• Painful inflammatory swelling of a hair follicle that forms an abscess; typically appears as a small rounded or conical nodule surrounded by redness, progressing to a localized pus pocket with a white center.
• There is tenderness and pain and, if the condition is severe, mild fever.
• Staphylococcus aureus can be cultured from the abscess.
A boil (furuncle) is a deep-seated infection (abscess) involving the entire hair follicle and adjacent tissue. The most commonly involved sites are hairy parts of the body that are exposed to friction, pressure, or moisture, such as the neck, armpits, and buttocks. Using petroleum-based skin lotions or creams can plug the hair follicles and increase the risk of boil formation. Since the infection can spread, several boils are often found at one location. When several furuncles join together, they are called a carbuncle.
Causes
There is no particular cause of boils, although occasionally they may indicate an underlying disease that is associated with poor immune function, such as diabetes, AIDS, or cancer. Most lesions will resolve within one to two weeks. Recurrent boils can indicate a highly infective form of bacteria, poor hygiene, industrial exposure to chemicals, or depression of the immune system.
Therapeutic Considerations
Recurrent attacks of boils can also indicate a depressed immune system, which may be caused by nutritional deficiencies, food allergies, and/or excessive consumption of sugar and other concentrated refined carbohydrates (see the chapter “Immune System Support,” for further discussion). The treatment goals are to address any underlying immune disorder, achieve higher skin levels of vitamin A and zinc, and disinfect the area with topical application of herbal antiseptics. However, in severe cases consult a physician immediately.
The best herbal treatment for boils is the topical application of tea tree oil. The tea tree (Melaleuca alternifolia) is a small tree native to only one area of the world: the northeast coastal region of New South Wales, Australia. Tea tree oil possesses significant antiseptic properties and is regarded by many as the ideal skin disinfectant. It is effective against a wide range of organisms, penetrates the skin well, and does not cause irritation.1 Organisms inhibited by tea tree oil include:
• Candida albicans
• Propionibacterium acnes
• Pseudomonas aeruginosa
• Streptococcus pyrogenes
• Trichomonas vaginalis
• Trichophyton mentagrophytes
A clinical trial involving patients with boils demonstrated that tea tree oil encouraged more rapid healing without scarring, compared with matched controls.2 Presumably the positive clinical effects were due to the oil’s antibiotic activity against Staphylococcus aureus. The method of application included cleaning the site, followed by painting the surface of the boil freely with tea tree oil two or three times a day.
For boils and most skin infections, the most effective treatment appears to be direct application of full-strength, undiluted oil at the site of infection. If irritation occurs, try diluting the oil.
Various herbal poultices are commonly used in the treatment of abscesses. Folk healers have used burdock root, castor oil, chervil, licorice root, and others. Poultices, although quite simple, appear to be highly effective. Historically, naturopathic physicians commonly used a poultice made from a paste of goldenseal root powder. Its efficacy is probably due to berberine, the most active alkaloid in goldenseal. Berberine is well documented as an antimicrobial agent.3 It is toxic to the bacteria commonly associated with boils, particularly Staphylococcus aureus.4 It has also been found to stimulate immune system function and decrease inflammatory processes. An advantage of goldenseal poultices, as compared with hot packs and other types of poultices, is that they usually will not cause the boil to rupture.
QUICK REVIEW
• Recurrent attacks of boils can indicate a depressed immune system.
• Tea tree oil is an effective topical treatment for boils.
• If the boil is severe or does not resolve within two to three days, consult a physician.
TREATMENT SUMMARY
Eliminate from the diet any foods that may suppress immune function (sugar, refined simple carbohydrates, and food allergens). If the boil is severe or does not resolve within two to three days, consult a physician, since the infection can spread under the skin, causing cellulitis (inflammation of the connective tissue), or into the bloodstream, causing bacteremia (bacteria in the blood). Cleanliness should be rigorously maintained. The infected area should be immobilized and not handled, except when necessary to change the poultice. If tea tree oil or goldenseal poultices are not available, a pack of hot Epsom salts (mix 2 tbsp Epsom salts in a cup of hot water, soak a washcloth in the solution, and apply to the boil) will bring an abscess to a head.
• In addition to the general recommendations given in the chapter “Supplementary Measures,” take:
Vitamin C: 500 to 1,000 mg three times per day
Vitamin A: 5,000 IU per day (do not use more than 3,000 IU per day of vitamin A if you are pregnant or may become pregnant)
Zinc: 30 to 45 mg per day for up to one month, then 20 to 30 mg per day
• Tea tree oil (Melaleuca alternifolia): Apply undiluted oil to the affected area two to three times per day
• Goldenseal (Hydrastis canadensis) poultice: Mix 1 tbsp root powder with water to form a paste, then apply to abscess and cover with an absorbent bandage; use twice per day