What is a heat boil? Why should I care?

Heat Boils or ‘Bal Tod’ in Hindi is infection of the hair follicle by bacteria. This is one of the most common bacterial skin infections and probably every single individual will go through this at least once in his lifetime.

Heat Boils typically start by pulling of hair either by accident or on purpose. These are seen as small to large lesions filled with pus. Most often these are seen on areas like legs, armpits, buttocks and scalp. However that said they can occur practically on any part of the body.

They start off as a small ‘boil’ (see image), increase in size and eventually burst open; oozing out pus. If left untreated the infection moves deeper into the skin and can cause an abscess. (An abscess is a very deep and large lesion which often needs surgical intervention)

As they are an infection caused by bacteria they are contagious and can transfer from one individual to another.

Why me?

Main Causes :

• Pulling of Hair
• Nicks and Cuts caused by Shaving
• Blocking of pores due to oil massage.

Factors that aggravate (not the cause, but the reason why they increase) these boils include:

• Hot and humid conditions
• Diabetes
• Decreased immunity
• Usage of Certain Medications
• Poor hygiene

What should I do?

Like all skin conditions it is probably more important to know what not to do before anything else. In my career as a dermatologist I have seen more damage be done to patients by the actions they have taken themselves rather than approach a doctor. Here’s a list of DO NOTs for heat boils:

• Do not squeeze or break the boils, as the infection worsens.
• Do not use Over The Counter (OTC) creams
• Do not use home remedies like : turmeric and castor oil
• Do not use Dettol or Savlon to clean the area as it may irritate the skin more.
• Do not ignore any painful boils, get the same treated immediately.

And how do I get rid of it?

For minor immediate relief the patients are advised to carry out warm compresses to decrease the pain and inflammation. Also cleaning the area with luke warm water ensures that the infection remains in check.

The boils being an infection require proper medical attention and are treated with oral and topical antibiotics. Also oral anti-inflammatory medications would be prescribed by the doctor to take care of the pain and inflammation.

If a heat boil advances and becomes an abscess, it becomes important to drain the abscess with a minor surgery.

I don’t want them again.

And as the age old saying goes: Prevention is better than Cure. Here are some helpful tips on prevention of heat boils:

• Wash clothes and linen of the infected person separately to avoid spread of infection.
• Do not wear tight clothes that may cause pulling / breakage of hair.
• Keep good hygiene – especially in areas with more sweating like armpits etc.

I got treated but they keep coming back.

Sometimes despite the treatment the bacteria causing the heat boils, stay or reside in certain areas of the body. They surface up again in certain circumstances when the body immunity is low like during an infection. In this case longer treatment is required (between 4 to 6 months), which typically has only oral and topical antibiotics.

This article is one in a series of articles on common skin conditions by Dr. Sejal Saheta – MD, DNB – Dermatology and Venereology. The objective of this series is to educate the reader and help them take precautions against various skin conditions they come across on an everyday basis. These articles are not meant to be used by patients for self-diagnosis or for avoiding proper medical treatment.