Incision and Drainage
George Woodbury MD 3/16/2023
A Boil, or “Furuncle,” is the result of an infection in an oil gland of the skin, called a sebaceous gland. Frequently this type of lesion starts out as an infected hair follicle, a small gland in the skin, can develop infection, in which case either the body walls off the Boil, into a Cyst, or else expels this type of lesion, to the surface, with a Boil.
Dermatologic Surgeons like myself – now with over 30 years with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Memphis TN – often treat this type of lesion with what’s called an Incision and Drainage, in which case we inject a solution of steroid and sometimes local anesthetic, then make a cut into the lesion, then try to expel pus from the lesion. We then often send off a test called a Bacterial Culture to the laboratory, to get the lesion checked for Staph infection, or Staphylococcal infection, and at times put the patient onto a two to three weeks course of oral antibiotics.
And alternative approach is to “excise” the nodule, through what’s called an “excision,” in which case we try to cut out the whole cyst, removing the Cyst wall or Cyst sack, then repair the area with stitches. This approach has the advantage that generally the Cyst wall or Cyst sack is gone, meaning the chances of the lesion coming back are lower, but an excision is not possible if the lesion is infected, because the sutured area would then become infected.
If Dermatologic Surgeons like myself see a lesion or lesions that are suspicious, we generally remove the lesion for evaluation by the Dermatopathology laboratory, for biopsy. It generally takes a week or two to get the results back. There is a type of Basal Cell Skin Cancer called a Cystic Basal Cell Skin Cancer, or Nodulocystic Basal Cell Skin Cancer. If the report shows a Skin Cancer, further work may later be needed, to “clear the margins,” meaning that we endeavor to successfully remove a rim of normal skin around the skin cancer, often requiring a margin of 3 millimeters, or an eighth of an inch.
The image below shows what was found to be a Basal Cell Skin Cancer, rather than a Cyst.
What groups are at higher risk of Boils or Cysts?
Anyone can develop a Boil or Cyst, but people with widespread acne seem to be at higher risk. Athletes, including runners, football and basketball players, and weight lifters, seem to be at higher risk, perhaps because they tend to use gymnasiums where other people with infected cysts have been. People who use saunas also seem to have a higher risk of Boils, once again because of greater exposure to bacteria from other people with Boils.
Be aware that I am also President of Big River Silk™ Skincare, an organic skincare company that distributes a helpful deep cleanser that’s useful for people with Cysts and Boils: AmberSoy Soap Gel. We also manufacture and distribute a best skin cream moisturizer (HypoShea Moisturizer Cream and HypoShea Oil). Check us out at https://www.Bigriversilkskincare.com.
So if you or a family member or friend, has a suspicious lesion, or any type of a sore nodule that may be a Cyst or a Boil, consider seeing a “Dermatologist Near Me.” My own Memphis Dermatology practice since 1993 has been with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova TN 38018 (1-901-753-0168). Or you can find a Dermatologist closer to you by going to the American Academy of Dermatology web site, www.AAD.org, then plugging your zip code into the “Find a Dermatologist” tab. Don’t delay. Get examined today!
George Woodbury, Jr., M.D.