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Hello I hAve a few boils on my bicept (almost drained) and one on the back of my arm that just began to be extremely painful this morning, I also have 3 down my rib cage that have drained and are healing, as I can tell, and one in my waistline.. I am go to my GP today to hopefully get the one on the back of my arm incised, can anyone tell me how painful incising is? I want to be prepared I don't tolerate severe pain well.

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14 Replies

  • Posted

    I have had over 20 abscesses incised. It still hurts even though they numb it. The worst part for me is when they squeeze it. But it always fee la better the next day. I hope this helped you.
  • Posted

    I honestly can't remember how many I've had incised, mostly in my armpits and my hoohah, and stormy is correct. It's going to hurt, wish I could say that it didn't, but it does. As far as what to expect...the doctor will inject lidocaine, or whatever the UK equivalent of numbing medication is, directly into the tissue in and around the abscess. For me, that's always the worst part, it tends to burn when it's going in, and depending on how big and how inflamed your abscess is, it'll add a lot of pressure. That lasts for about 30 seconds to about a minute once the doctor's done, and then he'll let you sit for a few moments while the medication takes effect.

    Once you're good and numb, he'll take a cutting tool, usually a scalpel, and cut the abscess open. All you should feel at this point is a little tugging, there shouldn't be any pain, if there is tell the doctor to stop and give you another injection. The boil should start to drain immediately, but the doctor will have to squeeze to really get as much of the puss out. I call this the "milking phase", because that's essentially what they're doing. I wouldn't recommend watching unless you've got a really strong stomach. It is uncomfortable, and depending on the doctor doing it, can get painful. I'd recommend seeing a dermatologist to have an abscess drained next time, they tend to be a bit more gentle. Try asking your GP for a referral.

    Depending on how severe the abscess is, they'll probably pack the incision once they're done to keep it open so it can continue to drain. You'll want to keep it dry and clean until closes, so make sure you've got gauze pads and paper tape (don't use cloth tape it irritates the skin) on hand at home before your appointment. Also, ask for pain medication. Tylenol is not going to cut it. You'll probably feel pretty good after the procedure, but once the lidocaine wears off, you'll be hurting. I've only ever really needed pain medicine for that first day, so really you should only need 2 or 3 pain pills.

    Another option, one that I only found out about two years ago from my dermatologist, was to have them inject cortisone or a steroid directly into the abscess, it's much less painful and kills the inflammation within 24 hours. It doesn't take care of an infection, so you'd still need to take antibiotics, but it's much more preferrable to having it drained and milked. I'd talk about that option with your GP or ask him to refer you to a derma to discuss it as a possibility for any future abscesses.

    I was 17 years old the first time I had this done, and I was really nervous about it too. It's definitely no picnic, but nowhere near as bad as I'd made it out to be in my head. Just remember to breathe, don't look and don't be afraid to ask questions. Good luck!!

    • Posted

      Hello, my doctor did not incise my boils.. He prescribed me keflex 500mg to take 4 times daily for 10 days.. And if there is not a significant difference he said to go to the ER and have them lanced... Has keflex worked to



    • Posted

      Short answer: yes and no.

      Long answer: Abscesses caused by HS are simply a collection of white blood cells beneath the skin. That lovely puss that comes shooting out of your boil when it pops, that's all white blood cells. They flood a particular area of the body in reponse to some inflammatory trigger, everyone has a different trigger and part of the fun of HS is figuring out what that trigger is. Stress, diet and hormones seem to be the big three.

      It is very common for these abscesses to become infected, they're pretty much a breeding ground for bacteria, but the primary cause of the abscess is NOT bacterial infection, it's an autoimmune response.

      A boil that develops in a person without HS is caused by bacteria, usually Staph or MRSA or some other nasty bug, in which case powerful antibiotics and a rigorous hygeine routine will pretty much take care of it.

      With HS, antibiotics are a fairly standard treatment, not because they kill bacteria, but because they're very powerful anti-inflammatories. If an abscess does become infected, I'm not sure if yours is or not, then antibiotics are necessary, but beyond that they will simply mask the symptoms for a short period of time, not treat the underlying problem. And unfortunately, most antibiotics will only work for 3 -18 months on average depeding on the person, just because our bodies build up a tolerance to it. And a lot of those antibiotics have some nasty side effects after long-term use.

      So, if your abscess is infected, the antibiotics should kill the infection. Keflex is a broad-spectrum antibiotic which means it treats most gram negative and gram positive infections, so you should be covered. It should help the inflammation as well, but just be aware, it's not going to treat the primary cause. You will develop more abscesses going forward. And there is a chance that it may not take care of your boil, because again HS is not caused by bacteria. Once I hit stage three and my abscesses reached a certain point, the only thing that would take care of it was draining it. Antibiotics were more of an after-thought.

      Honestly, I'm kind of ticked off he didn't refer you to a dermatologist for follow-up. I would say, if after 48 hours you haven't seen significant improvement, you need to go to the E.R. and have it lanced. And if you do, put your foot down and insist that they refer you to a dermatologist for follow-up care. Make it very clear that this was not an isolated incident. One of my biggest problems early on was my easy-going nature. I was very passive about my health-care and I just did whatever the doctor told me. Unfortunately most doctors don't know crap about HS. Case in point, it took me almost 9 years to get a diagnosis. Dermatologists know more than most, so they're your best bet.

      My advice, do some research into HS, and really try and figure out what your specific triggers are. Personally, mine were stress and diet. Cutting out nightshades and managing my stress has put me into remission despite being stage 3. You may not be able to cure HS, but it is possible to put it into remission.

    • Posted

      Totally agree with everything 2atticus said! I am also in remission after cutting nightshades, peanuts and coconut.
    • Posted

      Hi I agree with you.  I have an painful abcess right now and the doctor gave me ab's and said if it doesn't help to go to ER and get it lanced.  I asked for a referral to a dermatoligist (was only referred once for a diagnosis years ago) and was refused.  The reason given was that there was no point until the surgery had tried everything first.   So they are going to fiddle faddle with me as they know nothing about HS!   I am not happy about this,  but what can I do?  

      A friend of mine was severe and was put on a maintainance dose of daily ab's though they change them from time to time so she doesn't get too used to them.  She has been in remission ever since and this was around 6 years ago without any at all.   

      Bev x 


  • Posted

    I always thought the numbing hurt the worst! My dermatitis sliced them open and scraped out the cystic material with a tool . I always felt immediate relief from the pressure and a couple of times I didn't get numbed. I don't think it hurts to have them cut but HS for many years builds up your pain tolerance.
  • Posted

    Hi in my experience doctors won't incise it while it is infected and they just give you ab's.  They should kick in within a couple of days.   Bev x
    • Posted

      My boils are infected they gave me keflex.. I think I'm going to the ER in the am to have them drained.. I'm so scared
  • Posted

    Whenever I have had incision and drainage I have had general anaesthetic and been put to sleep. so I'm not sure how it would be if you're awake. Best of luck!

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