Boils...! Boils...! (omputih cam ak ckp BISUL) eeeeuuuwwww...........!!!

What Is A Boil (BISUL lah).....

A boil @ Furuncles (its fancy name lah), also referred to as a skin abscess, is a localized (maknenye setempat). A several boils in groups or cluster of boils that form a connected area of infection we called Carbuncle. These infection takes place deep in the skin. 

A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with infection-fighting white blood cells that the body sends via the bloodstream to eradicate the infection. This collection of white blood cells, bacteria, and proteins is known as pus (nanah). Finally, the pus "forms a head," which can be surgically opened or spontaneously drain out (sng cite, picit sendiri lah tapi bila dah sampai masa lah... toksah dok gatai2x picit time awai2x tu...).
The most common places for boils to appear are on the face, neck, armpits, shoulders, and buttocks (kat pungkok yg paling x syiok tu...kalau hampa kena xtaw nk kata la... berak x basuh ka ap?!!). When one forms on the eyelid, it is called a STY (org kampung cam ak ni kate ketumbit laa an).

Risk factors (causes @ PUNCA) for boils
Cuts, abrasions or scratches allow the bacteria to gain access to deeper tissues. Certain factors make a person more susceptible to outbreaks of boils, including:

• Diabetes – recurring boils may be symptomatic of uncontrolled diabetes, especially for people aged over 40 years. 
• Kidney Failure - when your kidney doesn't work very well, your immune system might be impaired
• Poor hygiene!!! – sweat and dead skin cells in natural creases and crevices (celahan pada badan), such as the armpit, provide a hospitable home for bacteria.
• Nutrition – inadequate nutrition may reduce a person’s natural immunity.
• Broken skin – other skin conditions, such as eczema, can break the skin surface.
• Drug induce (kawan2x, ni ley masuk Drug related problem nih... hahaha) - Many medications can suppress (tahan @ halang @ block @ kurangkan etc) the normal immune system and increase the risk of developing boils. These medications include cortisone medications (prednisone [Deltasone, Liquid Pred] and prednisolone [Pediapred Oral Liquid, Medrol]) and medications used for cancer chemotherapy.

How to treat boils.......??? Easy beb... Simple-pimple je bro.........

First and Foremost.........!!! you must remember, the treatment should begin as soon as a boil is noticed since early treatment may prevent later complications.

A. Self-Care at Home - Home therapies should only be used on small boils. If your boil is bigger than a pea (kacang botak ke ap?haha...) or has a lot of redness around it, seek medical attention rather than trying to deal with it yourself.

• Apply warm compresses, and soak the boil in warm water. This will decrease the pain and help draw the pus to the surface. Once the boil comes to a head, it will burst with repeated soakings (maksudnye, kene rendam byk kali la baru jadi... lau rendam skali pastu nk jadi teros, baek korg hiris je kulit korg tu...). This usually occurs within five to seven days of its appearance. You can make a warm compress by soaking a wash cloth in warm water and squeezing out the excess moisture.
• When the boil starts draining, wash it with an antibacterial soap (bukan sabun biase ye... selalunye org pakai dettol atau protex)until all the pus is gone. Apply a medicated ointment and a bandage. Continue to wash the infected area two to three times a day and to use warm compresses until the wound heals.


• Do not...!!! pop the boil with a needle. This usually results in making the infection worse.

B. Medical Treatment

• Antibiotics are often used to eliminate the accompanying bacterial infection. Especially if there is an infection of the surrounding skin, the doctor often prescribes antibiotics.  
• However, antibiotics are not needed in every situation. In fact, antibiotics have difficulty penetrating the outer wall of an abscess well and often will not cure an abscess without additional surgical drainage. 
• If the boil is large, your doctor may need to open it up and drain the pus. This is done with a scalpel after the area of the boil is numbed with a local anesthetic (see explanation below).
• If the infection is deep, your doctor may put some gauze (cloth made of cotton, mcm kain nipis yg mcm tuk tutup luka tu la...) in the incision to keep it open and draining. The gauze is usually removed in two days.
• If there are concerns about the seriousness of the infection, blood tests may be needed. The doctor may prescribe antibiotics if the infection is severe.
• A large skin abscess caused by bacteria called the staphelococcus sp infection may need to be surgically opened and drained and treated with intravenous antibiotics (injecting directly through the vein as taken by mouth is not very effective... bunyi cam sakit tapi x sakit pon sebenarnye...).

Local Anaesthetic - (pain reliever)

• Benzocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body. Benzocaine topical is used to reduce pain or discomfort caused by minor skin irritations. 
• Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
• Apply a thin layer of benzocaine topical to the affected area up to 4 times per day. If using the spray, hold the container 6 to 12 inches away from the skin. Do not spray this medication onto your face.
• Do not use benzocaine topical to treat large skin areas or deep puncture wounds. Avoid using the medicine on skin that is raw or blistered, such as a severe burn or abrasion

Antibiotics - according to the Malaysian National Antibiotic Guidelines (2008)

PO - taken orally

q12h - 2 times daily
q6h - 4 times daily
 
For Methicillin-Resistance S. Aureus (MRSA) Infection -  we definitely can't use the B.lactam or penicillin base antibiotic. Therefore, you might want to consider using the Macrolides (eg, Erytromycin ethylsuccinate) and the 2nd or 3rd Gen Cephalosporine (eg. Cefuroxime or Ceftriaxone)

Eg of Cetriaxone that is available according to MIMS Malaysia:

1. Cefaxone (ceftrixaone Na) by Zyfas 

2. Celltriaxone DHA (ceftriaxone Na) by Pharmaniaga logistics

3. Ceftrex (cweftriaxone Na) by Medispec

4. Mesporin (Ceftriaxone Disodium) by Mepharm (Switzerland)

5. Trixon (ceftriaxone Na) by Antah Pharma

6. Vaxcel Ceftrixone (ceftriaxnoe Na) by Kotra Pharma

and ETC......................

(daaaaaan byk lagi lah... ni contoh2x yg selalu ade kat pamasi kat Malaysia nie........)

Ok lah... I think that's all for now... Hopefully this will help a bit

Thx for visiting my blog............!!