An abscess is a tender mass generally surrounded by a colored area from pink to deep red. Abscesses are often easy to feel by touching. The middle of an abscess is full of pus and debris.
Painful and warm to touch, abscesses can show up any place on your body. The most common sites are in your armpits (axillae), areas around your anus and vagina (Bartholin gland abscess), the base of your spine (pilonidal abscess), around a tooth (dental abscess), and in your groin. Inflammation around a hair follicle can also lead to the formation of an abscess, which is called a boil (furuncle).
Unlike other infections, antibiotics alone will not usually cure an abscess. In general an abscess must open and drain in order for it to improve. Sometimes draining occurs on its own, but generally it must be opened by a doctor in a procedure called incision and drainage (I&D).
Abscesses are caused by obstruction of oil (sebaceous) glands or sweat glands, inflammation of hair follicles, or minor breaks and punctures of the skin. Germs get under the skin or into these glands, which causes an inflammatory response as your body’s defenses try to kill these germs.
The middle of the abscess liquefies and contains dead cells, bacteria, and other debris. This area begins to grow, creating tension under the skin and further inflammation of the surrounding tissues. Pressure and inflammation cause the pain.
People with weakened immune systems get certain abscesses more often. Those with any of the following are all at risk for having more severe abscesses. This is because the body has a decreased ability to ward off infections.
- Chronic steroid therapy
- Sickle cell disease
- Peripheral vascular disorders
- Crohn’s disease
- Ulcerative colitis
- Severe burns
- Severe trauma
- Alcoholism or IV drug abuse
Other risk factors for abscess include exposure to dirty environments, exposure to persons with certain types of skin infections, poor hygiene, and poor circulation.
Most often, an abscess becomes a painful, compressible mass that is red, warm to touch, and tender.
- As some abscesses progress, they may “point” and come to a head so you can see the material inside and then spontaneously open (rupture).
- Most will continue to get worse without care. The infection can spread to the tissues under the skin and even into the bloodstream.
- If the infection spreads into deeper tissue, you may develop a fever and begin to feel ill.
Exams and Tests
The doctor will take a medical history and ask for information about the following:
- How long the abscess has been present
- If you recall any injury to that area
- What medicines you may be taking
- If you have any allergies
- If you have had a fever at home
- The doctor will examine the abscess and surrounding areas. If it is near your anus, the doctor will perform a rectal exam. If an arm or leg is involved, the doctor will feel for a lymph gland either in your groin or under your arm.
The doctor may open and drain the abscess.
- The area around the abscess will be numbed with medication.
- It is often difficult to completely numb the area, but in general local anesthesia can make the procedure almost painless.
- You may be given some type of sedative if the abscess is large.
- The area will be covered with an antiseptic solution and sterile towels placed around it.
- The doctor will cut open the abscess and totally drain it of pus and debris.
- Once the sore has drained, the doctor will insert some packing into the remaining cavity to minimize any bleeding and keep it open for a day or two.
Maintain good personal hygiene by washing your skin with soap and water regularly.
- Take care to avoid nicking yourself when shaving your underarms or pubic area.
- Seek immediate medical attention for any puncture wounds, especially if:
- You think there may be some debris in the wound
- You have one of the listed medical conditions
- You are on steroids or chemotherapy
Once treated, the abscess should heal.
- Many people do not require antibiotics.
- The pain often improves immediately and subsides more each day.
- Wound care instructions from your doctor may include wound repacking, soaking, washing, or bandaging for about 7 to 10 days. This usually depends on the size and severity of the abscess.
- After the first 2 days, drainage from the abscess should be minimal to none. All sores should heal in 10-14 days.