How to Lance a Boil

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

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.

  • Jen

    I need some advice or help on how to heal my grandmother’s wound that is confirmed mrsa. My grandmother mysteriously got a large red bump on her stomach close to a surgical scar on her abdomen that she had done 7 years ago, I looked at it and wasn’t sure what it was. I made a doctor’s appointment because I was concerned it was from her massaging her stomach which she didn’t do after her surgery but just started doing, two days later on the day of her appointment it had started to drain and formed three holes on its own without being touched. The doctor thankfully gave her the proper medication before her swab results confirmed it as mrsa and the topical antibiotic for it as well. I don’t think she maintained it properly because two weeks later it was still there, the dr also had her get further testing and we got other bad news as well but my concern is that the wound is not healed yet. It’s still draining and he informed her that if it’s not completely healed in two weeks or gets worse he will have it cut out! My grandma will not do it if it comes to that, I’m already furious with this doctor because my grandfather had it while he was in the hospital and no one told us. I had to find out myself by looking in his chart and I ended up with mrsa in my nose, her crap doctor refused to test her because he said it wasn’t necessary and now almost a year after my grandpa’s passing she has a mrsa sore. Since her last appointment I have been going myself to change her dressing once a day so I know it’s cared for properly, it’s still draining slightly and I need help how to speed this process up if possible. I’m literally running out of time, she took two weeks of oral antibiotic and has been using the cream for almost a month. It is scabbing slightly but whenever she changes it herself she rubs off part of the scab and it seems to still have a slight drainage. How should I care for this to get it to finally heal. Any help would be greatly appreciated and yes I wash my hands and sanitize them before and after touching anything and make sure only new clean products are used on her wound.

    • James Hubbard, MD, MPH

      If any foreign body, such as an old suture, is in the infected area, the area won’t heal until the foreign body is taken out. If you don’t have confidence in that doctor, perhaps she could seek a second opinion and asked to be referred surgeon or an infectious disease doctor or both.

      • Jen

        I truly don’t believe that’s the case with her, it’s not related to her previous surgery. He had her do an ekg as well it’s not deep so it didn’t come from anything on the inside, my initial reaction was that I thought it came from that but it didn’t. She just got a bump and it started draining two days later. I don’t know if I should let the scab form or try to keep it moist, I’m not sure if it’s done draining. I just want to make sure it goes away and heals properly. Thank you soo much for your quick response, I’m sorry for the confusion about how it started. The doctor is not educated enough on mrsa, no one in my area seems to be. He’s trying to tell us she got a bump from her irritating the skin by wearing jeans with the button rubbing on her skin and she furthered its irritation by massaging her stomach. Smh, I’ve done my best to research mrsa and be knowledgeable about it because I helped care for my grandfather and ended up with it in my nose. From what I’ve seen and read it’s just the common mrsa sore, started as a bump and thankfully started to drain on its own.

  • bee84

    Hi Doctor Hubbard, I’ve had a boil the size of a golfball since early last week. It burst on Friday so I thought my problems were over until Sunday, it began to swell again. I had a family planning appointment scheduled for Monday so I let them check it out. Just so happen, it started draining while I was in the waiting room & the doctor squeezed all the pus out and prescribed Cephalexin 500mg, I felt immediate relief. Sadly, I woke up this morning to it seelling again, I took a warm soak now what? My followup is on Friday, please help.

    • James Hubbard, MD, MPH

      I’d use heat, as in the post, and call the doctor to see if you can move your appointment up, or they should tell you what to do and where to go.

  • jay

    I’ve had a boil for three days, however on the second day I squeezed it and pus and blood came out. I didnt realise squeezing it would be harmful, it became very sore but by the next day it went down in size again but was still there. It is now just a hard stubborn boil, it started as a small hard pimple. What should i do? Is it harmful to just leave the boil to be, Im almost certain it will remain hard and small, it is not painful but when i press it there i have minor uncomfort. I dont really want to get it lanced so is it okay to leave it as scar, Pls help

    • James Hubbard, MD, MPH

      Jay, it could be just a plain cyst now. If that’s the case, it’s ok to leave it. However, there’s no way I can tell you for sure for your specific case.

