Pictures on Skin, Causes, and Treatment

Medically Reviewed by Dany Paul Baby, MD on June 26, 2022

A boil is a common, painful infection of a hair follicle and the surrounding skin. It begins as a red lump, then fills with pus as white blood cells rush in to fight the infection. Good home care can often clear up a single boil, also known as a skin abscess. A doctor’s care is needed when a boil resists treatment or develops in certain vulnerable areas of the body.

Boils are usually pea-sized, but can grow as large as a golf ball. Symptoms can include:

• Swelling, redness, and pain
• A white or yellow center or tip
• Weeping, oozing, or crusting

You may also have a general feeling of ill health, fatigue, or a fever, which is reason to call a doctor.

Boils can form anywhere on the body, but they’re most common on the face, neck, armpits, shoulders, back, and buttocks. Hairy, sweaty areas are typical sites, as well as areas of friction, such as the inner thighs. Boils can also develop around the ear or near the nose. The pain often worsens as pus collects under the skin, then eases as fluids begin to drain.

Most boils are caused by staph bacteria (Staphylococcus aureus), which many healthy people carry on their skin or in their noses without a problem. When a scrape, cut, or splinter breaks the skin, the bacteria can enter a hair follicle and start an infection. Others boils, such as those associated with acne, develop from clogged pores that become infected.

MRSA can look exactly like an ordinary boil: red, swollen, pus-filled, and tender. But MRSA infections are caused by one particular type of staph that is resistant to many antibiotics. If a skin infection spreads or doesn’t improve after 2-3 days of antibiotics, your doctor may suspect MRSA. The right treatment given promptly is important to heal a MRSA infection and prevent a deeper, more dangerous infection.

Not exactly, but the germs that cause boils (staph) are easily spread through skin-to-skin contact and contaminated objects. These bacteria usually do no harm unless they find a break in the skin. To avoid spreading staph, don’t share towels, bedding, clothes, or sports gear while you have a boil. Avoid touching the boil, and keep it covered. Frequent hand washing can also help prevent spreading the bacteria.

Folliculitis is an inflammation or infection of the hair follicles that can develop into a boil. Tiny pimples with whiteheads appear around individual hairs, sometimes surrounded by red skin. It can be itchy, tender, and uncomfortable, but is typically not as painful or deep as a boil. Shaving or friction from tight clothing can let staph bacteria slip under the skin — the most common cause of both folliculitis and boils.

When several boils form close together and join beneath the skin, it’s called a carbuncle. They are most commonly found on the back and the neck but can develop anywhere. Men are more likely to develop carbuncles than women. A carbuncle tends to lie deeper beneath the skin than a boil and can take longer to heal.

Cystic acne is a type of skin abscess that forms when oil and dead skin cells clog a hair follicle, creating a place where bacteria grow and thrive. It affects deeper skin tissue than regular acne, leading to firm, painful cysts. It’s most commonly on the face and shoulders and typically occurs in the teenage years.

When lumps and pus-filled abscesses repeatedly develop in these areas of the body, it may be a chronic condition called hidradenitis suppurativa. Infection starts in sweat glands and hair follicles that become blocked. Mild cases heal with home care. Several drugs and treatments are available for more serious and recurring cases.

When a boil forms in the skin just above the buttocks crease, it may be a pilonidal abscess. Hair is believed to play a role, and irritation, pressure, and prolonged sitting may also contribute to the development of a cyst here. If a cyst becomes inflamed and infected, it becomes an abscess. Some children are born with a “pilonidal dimple” where infections can crop up. Signs of infection require a doctor’s attention.

The familiar “stye on the eye” is a boil, usually caused by staph bacteria. It starts in the follicle of an eyelash and may be red, warm, swollen, and uncomfortable. A stye is sometimes confused with a chalazion, which is also a lump on the eyelid, but a chalazion is usually painless and is caused by a blocked oil gland, not an infection.

Anyone can develop a boil. The risk increases with:

• Close contact with an infected person
• Acne, eczema, or other causes of breaks in the skin
• Diabetes
• A weakened immune system

You can take care of most boils at home. Apply warm, moist compresses several times a day to help a boil open and drain. After it starts draining, keep it clean, and continue using warm compresses — a clean one every time. Change the bandage often and wash hands well. Resist the urge to squeeze or pop the boil. This can make the infection worse.

