Your Health   -  A to Z of Common Medical Conditions

Boils / Impetigo

Description - Boils are infections of the skin. The infection often starts in a hair follicle but can sometimes enter through a break in the skin. The skin becomes inflamed, hardened and swollen and there is, invariably, in the middle of this inflamed tissue a collection of pus. The pus nearly always points to the outside, "comes to a head", and, once the boil has discharged, the inflammation and swelling gradually subsides, sometimes leaving some scarring. Several boils can join together to form a carbuncle. Boils are invariably caused by strains of Staphylococcus aureus, bacteria increasingly resistant to antibiotics and in their most resistant forms the cause of much anxiety regarding hospital infections. Many people harbour a staphylococcus in their nose, some in the ano-genital region. Boils are most common in winter months (more clothing), when people are tired or run down, anaemic, and in some diseases like diabetes. They most commonly develop in adolescence. Boils can be very painful and debilitating. Particular care has to be taken with boils around the mouth, nose and eyes as they can occasionally cause a hazardous thrombosis deeper within the head. People who carry staphylococcus in the nose can be quite potent sources of infection, endangering other people, particularly in such an environment as a hospital. Impetigo is a staphylococcal or streptococcal infection of the surface of the skin. It is not usually painful. It most often affects children, mostly on the face and limbs. Patches of impetigo are red, wet with a yellow crust on the top. It is very easily transmitted from person to person by touch, shared towel, face cloths etc.

Management  - Painkillers are often necessary to ease the discomfort of boils. Local warmth and poultices sometimes help relieve the pain and encourage the infection to point. Once the boil begins to discharge, it should by cleansing  - not vigorous squeezing - be encouraged to drain. This can be helped with such applications as magnesium sulphate paste. Antibiotics from the doctor will usually reduce the time to recovery. Treating nasal carriers of staphylococcus with local antibiotic nasal cream can reduce the frequency of infection. If people have recurrent boils, doctors will always test their urine to make sure they are not diabetic (see Diabetes). They will often take swabs from the boil, and from the nose, to determine whether the patient is a carrier and the exact nature of the staphylococcus involved. Impetigo is treated with antibiotics by mouth and antibiotics locally. Children with impetigo should be kept off school.

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