  • jay

    hi thanks for sharing

  • Phil

    I have hidradenitis and there is a very painful boil like sore on my buttocks. Hurts so much I can barely walk. I’ve been talking rifampin and clindamycin orally for several days and it hasn’t helped. I want to lance it so it can drain and get the pressure down but I’m not sure if it’s a good idea.

    • James Hubbard, MD, MPH

      Phil, your best option is to let a doctor lance it–either the one who’s been treating you or an urgent care clinic.

  • Tricia

    I have both sides of shoulder blades 1/1 w idk fever tonight ache all over

    • James Hubbard, MD, MPH

      Time to see a doctor.

  • Lisa

    I have what the doctor thinks is a insect bite, it’s on my inside arm, yes I have fever, dr prescribed augmentin, and prednisilone, it’s sore, but a really hot mass. I stuck a pin in deep and out came clear but slightly yellow fluid. Now it’s back again to a hard mass. I feel somewhat dizzy. But still taking the required medication . As it’s not a boil as such, do u recommend trying again to lance it with a scalpel ?

    • James Hubbard, MD, MPH

      No. The only time I would consider that is after heat, if the area is getting soft, and if getting back to a doctor is impossible. Otherwise, an a unsterile environment, you’re just about as likely to spread the infection as help it. Hopefully you have a followup appt. Some MRSA infections start out looking like an insect bite and they may require a different antibiotic if it’s not getting better in a few days.

  • Marvin

    I had a matrix done to my big toe and it grew a golf ball size lump on it. I gave it some time to work itself out but when it grew to golf ball size I thought it would be nice to take care of it. I’m canadian so going to the er to take care of it would not be a problem but I’m lazy so I just cut the sucker open myself. The thing that I remember the most was the relief when it drained. I had been going to the doctor for over seven years dealing with the ingrown toenail so when the lump happened I just took care of things myself. Now anything minor like that I just hack away. No real surgery, but anything skin deep I can deal with.

    • James Hubbard, MD, MPH

      Thanks, Marvin.

  • Liz

    My husband has a large boil (or maybe a carbuncle) on his back (half dollar size or larger and very dark and angry looking). He has had it for a few days and we have been putting heat on it daily as well as poultices. We first used a poultice of white soap & sugar made into a paste (was told this would draw it out), then when it did not seem like it was coming out we tried a carrot poultice, then ichthammol ointment and lastly a cornmeal poultice with some golden seal & lobelia. We applied heat over each poultice. After a round of the cornmeal & herbs for a few hours, he took another hot shower and afterwards I cleaned it with a antiseptic, antimicrobial cleanser. When I was drying it with gauze afterwards, I applied a little pressure around the sides and it started squirting pus in very large volumes. I again applied a slight bit of pressure around the edge with the gauze and a little hard blob shot out, then a long whitish hard squiggly worm like tube looking piece. After this a bunch more greenish yellow & pink tinged push came out and then it started just bleeding quite a bit. He got back in the shower and washed the area well with the cleanser and then I swathed all around it and down his back with alcohol to prevent any further spread. I put another poultice and heat on it Is this all normal for a boil? Does any of this sound abnormal? or something that might need a doctors attention? Thanks in advance for any advice you can give.

    • James Hubbard, MD, MPH

      At best, large boils take a long time to drain completely. Often they have to be helped along by opening some of closed, deep pockets of pus. Since this is not a time when expert help is not available, the cleaning out should be done under sterile conditions by a doctor. Some reasons to absolutely see a doctor would if the infection is spreading, if he develops any fever, or if he has any diseases that affect his immune system (such as diabetes).

  • Nicole

    I had an abscess on my pubic region, it popped lots of pus and blood. Now there’s this fairly small hole there what should i do? I’ve left holes like this alone and it cleared on its own but is it different because it’s on the pubic region?

    • James Hubbard, MD, MPH

      I don’t think it should be any different there as anywhere else as far as healing but if you have concerns, see a doctor.

      • Rachelle

        what does it mean it your boil doesn’t have a head???

        • James Hubbard, MD, MPH

          Rachelle, the white top of pus that sometimes forms on small pimple-like lesions is one example of a lesion coming to a head. It means the pus has gathered and concentrated close to the skin surface. Hints on boils are a soft area, or some tenting or pointing of the skin.