If a boil doesn’t heal after a week of home care, call your doctor. Other reasons to call include:

• A boil on the face or spine
• A fever or red streaks coming from the sore
• A very large or painful boil
• A boil that keeps coming back

If the fluid inside a boil doesn’t drain by itself, your doctor may prick the top of the sore with a sterile instrument to be sure it drains completely. A deep infection may be packed with sterile gauze so it continues to drain. Antibiotics and steroid shots are sometimes given to help with healing.

For some people, boils are a recurring problem. In addition to standard treatment, your doctor may try to eliminate or reduce staph bacteria throughout the body. This can include any or all of the following treatments: washing up with a special antiseptic soap, using an antibiotic ointment inside the nose, or, if necessary, 1-2 months of antibiotics taken by mouth.

Most boils heal with home treatment or a doctor’s visit. Sores on the face may require antibiotics because they’re so close to the eyes and brain. Rarely, the staph bacteria from a boil or carbuncle can get into the bloodstream, which can then affect the heart and other internal organs.

Since bacteria are everywhere in our environments and on many people’s skin, the best defense against boils includes:

• Hand washing or use of alcohol-based hand sanitizer
• Careful cleaning of cuts, scrapes, and other wounds
• Keeping wounds covered
• Not sharing towels, sheets, razors, etc.

Wash towels, sheets, and anything else in contact with an infected area in very hot water. Throw away any wound dressings in a tightly sealed bag.

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REFERENCES:

Nemours Foundation: “Staph Infections.”

Skinsight.com: “MRSA.”

University of Chicago Medical Center: “MRSA FAQ.”

Merck Manual of Medical Information, 2nd Home Edition: “Folliculitis and Skin Abscesses.”

NIH Genetics Home Reference: “Hidradenitis Suppurativa.”

Hidradenitis Suppurativa Foundation: “What is Hidradenitis Suppurativa?”

American Academy of Ophthalmology: “What Are Chalazia and Styes?”

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Causes, Symptoms, Diagnosis, Stages, and Treatment

Written by Katherine Kam

• What Is Hidradenitis Suppurativa?
• Causes
• Symptoms
• Common Sites
• Diagnosis
• Questions for Your Doctor
• Stages
• Treatment
• Lifestyle Changes
• Complications
• Outlook
• More

Hidradenitis suppurativa (HS) is a chronic inflammatory condition that causes painful bumps under your skin in the hair roots and/or near some of your sweat glands. It’s also known as acne inversa.

The bumps can get infected. When that happens, pockets form under your skin and fill with pus. They can smell bad when they break open. They can also leave scars.

There’s no cure for HS, but treatments and lifestyle changes can bring some relief and cut down on flare-ups.

Because this condition lasts a long time, it can be frustrating, and it can take an emotional toll on you. Make sure you get the support you need.

Doctors aren’t sure what causes hidradenitis suppurativa, but it’s probably due to a combination of genes, hormones, and the environment. 

It’s more common in women than in men. It’s also more likely if you’re overweight, if you smoke, and if you’ve had acne. About a third of people who get HS have a relative with it.

The skin problems start when hair follicles get blocked. You often get the first symptoms in your teens or 20s.

You don’t get HS because you don’t wash enough, because you use deodorants or powders, or because you shave your underarms. You also can’t catch it from someone else or give it to another person.

HS usually affects both sides of your body. You can get the bumps in one place or in several areas at once.

The first warning sign might be a single painful bump that gets inflamed. It can last days or months. You could have repeated outbreaks of a single bump in the same location or the same general area.

Besides turning into pockets of pus, the bumps can be itchy. Your skin might have small pitted areas with blackheads.

Some people get tunnels under their skin, called sinus tracts, which connect different areas of HS outbreaks.

The bumps and leaky pockets can go away and come back. In severe cases, they don’t fully heal.

The blockages usually happen in areas where you have hair or where your skin rubs together, such as:

• Under your arms
• In your groin
• Between your buttocks
• Between your thighs
• Under your breasts
• In the folds of your stomach
• On the nape of your neck
• Behind your ears

Your doctor will check your skin and make a diagnosis based on where the bumps and pockets are and how often you have them.

