Skin Abscess

A skin abscess, commonly known as a boil, is a pocket of pus that forms under the skin due to a bacterial infection. It is the body's natural response to trap the infection, but it requires proper treatment to heal. While some small abscesses may go away on their own, many need medical care to drain the pus and prevent the infection from spreading.

Signs and symptoms

A skin abscess can appear anywhere on the body, but it is common in areas with hair follicles, sweat glands, or where skin rubs together, like the face, neck, back, armpits, and buttocks.

  • A painful, swollen lump: The most prominent sign is a tender, raised bump or mass under the skin.

  • Redness and warmth: The skin surrounding the lump will appear red and feel warm to the touch.

  • Pus buildup: The center of the bump may look white or yellow as pus collects beneath the skin. It can feel soft and "squishy" when you touch it.

  • Fever and chills: If the infection is more severe or has spread, you may also experience flu-like symptoms, such as a fever or chills.

  • Fluid drainage: Eventually, the abscess may rupture and release pus.

Diagnosis

A doctor can usually diagnose a skin abscess with a simple physical examination.

  • Visual and physical exam: Your healthcare provider can identify an abscess just by looking at and feeling the affected area.

  • Lab tests: If you have frequent infections or your current one does not respond to standard treatment, a doctor may send a sample of the pus to a lab. This can identify the specific type of bacteria, especially if it's a resistant strain like MRSA, to ensure you get the right medication.

  • Imaging tests: For deeper or less obvious infections, imaging like an ultrasound may be used to locate the abscess and guide drainage.

Treatment

Treatment for a skin abscess depends on its size and severity.

  • Warm compresses: For a small abscess, you can apply a warm, moist compress to the area for about 10–20 minutes, several times a day. This can help promote natural drainage, but you should never squeeze or pop the abscess yourself, as this can push the infection deeper or cause it to spread.

  • Incision and drainage (I&D): For larger or more serious abscesses, a doctor will perform a simple procedure to cut open and drain the pus. The area will be numbed with a local anesthetic first.

  • Gauze packing: After draining a large abscess, the doctor may pack the empty space with sterile gauze to absorb any remaining pus and allow it to heal from the inside out. You may need to change the dressing regularly or return to the doctor for follow-up care.

  • Antibiotics: Antibiotics alone are often not enough to treat an abscess, but they may be prescribed along with drainage for more severe or spreading infections.

  • Home care after drainage: Keep the wound clean and dry, and change the bandage as instructed. For a packed wound, follow your doctor's guidance on gauze removal.

When to see a doctor

You should see a doctor for a skin abscess if:

  • It is larger than a half-inch across.

  • It is in a sensitive area, like near your groin or rectum.

  • It continues to grow larger or becomes more painful.

  • You develop a fever or chills.

  • You see red streaks extending from the abscess.

  • You have a chronic condition, such as diabetes or a weakened immune system.

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