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.

  • 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?

    • http://thesurvivaldoctor.com/ 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?

    • http://thesurvivaldoctor.com/ 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.

    • http://thesurvivaldoctor.com/ 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.

  • Susy Kahne

    I’ve been having reccurent boils on my inner thigh for about 2 years now due rubbing thighs and clothes. I recently got 2 on my thigh butt line and it hurts to even sit or walk. I was planning to pop them that day thay were hurting ao much but when I got home due to the pant friction it somewhat popeped but it still hurts a lot. I went to the doctor and got sntibiotics and an ointment with no help at all. Theyre leabing me embarrasing purlle scars that I cant eben wear shorts now because theyre going lower on my thighs now. Anything I can do?

    • Michelle Cleary

      Hi Susy. I am a sufferer of Hidradentits and frequently got boils between my thighs. Usually I try to wear baggier jeans for work when they flare up, and immediately change to baggy shorts or sweatpants when I get home. I sleep without bottoms to let my inner thighs breathe overnight. I shower twice daily and make sure to scrub/clean my inner thighs very well. While all these preventative things help, I still have purple/blackish discoloration on my inner thighs from the healed boils. One thing I did was make a natural skin bleach. Take fresh lemon juice and mix it with powdered milk into a paste. Spread the paste on your (clean) discolored areas and leave on for 10-20 minutes about 3x per week. Rinse off with warm water or just shower it off. The skin bleach lightened the discoloration some, but I think healing time really helps with the discoloration. Hope this helps.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Susy, unfortunately, not a lot that I know of. You might ask the doctor to culture the next one and see what exactly the bacteria is and what antibiotic will work the best.

  • Freakzilla

    I have never had boils before, and now all of the sudden I have 3 egg sized boils in my armpits. I have been living overseas and my wife brought back some underarm deo / antiperspirant from the states and I used it. The following day is when it started. I have managed to wait for 5 days before seeking medical attention, however the medical attention that’s available here if very questionable to me. The Dr. noted the hard swelling, and also noted that I was feverish and in overall poor condition at the time of the visit, and she prescribed me Co-Amoxiclav twice a day, Clindamycin 3x a day, and 120mg Etoricoxib 1x a day…she also owns the local pharmacy I might add. I am very leary of taking any kind of antibiotic, unless absolutely 100% needed. I do agree that I need some type of antibiotic at this point, but why 2 of them, and why not lance and drain them like I asked her to do? I cannot lance it by myself, as I am alone now, as I am fearful of the drainage causing further boils, etc…I am in extreme pain, and havent slept well in 2 days now, and haven’t been able to eat.

    • Freakzilla

      I will add that on one of them a hole has developed, however it is not draining. I have also been using hot water and a towel to cover them at least 3 times a day.

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        That’s not nearly enough.

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        She may have prescribed one antibiotic to cover the regular types of infections and the clindamycin to cover mrsa. I don’t know. Different countries can have prevalence of different bad bacteria. Again only speculation but perhaps she thought the boils were still so hard that she was unlikely to get out anything if she lanced. Rather than be fearful of drainage, I would welcome it. Just keep the area clean. Are you using frequent heat? Are you going back to follow up? I can’t tell you whether or not to take the antibiotics but I’m guessing it’s either that, or they start draining, or you need to go to the hospital. Especially if you’re running fever and the symptoms are not improving. And I’m not saying you won’t have problems with the antibiotics. There are always risks with them, diarrhea being almost a certainty (Probiotics might help), but there’s also a big risk in not taking them. From your description, I’d probably go to the hospital.

        • Freakzilla

          that was the hospital i went to….Philippines

          • Freakzilla

            time to find a knife i suppose. Thank you.

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            My opinion, is unless that’s sterile, the antibiotics pose a lesser risk. And, again, don’t forget the heat. I know nothing about Philippines Health Care. Perhaps there’s surgeon in an outpatient clinic?

  • JessH128

    Hello, my daughter called me on a Sunday night about a large lump in her groin area. Told her to clean with hydrogen peroxide and put antibiotic ointment on it until I saw her Monday. When indie, breadboard, obviously inflamed, and causing her a great deal of pain. There was what appeared to be a small scab in the center at the peak, she’d been trying to “pop” it with no luck. It was also hard and even clothing pressure was painful. I had her keep cleaning it and applying tea tree oil and antibiotic ointment. She saw a doc on Wednesday morning, who did not take culture, lance or anything. He prescribed oral antibiotics. By Wednesday afternoon it opened up almost on its own after about a half hour in the pool. Puss, some tinged green drained out. Again, had her clean and treat with tea tree oil, then cover with regular bandaid. By Wednesday night hardened puss appeared and her roommate began trying to tweeze it out. Thursday afternoon she was at my home where she tweezed out a rather large, square of hardened puss, leaving a large hole in the tissue. She has to get in pools almost daily, and I am pretty sure the wound is now too open to use tea tree oil or peroxide. I had her clean with warm water and soap, using regular antibiotic ointment, and covered with waterproof tagaderm as we had to get in a pool. It is still form puss and draining, tagaderm is clear, so we can see. Any advice on further care as the doc she saw seemed an idiot?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      If, by pools, you mean warm soaks, then that can help, If you mean a public pool, she should not be getting it at all.

  • worried girl

    I have a boil on the mound of my vagina and I went to quick are care today and they just gave me bacterium. I’m getting sharp pains where the boils are. Plzz help. Should I go to ER/ and its like a few together

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Remember to use moist heat. (Plan A). Getting in a tub is an option. Did they give you a followup time? I would think you’d need to be rechecked tomorrow.

  • eeck27!

    It started out as a bump on my inner labia minora. I foolishly squeezed it as I get ingrown hairs from shaving. Puss and blood came out. The next day it swelled back up and became even more tender. I have been soaking in the tub the past few weeks and this has not helped any. Do you think lancing this will help?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sounds like you definitely need a healthcare professional to take a look so you don’t risk making it worse. The only reason you would ever try lancing it on your own would be in an only option survival situation.

  • PinkBird

    Hey Doc,

    I have a boil like lesion under my stomach that my doctor says is related to my hidradenitis supprativa. I am on doxycycline for several months now. I have tried to get several doctors to remove it, because it feels like a sack is in there. It pops and fills back up with blood and pus. Finally the doctor lanced it a few days ago, but you can still feel a cylander shaped object in there and I imagine it’s just going to fill up again. The doctor said she wasn’t sure it was a cyst and keeps putting off removing it. If this is related to HS would it be removable so that it doesn’t return?

    • Shawna

      It may not be possible to get rid of it entirely. I have several that just come back over and over, no matter what I do.

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Unfortunate but true, Shawna.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      It’s speculation on my part but a doctor may have to do more than just lance it. They may have to kind of “bore it out” for lack of a better term and pack it, keeping the wound open to heal from the inside out. I may not have explained it the best but your doctor will probably know what I’m talking about.