They may also ask you things like:

• How long ago did your symptoms begin?
• Are they painful?
• Have you had these symptoms before?
• Have any close relatives had this problem?

You probably won’t have tests unless your doctor needs to rule out other kinds of infections. Then, they’ll take a sample of pus and send it to a lab for testing.

• How mild or severe is my hidradenitis suppurativa?
• What treatments are available? Which do you recommend?
• Should I take an antibiotic? What about other medications?
• Could these medications cause side effects?
• Will I need surgery?
• What lifestyle changes should I make to improve my illness?
• Should I lose weight?
• If my symptoms get worse, when should I call you?
• Will the disorder go away on its own?

HS is divided into three stages, based on how severe it is, called Hurley stages.

• Hurley stage I: A single or multiple isolated bumps with no sinus tracts
• Hurley stage II: Multiple bumps with some sinus tracts and scarring
• Hurley stage III: Multiple bumps with a lot of sinus tracts and scars, involving an entire area of your body

Your treatment will be based on how severe your case is. You and your doctor might have to try multiple treatments to find the one that works best for you.

Treatments include:

Warm compresses. You might try this first if your case is mild. Run a clean washcloth under hot water and hold it on your skin for 10 minutes.

NSAIDs(nonsteroidal anti-inflammatory drugs). These over-the-counter medicines can ease your pain and help manage swelling. They include:

• Aspirin
• Ibuprofen
• Naproxen

Antibiotics. These medications fight infections. You can swallow them as a pill, or you can use a cream, ointment, cleanser, wash, or gel on your skin.

At first, you may use doxycycline or minocycline for 2 to 3 months. If that doesn’t help, your doctor may suggest a combination of clindamycin and rifampin (Rifadin, Rimactane).

Corticosteroids. Your doctor injects these medicines into the bumps. They can ease inflammation, pain, and swelling. You usually get these shots once a month for up to 3 months. If your case is severe, your doctor may recommend that you take steroid pills by mouth.

Oral retinoids. Your doctor may suggest a retinoid medication in a pill, such as acitretin (Soriatane) or isotretinoin (Accutane). Both can improve severe cases of HS.

Topical resorcinol. This is a cream that you put on inflamed areas of your skin. It has chemicals that peel the skin.

Hormone therapy. Some women find that their condition gets better if they take birth control pills or a drug called spironolactone.

Biologics. These medications work on your immune system, your body’s defense system against germs. You take them by getting a shot, either at the doctor’s office or at home. Or you may need to get the meds through an IV in your veins. This is done at a clinic or hospital.

These drugs include:

• Adalimumab (Humira). This medicine is the only one approved by the FDA to treat HS.
• Infliximab (Remicade). The FDA hasn’t approved this for HS, but doctors still use it.
• Anakinra, canakinumab, and ustekinumab. These medications may help some people with severe or hard-to-treat HS. Researchers are studying how well they work.

Biologics can clear up HS for a long time, but they can also have serious side effects, so doctors use them only for severe cases.

Other medications. These include:

• Metformin (Glucophage). Doctors use this to treat adult-onset diabetes and metabolic syndrome. It may also help patients with HS.
• Methotrexate (Xatmep). It is a pill, shot, or IV that controls the inflammation of psoriasis and other medical conditions, including some cancers. It works on your immune system and may help control HS in some people.

Surgery. If your bumps grow deep into your skin, you might have a surgical procedure. If you’re having problems in a small area, your doctor can cut open pockets to drain pus. This gives you short-term relief.

In a procedure called deroofing, your doctor turns deep, painful bumps and pockets into scars that won’t hurt. It’s an option if you have painful bumps that come back over and over.

Another type of surgery involves cutting out skin in the problem spots. Afterward, your doctor will do a skin graft. They take skin from another part of your body and use it to cover the area where you had the operation.

Laser surgery is another option to clear new, deep bumps. It destroys hair follicles, the shafts in your skin where hair grows. You may need several treatments.

Surgery can help with stubborn or severe cases of HS, but for some people, it may come back in the same area or somewhere else.

Try these tips to make your HS less severe and slow outbreaks.

Lose extra weight. This can ease your symptoms by making your skin rub together less.

