How to Lance a Boil

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Get the Pus Out! How to Lance a Boil

Boilby James Hubbard, M.D., M.P.H.

Okay, I know you think it’s gross, but if you get a boil and it’s impossible to find a health-care professional, you’re going to want to know this.

A boil is an infected lump in your skin that’s hard and filled with pus. It can be the size of a pea or golf ball. Something as simple as a single infected hair follicle can cause it. Or a cyst might get infected.

A boil can not only be extremely painful, it can get you down. The infection can make you weak and give you a fever.

There are other things to try first, but sometimes, a boil just has to be lanced.

Plan A: What to Try Before the Lance

If you’ve read some of my other skin-infection posts, you’ve probably seen a trend. I like to use heat. Specifications:

  • Moderate temperature
  • Preferably moist (soaking the area or using a wet cloth), but dry will do
  • Ten to twenty minutes at a time every hour or so

The heat gets things going, increases the antibody-carrying blood supply, and helps the infection either go away or come to a head. By “come to a head,” I mean you’ll see a slight tenting close to the middle of the redness. That’s where the pus is trying to make its way to the surface to drain out. Sometimes it makes it, sometimes it needs help by incising and draining. That’s doctorspeak for lancing.

Never squeeze the area. You’re very likely to spread the infection.

If you can’t get to a health-care provider, you might want to take some oral antibiotics if you have them. Mupirocin ointment is a cool alternative. It’s an expensive prescription antibiotic ointment that treats the infection. The over-the-counter ointments prevent infections and are not going to be much use with a boil.

Use the intermittent heat for a few days. Your hope is that the infection will go away or that the boil will drain without lancing. At the least, you’ll be giving the boil time to turn from a firm mass (that will just bleed if you lance it) into a softer, fluctuant one that will drain easier.

Plan B: How to Lance a Boil

If the heat hasn’t worked or the redness is spreading or you’re feverish or the pain is just too bad, it might be time for a lancing. You could leave it alone, but if it’s going to be days before you can get to a health-care provider and it’s too painful or, more important, causing high fever and weakness, consider lancing.

To lance a boil if it’s impossible to get to a health-care provider, you’ll need:

  • Cleaning supplies (soap and water, and alcohol or Betadine)
  • A numbing agent (lidocaine or ice)
  • A sterile scalpel (or a knife with fire and alcohol for sterilization)
  • Clean cloth or gauze—some for catching the drainage and some for covering the wound

Step one: Prep yourself and the boil.

  1. Wash your hands.
  2. Put on some nonporous gloves, such as latex.
  3. Feel for a soft area on the boil, and look for a point or rising in the skin.
  4. Wash the affected skin with soap and water.
  5. Clean the area further with iodine or povidone/iodine (Betadine). If you don’t have that, use alcohol.
  6. If you have lidocaine and know how to use it, numb the area with it. If you don’t have numbing medicine, applying ice for a few minutes might help.

Step two: Prep your equipment.

  1. Unwrap a sterile scalpel blade, or sterilize a clean knife tip. (Put it under a fire until it becomes red. Let it cool. Pour alcohol on the tip.)
  2. Place some of the cloth or gauze under the boil for when the pus starts draining. (Reserve some to cover the wound.)

Step three: Lance the boil.

  1. Stab the skin at a ninety-degree angle. You shouldn’t have to insert the scalpel more than an inch or so. You’re waiting for pus to drain out. If it doesn’t, you can roll the blade around a bit, or try again if the pain’s not to bad,. But don’t just keep stabbing. If there’s pus close by, it’s likely to find it’s way out the hole. Sometimes you’re just not going to get a return.
  2. As soon as the pus flows, you may want to slant the blade a little to open up the wound. Then, remove the knife.
  3. Let the wound drain. Catch the pus with cloth or gauze.
  4. After the draining lessens, be sure to wipe the wound, and throw away any contaminated cloths and gloves. The bacteria from abscesses can be contagious.
  5. Cover the open wound with a loose, absorbent cloth or gauze.

