DEAR DR. DONOHUE: Can you explain what causes boils and where they are most likely to appear and why? What treatments can an individual do versus what a doctor can do? How can future boils be avoided? – C.W.

ANSWER: Staph germs living and multiplying within hair follicles cause boils. They can appear anywhere, but the favored sites are the back of the neck, under the arms or on the buttocks.

People get boils because Staph germs are everywhere. Many people, however, are particularly susceptible to boils because Staph germs live inside their nose just a little deeper than the entrance to the nostril. You would be surprised to learn how many times you and I touch our noses during a day. When Staph are in the nose, each touch transfers them to the fingers, which transport the germ all over the body.

Patient treatments include applying wet, warm compresses to the boil for 10 minutes and repeating the treatment several times a day. The compresses bring the boil to a head, and it then drains, a prerequisite for healing.

Doctor treatments include lancing the boil for drainage and antibiotic prescription when indicated.

Prevention entails keeping Staph off fingers. Hand washing should become a habit, and the use of an antibacterial soap is added protection from the ubiquitous Staph. Hibiclens is an example of such a soap. Bactroban Nasal ointment, applied to the inner nose just a little way inside the nostril, can root out Staph from their safe haven.

Recurrent boils require greater treatment and testing. One reason is that diseases associated with recurrent boils must be investigated. Diabetes is one of those illnesses.

DEAR DR. DONOHUE: Your recent article on vertebroplasty and kyphoplasty is misleading. I had successful kyphoplasty two years ago in New Jersey. Anyone needing such treatment should consult the local hospital to see if either is done there. – R.K.

ANSWER: I can’t argue with you. You are right. My statement was misleading.

In vertebroplasty, a large-bore needle is inserted into a collapsed backbone (vertebra), and through it the doctor injects bone cement to strengthen the collapsed bone. It is done painlessly. Such backbone collapse is common in osteoporosis, where the backbones can no longer support body weight. They crumble. The squashed backbone is said to have had a compression fracture. Those fractures cause great pain.

Kyphoplasty is similar, but it has one added feature. Attached to the needle is a balloon that is inflated once the needle is positioned in the backbone. That creates a hollow space that is filled with bone cement. This procedure restores the height of the backbone.

I said: “… these procedure are not available throughout North America.” I should have said that they are not available everywhere in North America. They are available in many places and will soon be available everywhere.

Back pain disables millions. The back pamphlet describes causes and treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 303, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What is a germ cell tumor? I have a relative who has one, but none of my relatives or friends has heard of this tumor. – W.D.

ANSWER: Germ cell tumors are cancers that arise from ova (eggs) or sperm, the body’s “germ” cells. These tumors are not at all uncommon. Most testicular cancers are germ cell tumors.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.