Quit smoking. Not only does this cut your risk of cancer and heart disease, it can make your HS less severe. Talk to your doctor about programs that can help you break the habit.

Don’t shave trouble spots. This can keep you from irritating your skin. Ask your dermatologist about other ways to get rid of unwanted hair.

Wear loose-fitting clothes. Outfits that are tight can cause your skin to rub, making your flare-ups worse.

Stay cool. You can get flare-ups when you get too warm and sweat. But be careful about using deodorants, which can sometimes irritate your skin. Ask your dermatologist for suggestions about one that won’t cause problems.

Keep clean. Wash HS areas gently every day with your fingers. Scrubbing with a washcloth or brush can irritate your skin. Use an antibacterial soap, which can help get rid of odor.

Use the right bandage. If a pocket is leaking, cover it with a bandage that doesn’t stick to the bump. Use plenty of petroleum jelly on the gauze that covers the area. Avoid using adhesive tape as much as possible.

HS that is severe or isn’t treated can have complications over time, including:

• Deep pockets of infection (abscesses)
• Trouble moving because of scar tissue
• Hollow passages inside your body (fistulas)
• Lymph node problems
• Arthritis
• A skin cancer called squamous cell carcinoma
• Depression and isolation

HS can last for years, but early treatment can help you feel better and lower the risk of flare-ups.

In severe cases, hidradenitis suppurativa can get worse and cause scars. Surgery can help, although the disease comes back about one-third of the time. It’s still important to keep up with lifestyle changes that can make you feel better.

Turn to people you trust to give you the backing you need while you get treated. You might join a support group where you can talk freely with people who understand your situation. Ask your doctor about how to find a group near you.

Talk to your close family and friends about your condition, or consider seeing a professional counselor. They can help make sure you don’t let your skin problems keep you from enjoying an active social life.

You can learn more about your condition on the website of the Hidradenitis Suppurativa Foundation.

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causes, symptoms, diagnosis and treatment

Getting into the hair follicle of the skin of staphylococcal bacteria can cause serious inflammation. The accumulation of pus with tissue necrosis, which captured the affected area along with the sebaceous glands and fiber, is called a furuncle, and the disease itself is called furunculosis. Its appearance is quite painful, and the development is relatively fleeting. To avoid infection of the skin and the spread of the inflammatory process to healthy tissues, at the first signs of pathology, you should seek medical help.

Causes

The inflammatory process and suppuration of tissues contribute to:

• non-compliance with personal hygiene requirements or its inadequate quality;
• constant rubbing of clothing against skin;
• abrasions and injuries that provide access for bacteria to the subcutaneous layer;
• intensive work of sebaceous and sweat glands;
• hypovitaminosis;
• metabolic disorders.

Most boils form on areas of the skin with hair follicles. Often they appear on the neck, face, back of the hands, in the lumbar region. At the initial stage, inflammation makes itself felt by the appearance of a characteristic red tubercle that rises above the surface of the skin. After 3-4 days, a purulent head appears. Later, the boil breaks through under the influence of an increase in the volume of purulent secretion or mechanical impact. At the site of the rupture of the skin, a core is visible – the so-called necrotic tissue. After 2-3 days after the rupture, the rod, together with the rest of the purulent contents, is rejected, and the wound begins to heal.

Species

Depending on the location and features of development, general and local furunculosis are distinguished.

• The local type of the disease occurs in a limited area of ​​the skin. Its cause is the incorrect treatment of one rash or a violation of sanitary requirements in matters of skin care.
• General furunculosis captures a significant area of ​​the skin and is characterized by numerous rashes. More often it occurs against the background of a weakening of the body, disturbances in the functioning of the immune system, long-term chronic diseases or during remission, with anemia or disorders in the functioning of the nervous system.

The course of furunculosis can be acute or chronic. In the first case, inflammation occurs simultaneously or with a short time interval, and the disease makes itself felt by fever, headache and a feeling of weakness. The chronic form of furunculosis develops with prolonged physical overwork, with overheating or hypothermia of the body, as well as against the background of a weakened immune system. Regardless of the type of disease, when symptoms of furunculosis appear, it is worth contacting a dermatologist as soon as possible to clarify the causes of the boil and develop an effective tactic for its treatment.

