment methods.

Yep. I had the same problem in 2008 and it ended up being MRSA. Painful nasty crap. The cure was damn near as bad as the cause.

(thanks for the spelling correction, Dr. Howell!)

Shoulda bit my tongue.

Got into the office this am and our Xray tech walked in with a horrible chalazion, pain beyond toleration, begging me to do incision & drainage. He's on call for the week so he can't leave town, so referral to ophthalmology was out of the question.

So I took him across the street to the ER and I opened it for him. Tricky business, but we got 'er done. No fun for him, I must say!

Wonderin' 'bout a coupla things here �

� Dad maintained that keeping loose eyelashes plucked precluded sties. He and I have always plucked 'em regularly, and have never had a sty. Folklore? Coincidence? Good practice?

� My limited experience with boils is over seventy years past. IIRC, suddenly released internal pressure, for all its drama and relief, doesn't empty the pit, which can't be cleaned while gunk remains. Does a breast pump have enough pull to be of any help?

Doc Rocket, that sounds like an internal hordeolum to me. Chalazion is the fibrotic scar tissue of the meibomian gland that remains after the acute infection (hordeolum). Usually staph a.

Right you are, eyeball.

As I stated earlier, I used to have the difference clearly catalogued in my head in medical school. Now I just call 'em "styes", and send 'em on.

Except in this case I couldn't. Fortunately, my clumsy surgical skills "took". Thanks to the I&D and some hi-dose cephalexin, Kevin is looking and feeling great today.

Doc, are most of the things we, the uneducated, refer to as "boils" really infected sebaceous cysts?

Ed

Dunno, really. If your family is prone to styes, then maybe plucking eyelashes makes a difference. But most folks don't need to do such things. If keeping the meibothian ducts clear was all that difficult, one would assume that women who use mascara would have styes all the time, which they don't...

So there you go, a firm "maybe"!



Pumping the purulent material out really isn't going to take care of the problem. The bacteria that remain in the abscess space will be cleaned up by the immune system provided the abscess doesn't close up again, so what you actually have to do is pack the abscess to allow it to shrink to modest size before you let it heal over.

My rule of thumb is, quite literally, a rule of thumb: i.e., if after incision and drainage I can feel a space under the skin as big as the ball of my thumb or bigger, I pack it with iodophor gauze. The packing may need to be drawn and repacked several times, in instances of large abscesses.

When one of my daughters was about 9 months old it was discovered that she had some sort of cyst/boil at the corner of her eye. A specialist performed surgery to remove & then a plastic surgeon did some sort of procedure to lessen the scar. After a couple of years you couldn't see the scar. We were very concerned at the time. Saw lots of boils & jungle fungus when serving in Vietnam. I had some sort of jungle fungus on my right ankle & later a small one on my lip. Had to have the one on my lip removed with surgery. Never knew what the hell they really were. I have read where a lot of cowboys used to have them on their butts & crotch. Probably from ridding, improper hygiene, & associating with assorted critters (including shady women). Ouch!

I've heard that Marx was such a bastard because he had boils on his azz and couldn't sit down.

Thats good to hear. Typically the lid is inverted and incision made from the back side to reduce the risk of sec. infection and lid scarring. Usually in the acute stage hot compresses are used. If the entire lid becomes involved it is dxed as preceptal cellulitis and txed with keflex and hot compresses. If it involes both lids then it is considered to involve orbital structures and close to the optic nerve and brain and is dxed as orbital cellulitis and sent to you for iv antibiotics. After the acute phase of hordeolum the non infective chalazion bump should be treated with warm comps and digital massage to possibly reduce the size of the mass. If the mass remains large it would be excised for cosmetics or to prevent subsequent deformation og the globe with resultant abnormal refractive error. thanks

No. What is commonly called a "boil" is medically termed a furuncle, or less often a carbuncle. A furuncle is a type of abscess. Abscesses are walled-off collections of pus (bacteria, bacterial byproducts, and leukocytes) that can occur anywhere in the body, but when they occur in/under the skin they're called furuncles. It is primarily an infectious process, the offending bacterium usuallly being a persistent strain of Staphylococcus aureus, or less commonly E. coli, Pseudomonas sp., Streptococcus faecalis, or sometimes an anaerobic bacterium such as Bacteroides sp. or Lactobacillus sp. The furuncle starts as a localized infection such as an infected hair follicle. The bacterial infection follows tissue planes, so the shape of the infection is irregular and can travel deep into the subcutaneous tissues. The key thing to remember is that a furuncle is an infectious process from start to finish.

