Causes of an Abscess and Treatments

A skin abscess is a walled-off, bump-like collection of pus that appears either within or just below the surface of the skin. Abscesses are typically caused by a bacterial infection. With proper treatment, abscesses heal in stages within two weeks.

They tend to appear on the back, chest, buttocks, and face. Sometimes, they develop in areas where hair is present, such as the armpits and pubic area.

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This article explains the symptoms, causes, and treatment options for abscesses. It also provides pictures of abscesses and points out how to prevent them from developing in the first place.

Abscess Symptoms

An abscess looks like a little bump or a pimple that can grow into an inflamed, fluid-filled cyst. The skin surrounding an abscess is often painful and warm to the touch. In some cases, an abscess can be extremely hard and firm (indurated).

Depending on the cause, the appearance of an abscess may be accompanied by fever, nausea, or swollen lymph nodes (lymphadenopathy).

Types of Skin Abscess

Furuncles and carbuncles are two similar types of skin abscesses. A furuncle, sometimes called a boil, is caused when a hair follicle becomes infected and creates a small abscess. A carbuncle is defined as multiple pus-draining follicles that combine to create a single infected mass.

Furuncles and carbuncles tend to appear in areas that have been exposed to minor trauma, sweat, or friction (such as beneath a belt or where the skin has been irritated from shaving).

Causes

Abscesses are most often caused by bacteria called Staphylococcus aureus, which normally exist on the skin and inside the nose. It can enter the body through a cut, abrasion, puncture, or even an insect bite. Other factors can increase the risk of S. aureus infection, including:

• A chronic skin condition, such as acne or eczema
• A weakened immune system
• Close contact with an infected person
• Diabetes
• Obesity
• Drug use
• Poor hygiene

A condition called folliculitis can cause an abscess to form within a hair follicle. Infection begins when a hair is trapped beneath the surface and can't break through (a condition commonly referred to as an ingrown hair). Folliculitis can be caused by shaving (particularly in Black people). It is also associated with swimming in an improperly chlorinated pool or hot tub.

Diagnosis

Diagnosis is usually made on appearance alone. While smaller abscesses usually can be treated at home, medical attention should be considered if an abscess:

• Becomes painful
• Develops on the face
• Grows to be more than 2 inches in diameter
• Persists for more than two weeks
• Multiplies into more than one
• Recurs after treatment

Treatment and Healing Process for Abscesses

Small abscesses can be treated at home with a warm compress to relieve pain and promote drainage. A larger abscess may need to be drained at the doctor's office to both relieve the pain and treat the infection. Depending on the cause of an abscess, a doctor may consider whether an antibiotic is needed.

Antibiotics are often prescribed to people who have a weakened immune system or are experiencing whole-body symptoms like fever. In such cases, a doctor may take a pus sample to better evaluate the cause and ensure that the bacteria is not drug-resistant.

Medical Procedure for Abscesses

Some abscesses need to be drained, particularly if they are not resolving on their own or are causing significant pain.

Procedure

Minor surgical procedures called incision and drainage (I&D) may be performed to drain an abscess of pus, dead skin, and any other material that has built up. A healthcare professional will numb the area then make a small incision to allow the contents of the abscess to drain fully. The area is cleaned out thoroughly. Stitches are not required for smaller abscesses, but the area is left open to heal.

Deeper abscesses might be drained with a needle. In both procedures, medicine will be injected to numb the area. You might also be given pain medication. After the procedure, the area is covered with a dressing.

Recovery

Pus will continue to drain for a day or two after the procedure. Follow your healthcare provider's instructions about changing the dressing. Warm compresses applied 3-4 times daily can help heal the wound.

Depending on your particular case, you might be given antibiotics. However, antibiotics are not always necessary. Over-the-counter pain medications can help with both pain and inflammation.

Outlook

A week after the procedure, a healthcare professional should examine your wound to ensure it is healing properly and not becoming infected. New skin should begin covering the wound within a couple of weeks.

At-Home Care

Caring for abscesses at home can include using warm compresses, keeping the area clean and dry, and possibly using antibiotics to mitigate bacterial infection.

It is important not to try to pop or press the pus out of the abscess at home. This can actually push the pus deeper into the tissues of the surrounding area, causing increased inflammation. It can also lead to infection.

Prevention

While abscesses are not entirely avoidable, there are a few simple measures you can take to prevent them:

• Wash your hands often.
• Treat any cuts with care, keeping them clean, covered, and dry until they fully heal.
• Do not share personal items like razors, towels, lipstick, or lip balm.
• Avoid cutting yourself when shaving your underarms or pubic area.

Summary

An abscess looks like a little bump or a pimple that can grow into an inflamed, fluid-filled cyst. Most often, it is caused by bacteria, called Staphylococcus aureus, which normally exist on the skin and inside the nose. But other culprits, like acne, eczema, or poor hygiene shouldn't be overlooked as possible culprits.

Large abscesses must often be drained (by a medical professional only) to ease the pain and discomfort. Depending on the cause, an antibiotic may be justified to finish off the abscess.