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Abscess

Abscess Overview

An abscess is a tender, easily pressed mass generally surrounded by a colored area from pink to deep red. 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 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.

Abscess Causes

Abscesses are caused by obstruction of oil (sebaceous) glands or sweat glands, inflammation of hair follicles, or from 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
Chemotherapy
Diabetes
Cancer
AIDS
Sickle cell disease
Leukemia
Peripheral vascular disorders
Crohn disease
Ulcerative colitis
Severe burns
Severe trauma

Abscess 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.

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.
You have an underlying illness such as AIDS, cancer, diabetes, leukemia, sickle cell disease, or have poor circulation. You are an IV drug abuser.
You are on steroid therapy or chemotherapy.
The sore is on or near your rectal or groin area.
You have a fever of 101.5°F or higher.
You have a red streak going away from the abscess.

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