Diagnostic methods

It is possible to accurately establish the development of a boil already with an external examination of the patient. Additional information about the disease will be provided by the results of a clinical and biochemical blood test, as well as cultural diagnostics to identify the type of bacterial infection. The latter method will allow you to select effective antibiotic drugs that will help destroy the pathogen and reduce the risk of recurrence of the disease.

Treatment

The main method of treating furunculosis is the use of external topical agents that relieve the inflammatory process and pain syndrome. The course is based on the consistent intake of antibiotics, antiseptics and painkillers. If there is a possibility of developing an abscess, it is possible to surgically open the boil with the extraction of its contents and the treatment of the site of inflammation. It is possible to use UHF-therapy, which demonstrates high efficiency at any stage of the development of the disease.

Please note: it is strictly unacceptable to self-medicate, as well as to try to open the boil on your own to extract its contents. In addition, it is important to change clothes and bedding more often, strictly observe the rules of personal hygiene, but limit exposure to raw water on the affected area.

Methods of prevention

You can reduce the risk of infection with staphylococcal bacteria and the development of furunculosis if:

• keep the body clean, take a shower regularly;
• treat injuries and cuts carefully;
• lead a healthy lifestyle;
• exercise regularly;
• diversify the diet, focusing on foods with a high content of vitamins.

In addition, it is important to treat emerging diseases of internal organs in a timely manner, as well as dress according to the season, preventing overheating or hypothermia of the body.

Treatment of furunculosis in JSC “Medicina” (clinic of Academician Roitberg)

Qualified therapists and dermatologists of JSC “Medicina” (clinic of Academician Roitberg) in the Central Administrative District of Moscow are ready to receive and examine patients with suspected furunculosis. To confirm the diagnosis, it is recommended to undergo a comprehensive examination in your own laboratory center. Treatment is prescribed on an individual basis, and its course and results are strictly controlled by specialists. Each client is guaranteed a tactful and attentive attitude, confidentiality of personal information, as well as comfort and safety during diagnostic and treatment procedures.

How to open a boil yourself?

Dermatologists categorically do not recommend trying to cope with inflammation on their own, wanting to squeeze out the purulent contents and the core of the boil at home. This is dangerous by secondary infection, the spread of the inflammatory process to healthy tissues, the formation of new areas of inflammation and blood poisoning. The decision to open the boil is made only by the surgeon of the specialized medical institution, and only he has the right to carry out such manipulations.

What does a boil look like?

A furuncle is a thickening or a red tubercle with a purulent head that is noticeable on the surface of the skin. When touching its surface, a relatively strong pain is felt, the skin around it is noticeably inflamed, its temperature is increased. The most common places of development are the back of the head, the back of the hands, the lower back, and the face. The rash can be single or massive, its symptoms do not depend on the number of points of inflammation.

Why do boils appear?

This question can be answered accurately only after a thorough diagnosis of the boil. Among the most likely causes are infection of the hair follicle of the skin with staphylococcus bacteria against the background of beriberi, violation of personal hygiene rules, wearing too tight clothes, poor-quality antiseptic treatment of abrasions and skin injuries. Also, the disease can be caused by the intensive work of the sebaceous and sweat glands, the secret of which is a favorable environment for bacteria.

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treatment, causes, symptoms, prevention, types, diagnosis and complications of the disease

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About the disease Classification Symptoms Causes Diagnosis Doctor’s opinion Treatment 5 In % of cases, the abscess develops due to infection with Staphylococcus aureus and only in 5% of cases there is another bacterial flora.

The appearance of a pimple on the skin rarely causes a person to seek medical attention. But few people understand that an abscess can turn out to be a boil or a boil. The disease requires a referral to a specialist, especially if abscesses appear one after another. This may indicate serious disorders in the body and high risks of complications.

About disease

Furuncles often form on areas of the skin where there are many sebaceous glands – around the lips, along the back of the neck, on the hands, on the thighs and buttocks. Abscesses do not form on the palms and soles.

A boil is often preceded by folliculitis. When you try to squeeze out the contents, the bacteria are carried to the surrounding tissues, which leads to inflammation.

Classification of boils

In the process of its development, the boil passes through several stages, each of which has its own characteristics.

