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Abscess: What to watch out for

Posted: 5:26 AM, Jul 09, 2018
Updated: 2018-07-09 06:26:58-04

Every year between four and five million Americans suffer from chronic non-healing wounds, many caused by diabetes, poor circulation, pressure ulcers or other conditions.

Proper wound care is necessary to prevent infection and make sure there are no other associated injuries to the skin. 

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It is difficult to prevent an abscess inside the body as it usually happens in people who are ill with other problems. 

"Abscess is very common just in the general community, and they are more common in diabetics. Some people think that it is a hygiene-related factor, and it is not. Anybody can get an abscess. It is from normal bacteria on your skin. 

There is an opening on your body, and it allows it in and that causes an infection, and in some people, the infection gets out of control and needs medical intervention instead of taking care of it at home," said Corpus Christi Medical Center physical therapist Jeanne Taylor. 

Unlike other infections, antibiotics  alone will not typically cure a skin abscess. In general, abscesses must open and drain to improve. Although sometimes an abscess will open and drain spontaneously, it often needs to be lanced (incision and drainage) by a health care provider. Certain abscesses may require a surgical drainage procedure in an operating room. 

"If it goes untreated, the infection can spread and actually spread into your bloodstream and require hospitalization and need intravenous antibiotics,"said Taylor. 

If an abscess is not treated, the infection can last for months or even years. It will not go away on its own so it’s important not to ignore the symptoms. 

"The signs people notice are raised lump, redness, hardness, and with some people, it comes to a head, and actually you can see a puss filled blister, hardness around it, and warm to the touch and incredibly painful," said Taylor. 

Is it an Abscess? Everything you need to know.

A skin 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 vast majority of them are caused by infections. Inside, they are full of pus, bacteria and debris. Painful and warm to touch, abscesses can show up any place on your body. 

The most common sites on the skin 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 with the help of a warm compress or by a doctor in a procedure called incision and drainage (I&D). 

Abscess are caused when our normal skin barrier is broken, even from minor trauma, or small tears, or inflammation, bacteria can enter the skin.  

An abscess can form as your body’s defenses try to kill these germs with your inflammatory response (white blood cells = pus). Obstruction in a sweat or oil (sabaceous) gland, or a hair follicle or a pre-existing cyst can also trigger an abscess. 

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 infection.
 
Symptoms:

  • 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.

Abscess Treatment: Self-Care at Home

  • If the abscess is small (less than 1 cm or less than a half-inch across), applying warm compresses to the area for about 30 minutes 4 times daily may help.
  • Do not attempt to drain the abscess by squeezing or pressing on it. This can push the infected material into the deeper tissues.
  • Do not stick a needle or other sharp instrument into the abscess center, because you may injure an underlying blood vessel or cause the infection to spread.

Medical Treatment:

  • 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 local anesthesia can make the procedure almost painless.
  • 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 may insert some packing into the remaining cavity to allow the infection to continue to drain. It may be kept open for a day or two.
  • A bandage will then be placed over the packing, and you will be given instructions about home care.
  • Most people feel better immediately after the abscess is drained.
  • If you are still experiencing pain, the doctor may prescribe pain pills for home use over the next 1-2 days.
  • You are usually sent home with oral antibiotics.

 
When to Seek Medical Care:

  • Call your doctor if any of the following occur with an abscess:
  • You have a sore larger than 1 cm or a half-inch across.
  • The sore continues to enlarge or becomes more painful.
  • The sore is on or near your rectal or groin area.
  • You develop a fever. You notice red streaks, which can mean the infection is spreading.
  • You have any of the medical conditions listed above.
  • Go to a hospital’s Emergency Department if any of these conditions occur with an abscess: * Fever of 102°F or higher, especially if you have a chronic disease or are on steroids, chemotherapy, or dialysis
  • A red streak leading away from the sore or with tender lymph nodes (lumps) in an area anywhere between the abscess and your chest area (for example, an abscess on your leg can cause swollen lymph nodes in your groin area)
  • Any facial abscess larger than 1 cm or a half-inch across