Step four: Watch and wait. After the boil finishes draining, start back on the Mupirocin ointment if you have it, and keep using the heat. If the wound closes before the infection heals, you may need to reopen it. (Only if you’re experienced should you pack the wound to keep it open.)

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Boil image courtesy CDC/Bruno Coignard, M.D.; Jeff Hageman, M.H.S.

  • VNE

    I have this abscess/boil on my hip. I’ve had it for a couple of years. It’s a bit larger than pea-sized, hard – & is not always painful. It does flare up on occasion & those flare ups are pretty bad. A while back, I didn’t know any better & tried squeezing it. Some puss came out, then a little blood – but there has never been a “head” & ever since, the area is a dark red all the time. I could only imagine what someone would think if they saw it – & didn’t already know what it was. Sometimes, it’s so painful, I can’t even lay on that side when I sleep. Feels worse than a really sore bruise. I don’t know what to do about it. I feel like even if I get it drained, my hip will forever have this ugly, dark scar on it.

    • James Hubbard, MD, MPH

      Sometime have a doctor check it and give you advise. It could be a sebaceous cyst.

  • MJ

    Hello Dr. Hubbard,

    I am diagnosed with hidradenitis suppurativa. I get boils in my private parts every month just before my periods. I usually avoid taking antibiotics and use just a topical ointment like clindamycin prescribed by my Derm. It works well on my boils. They come, lance on their own and come back mostly at the same places next month leaving scars. Honestly, i am getting used to it. But this time i got a big boil on my butt chick. I was not able to walk or sit or sleep. Then around 4 days back, it burst open on its own and lot of blood came out. Now this left a huge hole in my skin. This is something I have never seen before. I didn’t feel much pain after it burst open but I still feel that my skin around this hole has turned little darker and when I touch it, I feel there is something under my skin. It has become little hard. Do I need to go see my derm or urgent care? How long does it take to heal this hole in the skin? I have been cleaning the wound with povidone iodine 5 times a day. I am getting this triple action antibiotic ointment from CVS to apply on the wound. Will this help?

    Your advice will be much appreciated.

    • MJ

      Also, it stings while taking shower. Is it ok if the wound gets wet? I also read somewhere that epsom salt will help heal the wound. Is that true?

      • James Hubbard, MD, MPH

        Getting wet his ok to wash it or irrigate. Epsom salt won’t add anything but with big hole, you should see a dr. It will take a long time to heal and probably needs packing.

        • MJ

          Thanks for the reply Dr. I just got a triple antibiotic antibiotic with maximum strength from CVS. Will that help to heal the wound? I am just trying to hold on from going to urgent care because i have my Derm’s appointment on 3/2. Is it ok if i apply this ointment for next 8 days?

  • Tamika

    I have three painful boils under my arm two under one and one under another. They seem to keep coming back. They won’t drain just eventually go down and away.why is that? What can I do to relieve this pain?

    • James Hubbard, MD, MPH

      If I were you, I’d try to get in to see you’re regular doctor at the first sign they’re flaring up. Or go to an urgent care. If they can lance one and culture the results they can tell what bacteria is causing the problem and which antibiotic has the best chance of effectively treating it.

  • Michele David

    I have one on bikini area very painful. Tried to puncture didn’t seem to help. Trying heat not too much relief. Have crohn’s also. Thoughts?
    Thanks for your help.

    • James Hubbard, MD, MPH

      use heat and see a doctor. Don’t try to puncture it again.

  • amanda

    I have a boil with a hole first one and the head won’t drain . I have had a reaction to a few antibiotics serve and they don’t don’t no what ones I can take . I’m trying to squeeze as much as I can out and than clean and putting flaming forte cream in hoke and patching uo 2 weeks now . i can see the head in through the hole the size of 5 c pieace . im terrified of hosoivals after a miscarrigre dnc left me ovrie less and tirtured hole in utreaus from fitting in a mel practice doxter whi left ne scarred . what do i do to get this head to pop out please help

    • James Hubbard, MD, MPH

      Stop squeezing and see a doctor. You don’t have to go to the hospital. You can go to a family doctor’s office or to an urgent care clinic. If you don’t, and it gets worse, you may in fact end up having to go the hospital.

