We provide a mode-sum prescription to directly compute the renormalized stress-energy tensor (RSET) for scalar fields in the Boulware vacuum. The method generalizes the recently developed extended coordinate method which was previously only applicable to Hartle-Hawking states. We exhibit the accuracy and efficiency of the method by calculating the RSET in subextremal and extremal ReissnerNordström spacetimes. We find numerical evidence for the regularity of the RSET at the extremal horizon regardless of the field mass and its coupling. We employ our numerical results of the RSET to source the semiclassical Einstein equations, demonstrating that if the RSET is considered as a static perturbation, it will either deextremalize the black hole, or convert it into a horizonless object.