Patient information · Minor surgery and dermatology
Boils and abscesses
why antibiotics alone usually are not enough
A boil is an infection of a hair follicle; an abscess is a collection of pus in a cavity. The important principle is old and unchanged: pus under pressure needs to come out. Antibiotics cannot penetrate a walled-off collection, which is why they so often fail on their own.
Seek urgent assessment if there is
- spreading redness, or red streaks tracking away from the area
- fever, shivering or feeling generally unwell
- a boil on the face, particularly around the nose, eyes or upper lip
- an abscess near the spine, groin, or anus, or affecting a joint
- you have diabetes, a weakened immune system, or the area is on the hand
- severe pain out of proportion, or rapidly spreading swelling
Facial boils in the central triangle drain towards veins connected to the skull and need prompt treatment. Perianal and spinal abscesses often need surgical drainage under anaesthetic. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Do not squeeze it
Squeezing a boil forces bacteria deeper into the tissue and into the bloodstream, converts a simple boil into cellulitis, and causes far worse scarring. It also rarely achieves anything, because the pus is walled off. The urge is powerful; resist it.
What to do at home
- Apply a warm compress for 10 to 15 minutes, three or four times a day. This is the most effective self-treatment — it encourages the boil to come to a head and drain on its own.
- Keep the area clean and covered with a dry dressing.
- Take paracetamol or ibuprofen for pain.
- Wash hands thoroughly before and after touching it; use a separate towel and wash it hot.
- If it drains by itself, let it, then keep it clean and covered until it heals.
- Most small boils settle within a week to ten days.
When it needs draining
An abscess that is fluctuant — soft and full — needs incision and drainage. This is a small procedure under local anaesthetic, gives immediate relief from the pressure pain, and is usually the definitive treatment. Antibiotics are added when there is surrounding cellulitis, fever, or particular risk factors, but they are an adjunct rather than a substitute.
The cavity is sometimes packed and needs redressing over the following days. Healing is from the base upwards and takes one to three weeks depending on size.
Recurrent boils
- Staphylococcus carriage — many people carry the bacteria in the nose and it reseeds the skin. A course of nasal ointment and antiseptic body wash for the whole household can break the cycle.
- Check for diabetes — recurrent boils are a recognised presentation.
- Check iron levels and, less commonly, immune function.
- Avoid sharing towels, razors and flannels; wash bedding and towels at 60°C.
- Reduce friction and shaving irritation in affected areas.
When it is not simply recurrent boils
Repeated painful lumps and abscesses in the armpits, groin, under the breasts or between the buttocks — particularly with tunnels, scarring or discharging sinuses — may be hidradenitis suppurativa. It is a distinct inflammatory condition, not an infection, and it is commonly misdiagnosed as recurrent boils for years. It has specific treatments including long-term medication and biologics, and smoking cessation and weight management substantially improve it. If this sounds like you, say so — the average delay to diagnosis is around seven years.
Book an appointment if a boil is large, very painful, on the face, not settling after a week, or keeps coming back. We can drain abscesses under local anaesthetic in clinic the same day, take swabs, screen for diabetes, and arrange dermatology input for recurrent disease.
Same-day drainage in clinic
Seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.