Dr Margaret answers emailers’ embarrassing problems
in this monthly problem page.

Boils

Dear Dr Margaret
I keep getting boils. How can I stop them?

Your problem is caused by bacteria, which gain entry to your skin at the root of a hair. Each of the tiny hairs in your skin emerges from a deep pit – the hair follicle. The bacteria multiply at the bottom of the hair follicle and then spread into the nearby skin. The result is a lump that is red and tender, and which may discharge pus before it heals. Often it leaves a scar.

When a patient has this problem, doctors always look for a possible reason, such as diabetes or some other chronic illness. Usually no such cause is found and the person is completely healthy except for the annoying boils.

The usual culprits are staphylococci bacteria. It is very likely that you are carrying these bacteria just inside your nose and then transferring them to your skin. We all touch our noses surprisingly often without realizing what we are doing. Try to avoid touching your nose unnecessarily. (Getting out of the habit of touching your nose unnecessarily has another benefit – you will be less likely to catch colds and flu.) Your doctor can take a swab from your nose and send it to the laboratory to check whether you have staphylococci bacteria there. If so, your doctor can prescribe an antiseptic (such as chlorhexidine) or an antibiotic (such as mupirocin) to get rid of them. Patience is needed, because you will have to apply the antiseptic or antibiotic twice daily for 6 weeks.

I do not usually recommend antiseptic soap, but for people with recurrent boils it is a good idea. Bath or shower daily using the soap.

If the boils still keep coming, other people in your household should also have nose swab tests to see if they are carrying staphylococci, which might be transferred to you. If so, they should be treated. As a last resort, your doctor might prescribe low-dose antibiotic tablets for about 3 months.

If the boils are in only your armpits or groins, look at my previous advice on a condition called ‘hidradenitis’.