An epidermal cyst or sebaceous cyst can be thought of as a giant out-of-control blackhead, which for the majority of its clinical life is noninfectious. The cyst is usually spherical, and is lined with stratified squamous epithelium which secretes keratin and the oils normally found in sebum (natural skin oil/lubricant). A large amount of sebum may be produced (see the youtube video posted earlier for an example of this!), and over time the cyst may become quite large. Eventually the cyst will become infected, at which point it may point and drain on its own, or it may need to be incised.

If you incise & drain (I&D) a furuncle, and pack it if necessary, it usually heals closed, leaving no potential space that can be reinfected in the future. A drained epidermal cyst, however, remains the size it grew to on its last "growth spurt", and usually re-fills with sebum over time. This is why I like to excise sebaceous and other epidermal cysts, not just I&D 'em.

yep,
cupping works wonders on 'em

I had a mill helper years ago, and exAmish kid
He would get huge ones all over his back and shoulders.
He would be weraing a tee shirt while working at the hot rolling mill( up to 4000deg C furnaced )

At times he would stoop and bend to pick up something heavy and they would explode under his shirt.

Some gross smellin crap!

Right! However, given the circumstances here out in the sticks, my anesthesia options were limited, so inversion with a globe-side incision was out of the question. I used ethylene chloride (VERY carefully!!!! ) for cutaneous anesthesia, then a bit of 2% lidocaine with a 30-ga needle. Then I opened it as close to the eyelash line as I could get with a #11 blade and teased the deeper tissues with a very fine mosquito forceps. Bleeding was brisk, as I'm sure you can imagine. Pain relief was almost instantaneous.

I would not have attempted this if the guy hadn't been using warm compresses and antibiotics for 3 weeks already when the current flare occurred. (And also, as stated earlier, couldn't leave town because he's the ONLY xray/CT tech here for the next week!) Under such circumstances, and after phone consultation with an ophthalmologist colleague in Angelo, I concluded that he faced significant risk of greater morbidity if I didn't cut.

Fortunately the patient in question has never seen me gut a deer or antelope (ask eh76 or other Antelope Armageddon veterans... sigh), or I'm sure he would've found a local midwife to do the surgery!

I would have been begging for the same. i just thought i would go over the considerations as chalazions are often not removed when they should be and vice versa. I just had a pt. sent in by the pharmacy she works at after a dr rxed augmentin for a mild case of viral conjunctivitis. Also, many people don't worry about a stye until they need to go to the ER, when hot compresses can often prevent a serious condition.

10-4

Haven't had a boil in seventy-three years.

Now I'm sure to get one from this thread � like my father-in-law when he was reading-up on tropical medicine during weeks of waiting for his travel papers to Cameroon. (He came down with whatever he happened to be reading about right then.)

As physician-surgeon in China, 1921�1949, he'd pioneered many of the treatments that that huge textbook described in detail. Meeting "old friends" didn't convey any psychosomatic prophylaxis in 1964!

Thanks, Doc!

My task here is done. I have learned something today, so I guess I shoud go get some work done.

Ed

When I worked in a feedlot, abcesses, or boils were one of the most common things we treated in the cattle. Most were probably smaller than a softball, but I saw a few that looked like the bovine had a beach ball under their skin.

We'd get them in the chute and lance them with a clean knife. By the way they acted it had to be very painful. What comes out will test your ability to hold your lunch. Then we'd flush it with an idodine mixture and load them up with antibiotics. We did quite a few of them but they always seemed to be pretty easy to clear up.