Skin or Soft Tissue Abscess

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KEY POINTS

• An abscess is a pocket of pus in the deeper layers under your skin. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.
• Sometimes draining the abscess is the only treatment needed. If the infection starts to spread to other parts of your body or if your immune system is weak due to other conditions, you may need to take antibiotics.
• Ask your healthcare provider how to take care of yourself at home and what symptoms or problems you should watch for and what to do if you have them.

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What is a skin or soft tissue abscess?

An abscess is a pocket of pus in the deeper layers under your skin. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.

What is the cause?

Abscesses happen when germs get into tissue below the outer layer of your skin. Most of the time abscesses are caused by bacteria, but they can also be caused by a virus or fungus.

An abscess might develop when you have a cut, scratch, insect bite, or ingrown hair that lets germs get inside your skin. An abscess can also be caused by a blocked sweat gland.

Your immune system, which is your body’s defense against infection, sends white blood cells to the cut or scratch to kill the germs. A pocket forms in the area to keep the germs from spreading to other parts of the body. If the germs keep growing, the tissues around the abscess get swollen and painful. Some of the germs may get out of the pocket and infect nearby tissues or get into your blood and infect other parts of your body. Infection in the blood can be life-threatening.

Abscesses are more common and may be harder to treat in people who have diabetes or poor circulation, and in people whose immune systems are weakened by HIV, cancer, or other health problems.

What are the symptoms?

Symptoms may include:

• Swelling, redness, and warmth in the area of the abscess
• Rounded, raised “head” like a pimple
• Drainage of pus or other fluid

If the infection spreads to other parts of your body, you may have a fever, body aches, and feel tired.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may also have blood tests. A swab of the fluid from the abscess can often identify which bacteria are causing the infection and which antibiotics are best for treating it.

How is it treated?

Sometimes draining the abscess is the only treatment needed. To do this, your healthcare provider will clean the skin over the abscess and inject medicine to make it numb. Your provider will cut the skin over the abscess and drain it. Draining the pus often decreases the pain right away because it relieves the pressure. Your healthcare provider may pack the pocket with gauze, and leave some gauze sticking out through the cut in your skin. This lets any pus that forms in the abscess drain out. The gauze packing is changed every day or two until the abscess heals.

If the infection starts to spread to other parts of your body or if your immune system is weak due to other conditions, you may need to take antibiotics.

The time it takes for an abscess to heal depends on how big it is and where it is. It also depends on what other health problems you have. Sometimes it takes only a couple of days, but sometimes it takes weeks.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Take pain or antibiotic medicine exactly as prescribed by your healthcare provider. If you are given an antibiotic, take it for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and the infection may come back.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

To help prevent an abscess from spreading and coming back:

• Do not open or squeeze the abscess yourself. This can spread the infection.
• If the abscess opens or drains, clean it with an antiseptic soap. Cover it with a loose, gauze bandage. Change the bandage at least every day until the abscess stops draining.
• Wash your hands often with soap for at least 20 seconds. Always wash your hands after caring for the abscess, after using the bathroom, and before touching any food. You can also carry an alcohol-based hand cleaner to clean your hands when soap and water aren’t available.
• Wash clothes that touch the infected area in hot, soapy water.
• Contact your healthcare provider if you have new or worsening symptoms.

How can I help prevent a skin or soft tissue abscess?

• Wear gloves and protective clothing when gardening or working with sharp items, such as tools or knives.
• Don’t share washcloths, towels, clothing, bath water, or razors. Sharing these items could spread germs.
• If you have a small cut, scratch, or bite:
  • Wash your hands thoroughly with soap and water for at least 20 seconds before you touch the area.
  • Clean the wound under running water and mild soap, if possible. Remove any bits of dirt, small pieces of rock, or other debris that you can easily see, but do not poke or pick at the wound.
  • Keep the wound and the area around it clean and dry. You may need to put a bandage over the area to keep it clean and dry. Change the bandage every day. Change the bandage more often if it gets dirty or wet.
  • To prevent infection in a minor wound, you may use a nonprescription antibiotic ointment. Read the labels and follow instructions. If you are not sure which medicine is best for you, ask your pharmacist.