  • ralph

    Question I have a boil the larger than a golf ball in the same area as my right testical lol ofcourse it hurts but the doctor gave me antibiotics and turned me away friends told me to becarefull before it hardens what will happen if it does?

  • Lex

    I have a boil on the inside of my armpit that I am pretty sure started as an inflamed hair follicle. Tonight I drained it, until just blood was coming out, but it remained hard. I am continuing to apply heat, but I am not sure if it has a core due to the hardness? Do most boils have cores? I did squeeze it to help everything come out. The pus was very fluid, without any viscosity. It is not particularly painful, and I do not have a fever, but I am worried due to the location and its proximity to lymph nodes. My insurance expires in 3 weeks, how long should I wait before going in if it doesn’t improve?

    • James Hubbard, MD, MPH

      Continue heat and see a doctor this week. No squeezing and no more lancing.

  • Pat

    I’ve had a merca boil for over two years ago and it drains usually on a daily basis. I’ve gone to the doctor and have had bactrim 3x ~ the boil doesn’t go away, but the skin heals. 3 mo later the boil opens again and drains. I’ve had an ultra sound done and also went to talk to a surgeon about what to do. The surgeon advised me not to do anything~ he said if we lanced it, it could become a worse situation. I had a different boil several years ago that was lanced by a different doctor and it healed great and didn’t come back. It’s starting to really concern me. It hurts a little & is uncomfortabl. I did have a tummy tuck (hence where I think I got the mersa) done several years ago so my stomach is pretty numb. I think it would be a lot more painful if my stomach wasn’t numb from scaring… Should I go to a different doctor and have it lanced?

    • James Hubbard, MD, MPH

      Pat, that’s hard to say. I would think you’d need to find a doctor you trust and stick with that doctor so they could monitor what’s going on with you. After that, if you’d like to get a second opinion, then fine. Perhaps the doctor that lanced the boil and it healed would be one of those two.

      • Pat

        Hi James, thanks for the fast response. The doctor I saw years ago who lanced a boil I had different insurance and can’t see him now. The thing is that doctor lanced my boil the first time I walked in his room. The doctor I’m seeing now keeps giving me bactrim, sends me for an ultra sound and then to a surgeon who tells me to leave it alone and not to do anything. I’ve been reading if you leave it alone and don’t do anything it could end up in your blood stream and be deadly. My skin is trying to heal itself and scabs up a couple times a day and I pick the scab to release the puss because it gets bigger if I don’t. If I just leave it alone it eventually about a week later will open up by it self to let the puss out ~ but my skin is trying to heal itself. Other then this MRSA thing I’m in very good health. No other medical problems, don’t even get the common flu. Fit, eat well and been exercising pretty regularly since I was 14 and I’m 42 now… So for many years ~ even have done tri’s… So I’m not sure why this surgeon would think it would create more problems. I’d rather get it lanced now when I’m in good health then to wait until bigger problems arise.

  • pppfp

    I just had a boil on my labia minora lanced today by my doctor. During the lancing and draining, It was the worst pain I had ever felt, but after it immediately felt 100 times better. I would deffinetly recommend having a doctor do it so it can be numbed. I had a topical number, a pain medicine shot, and a local numbing shot, and it was still horrible. But the pain during the procedure is worth the relief afterwards.

    • James Hubbard, MD, MPH

      Thanks for sharing. There’s nothing like personal experience.

  • jules

    I’ve had boils/cyst ever since I was 22 years old and now out of control. I have one between butt and other , awe and another on inner thigh which is infected redness all around. I am taking Bactrim but it doesn’t work. Today is Saturday so no doctor open. I will wait until Monday and find a doctor to lance them both. My doctor is a idiot and won’t lance it.