• Infiltration. Represents the initial stage of inflammation.
• Maturation. A purulent-necrotic core is formed, which is rejected after a few days.
• Scarring. The healed wound heals with the formation of a scar.

The duration of the full cycle of development of an abscess is from one to two weeks. With a close location of several foci, their merger is possible. If the inflammatory process extends to the subcutaneous tissue, they are talking about a carbuncle. There are situations when boils are formed at intervals of three or more times a year. This indicates the development of furunculosis.

Symptoms of a boil

The first signs of a boil appear after hypothermia, injury or contamination of damaged skin. The skin around the hair follicle becomes red, swelling appears. Within a few days, it continues to increase with the formation of a cyanotic rod. The pain at this point becomes constant, pronounced, pulsating. In size, the abscess can reach a centimeter in diameter.

A bubble filled with pus forms in the center of the formation. After its self-opening, a purulent crust is formed. When it is removed, a necrotic rod is visible. Ripening continues for 3-4 days. During this time, the rod is torn away, the surrounding tissues are melted, and the contents of the abscess are constantly released from the wound. After complete cleansing, a deep wound remains on the skin.

If an abscess forms on the face, the symptoms of a boil are often accompanied by signs of general intoxication: fever, chills, severe weakness, loss of appetite.

Causes of boil development

The main reason for the formation of a boil is the ingress of bacteria on the skin – untimely change of linen, towels, razors. Presence of provoking factors matters:

• skin microtraumas, scratches, scratches;
• increased moisture on the skin;
• frequent overheating of the body;
• disruption of the immune system – diabetes mellitus, HIV, obesity;
• chronic pathologies of the cardiovascular system and metabolic processes;

Uncontrolled intake of antibacterial drugs contributes to the development of resistance and disruption of the natural balance in the opportunistic microflora, which is constantly on the surface of the skin. It also increases the risk of boils.

Diagnosis of boils

Patient examination begins with a questioning. It is important for the doctor to find out what factors preceded the appearance of boils, whether there are chronic diseases, what the patient is doing when an abscess occurs (what ointments to use, whether he tried to squeeze out). During the examination, the condition of the boil, its stage of development, is assessed.

To determine the severity of the disease, a laboratory blood test is prescribed. Only after that a diagnosis is made indicating the form and stage according to the classification of boils.

In the presence of chronic pathologies, additional examinations and consultations of narrow specialists may be required. Diagnosis of a boil necessarily includes an analysis to determine the sensitivity of the pathogen to antibiotics. This will allow you to choose the most effective treatment for boils.

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Learn more about the disease from the doctors of clinic

Doctor’s opinion

Treatment of boils

When there is a painful bump, ie. at the initial stage of the disease, it is possible to treat the boil with conservative methods. Local therapy includes:

• refusal to shave, mechanical trauma to the skin (use of scrubs, washcloths), replacement of cosmetics that clog the skin with lighter ones;
• daily treatment of the affected area with antiseptics;
• dressing with antibacterial ointment;
• taking vitamins in a course prescribed by a doctor.

As a result of these actions, the inflammatory process subsides.

If no action is taken when an abscess occurs, it proceeds to the next stage with the formation of a necrotic rod. Treatment will require surgery. The procedure is performed by a doctor under antiseptic conditions.

Under local anesthesia, the abscess is opened to ensure the outflow of the contents. After removal of the necrotic rod, the wound is washed and closed with a sterile dressing. The procedure takes 10-15 minutes and does not require hospitalization. Exceptions are situations when the abscess is located on the face, accompanied by severe swelling and symptoms of intoxication. To prevent negative consequences after treatment of a boil, it is recommended to observe a doctor in a hospital for 2-3 days.

Prevention of boils

Prevention consists of the following recommendations:

• avoid wearing tight clothing made of artificial materials;
• exclusion of alcoholic beverages;
• strengthening the immune system with vitamins and an active lifestyle;
• stress minimization;
• normalization of nutrition with a sufficient amount of trace elements in the diet;
• a competent choice of cosmetics that do not clog pores;
• use of antiperspirant instead of deodorant;
• skin protection against pollution;
• timely treatment of chronic diseases.

Rehabilitation

After opening the boil within 1-2 days, pain, swelling of the tissues is possible.