Boils are a form of bacterial skin infection that presents as inflamed, tender, pus filled sores. Most boils drain and heal shortly after appearing. However, large or severe boils may require medical attention and antibiotic treatment.
Minor or small boils often resolve on their own with good hygiene and at-home treatments, such as warm compresses. However, large or complex boils, boils on the face or neck, and chronic boils often require a doctor to drain them. Some people may also need to take antibiotics.
This article discusses what a boil is, which antibiotics may be effective, why it is important to take antibiotics exactly as prescribed, general tips for taking antibiotics, and additional treatments for boils.
Boils are painful, swollen, tender sores that develop under the skin due to a bacterial infection.
Bacteria cause most boils, with Staphylococcus aureus (staph) being the type that most commonly lead to boils. Staph bacteria normally live on the surface of the skin and only tend to cause infection when they enter the body or overgrow.
Boils usually grow as they fill with pus, which is a mixture of dead skin and immune and bacterial cells. Once the boil reaches a size where the pressure inside becomes too high, it will typically burst open, allowing the pus and other contents to drain out.
Boils can be any size and appear anywhere on the body, though they tend to develop in body regions that have hair, sweat a lot, and are subject to friction.
A wide range of oral and topical antibiotics may help treat boils. A doctor will determine which medication is most likely to be effective for someone based on several factors, such as:
- the person’s age
- additional medical conditions
- other medications that a person is using or has already tried
- any allergies
- the severity of the infection
- the person’s immune status
- the risk factors associated with the medication
Staph bacteria are the cause of many boils. Several types of staph bacteria have adapted to resist certain types of antibiotics, particularly methicillin-based medications.
Several studies have concluded that taking nonmethicillin-based systemic (oral or intravenous) antibiotics after a doctor has incised and drained the boils increases the likelihood of full recovery. However, other studies suggest that systemic antibiotics show no benefit after the incision and drainage of a boil.
Some of the antibiotics that doctors most commonly use to treat boils include:
In rare cases, a doctor may take a sample of pus from a boil and send it to a laboratory. There, technicians will analyze it to determine which specific type of bacteria is causing the boil. The doctor may require this information if:
- standard treatment is not working
- sepsis (a blood infection) is a possibility
- someone is allergic to several types of antibiotics or does not respond well to them
- there is a risk that the bacteria are antibiotic resistant
- there are multiple boils, or they are recurring
- the person has a weakened immune system
Knowing which specific type of bacteria is causing boil infections usually makes treatment more effective.
It is extremely important to take antibiotic medications exactly as per the prescription and to complete the whole course, even if the symptoms go away.
Not taking the whole course of prescribed antibiotics increases the risk that the infection will return. It also raises the risk that the bacteria causing the infection will become antibiotic resistant. People with a staph infection should take particular care, as several staph species are already antibiotic resistant.
Some research suggests that shorter courses of antibiotics may be as effective as longer courses. However, the doctor prescribing the antibiotics will prescribe as much as they feel appropriate. So, it is important to follow their advice.
- avoiding sharing medications with others
- avoiding saving medications for later use
- asking a pharmacist for advice on how to discard medicines safely, if necessary
- refraining from taking medications that a doctor prescribed to someone else
- refraining from breaking up or crushing medications
- taking medications with water only
- avoiding consuming fruit juices, dairy, or alcohol within 3 hours of taking antibiotics
- avoiding consuming dietary supplements with calcium
- spreading antibiotic doses out evenly throughout the day as much as possible
- asking a doctor whether it is best to take doses with food or at the same time every day
- talking to a doctor or pharmacist if taking other medications, as some may negatively interact with antibiotics, especially blood thinners, antacids, and hormone medications
In many cases, people do not need to take antibiotics for boils. Instead, several at-home remedies may help accelerate the healing process or improve the chances of recovery.
Additional treatment options for boils include:
- Using a warm compress: Make a warm compress by heating a wet, clean cloth or facecloth and gently applying it to the boil for 10–20 minutes, three to four times a day.
- Covering boils: Cover boils with sterile gauze or a bandage, especially once they have burst.
- Washing the hands and body frequently: Wash the hands thoroughly with hot water and soap before and after touching boils. Wash the body daily with a gentle antiseptic or antibacterial cleanser.
- Avoiding forcing boils open: Never try to squeeze, pierce, or forcibly open a boil, as this can spread the infection and cause it to become more severe.
- Taking over-the-counter (OTC) pain relievers: Take medications such as paracetamol or ibuprofen to reduce or manage pain associated with boils.
In certain cases, a doctor may also make a small cut to drain boils in their office. They may do this for boils that:
- are severe
- are on the face or neck
- do not resolve on their own
- have merged with other boils, forming a carbuncle
In some cases, a doctor may also prescribe antiseptic creams or ointments that a person can apply to the inside of their nose to help limit staph infection. OTC topical antibacterials, such as Neosporin, will not help treat boils as they do not penetrate the skin enough.
A doctor may prescribe one of several types of antibiotics that can help treat boils. Typically, the most common and effective antibiotics are not methicillin-based, but a doctor will decide which antibiotics or other treatments are most appropriate.
Some people may be able to manage boils with at-home remedies, and some boils may resolve on their own. In other cases, people may need medical help and require a doctor to drain a boil and prescribe antibiotics.
It is best to talk to a doctor about severe boils, clusters of boils, and boils with accompanying symptoms. People should also talk to a doctor if boils do not fully heal after completing a whole course of antibiotics.