What is an abscess?
An abscess is a collection of pus underneath the skin or inside your body. Abscesses usually form because of an infection or because a foreign object becomes trapped in your body. When your body fights an infection or tries to destroy a foreign object trapped inside, white blood cells fill the affected tissues, and the resulting fluid is called pus.
Pus contains living and dead bacteria, living and dead white blood cells, and the remnants of the cells and tissue that were killed or injured by the infection or by your body’s immune response.
Abscesses often form in or near the skin or in the mouth near the teeth. An abscess often looks like a bump of any size that is red and often swollen, and inside of the bump is a pus-filled space. It is unwise to attempt to drain any abscess—no matter how superficial. Doing so could lead to a lethal blood-borne infection and sepsis.
Abscesses are usually treatable with antibiotics, surgery, or a combination of these. In many cases, surgical drainage of an abscess is necessary. A specimen of the fluid within the abscess is generally sent to the laboratory to identify any causative bacteria. Most abscesses can be treated effectively and have fairly few complications, though some abscesses can occur deeper in your body or in your organs and can cause much more serious damage.
Seek prompt medical care if you suspect you have an abscess, or if you are being treated for an abscess and the condition persists or causes you concern.
What are the different types of abscess?
Abscesses can form throughout the body, both in locations that are visible and internally, where they may go unnoticed and cause serious complications, including organ damage.
The most common types of abscess are:
- Skin abscess, caused by infections that result in pus collecting in the skin. These can include infections from bacteria (most commonly Staphylococcus), infections in the hair follicle (folliculitis), boils, or minor wounds or injuries that become infected. Skin abscesses can form anywhere on the body.
- Dental abscess, which can form in the center of a tooth (the pulp) and spread to the root or bone structures that hold the tooth. A tooth can become infected when bacteria get in through an opening, such as a cavity caused by tooth decay or an injury that results in a broken, chipped or cracked tooth.
Less common types of abscess include:
- Abdominal abscess, which can be near or inside abdominal organs such as the liver, pancreas or kidneys. Causes of abdominal abscess include infections, burst organs (such as appendix or ovary), and inflammatory bowel disease (IBD).
- Amebic liver abscess, a type caused by amebiasis, an intestinal infection that can spread to the liver. The infection results from the intestinal parasite Entamoeba histolytica, which is spread through food and water contaminated with feces containing the parasite. Amebiasis is most common in crowded populations with poor sanitation.
- Anorectal abscess, located in or near the anus or rectum, most commonly caused by sexually transmitted diseases, infection of anal fissures, blocked glands, or trauma to the area.
- Bartholin abscess (or cyst), which can form in the Bartholin glands located on each side of the opening of the vagina. The duct from the gland can become blocked, causing fluid to build up over time, potentially leading to an infection and formation of an abscess.
- Brain abscess, typically the result of a bacterial or fungal infection in part of the brain. The pressure created by the abscess can cause serious brain issues, including seizures, loss of muscle function, and language problems. A brain abscess is a medical emergency that requires immediate treatment.
- Epidural abscess, a rare occurrence caused by an infection of the area between the meninges (the membranes covering the brain and spinal cord) and the bones of the skull or spine. If inside the skull, it is an intracranial epidural abscess. If in the spine, it is a spinal epidural abscess, which is the most common type of epidural abscess.
- Peritonsillar abscess, a potentially life-threatening complication of tonsillitis, an infection of the tonsils. Most often, this infection is caused by the bacteria group A beta-hemolytic Streptococcus, the same bacteria that cause strep throat. However, peritonsillar abscess is rare due to the use of antibiotics to quickly and effectively treat tonsillitis.
- Pyogenic liver abscess, which is simply an area on the liver that produces pus. This can result from many types of abdominal infection, an infection of the tubes that drain bile, or trauma to the liver.
- Spinal cord abscess, a very rare result of an infection inside the spine. When it does occur, it is most often a complication of an epidural abscess.
What are the symptoms of an abscess?
Abscess symptoms vary depending on the location of the abscess and underlying disease, disorder or condition.
Skin symptoms that may occur along with an abscess
An abscess may accompany symptoms affecting the skin including:
- Oozing or drainage of a fluid from the skin
- Peeling or ulcerating skin
- Redness, warmth or swelling
Other symptoms that may occur along with an abscess
An abscess may accompany symptoms related to other body systems. Such symptoms include:
- Enlarged lymph nodes
- Loss of appetite or rapid weight loss
- Neurological symptoms (if abscess presses on nerves or parts of the brain)
- Pain, such as a toothache for a tooth abscess or abdominal pain for an abdominal abscess
Serious symptoms that might indicate a life-threatening condition
In some cases, an abscess may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:
- Difficulty speaking
- Jaundice (yellowing of the skin and eyes)
- Severe weakness or paralysis
What causes an abscess?
An abscess is caused by your immune system responding to some type of infection or foreign object. Bacterial infections are the most common cause of an abscess, especially an abscess of the skin or mouth. Parasites can cause abscess formation in your organs and, though rare, this can be a serious medical condition. A foreign object lodged inside you, such as a bullet, can also cause an abscess.
Common causes of an abscess
An abscess may be caused by a variety of common conditions including:
- Foreign object trapped inside you, such as a thorn or piece of metal that breaks off in your skin; also, retained foreign body fragments after previous attempted removal
- Infected diverticulum in the large intestine can cause a diverticular abscess
- Infection at the site of previous surgery (perioperative wound contamination)
- Skin infection may result in an abscess
- Tooth infection may progress to a periodontal abscess
- Wound or trauma to the skin, especially a puncture wound, may cause an abscess
Rarer causes of an abscess
An abscess can also be caused by rare infections including:
- Infection by microorganisms like amoeba can cause abscess formation in your liver
- Infection by certain parasites can cause a variety of abscesses in your body’s organs
- Infection in your brain can cause a cerebral abscess
Questions for diagnosing the cause of an abscess
To diagnose your condition, your doctor or licensed healthcare practitioner will ask you several questions related to your abscess including:
- When did you first notice the abscess (or signs and symptoms of an abscess)?
- Have you had any other symptoms along with the abscess?
- Are you taking any medications?
- Have you wounded or injured your skin in the area around the abscess recently?
What are treatments for abscess?
Treatment for most types of abscess focus on draining the collected pus and clearing the infection that led to the abscess. This typically involves prescription antibiotics, aspiration or incision for drainage, surgery to remove an abscess—or a combination of these options. Minor abscesses can often be managed with self-care; however, individuals with any type of immunodeficiency should seek immediate medical attention whenever symptoms of abscess formation appear.
When to See a Dentist for Dental Abscess Treatment
A dental abscess is very painful and requires prompt treatment by a dentist to prevent further complications. To confirm an abscess is causing your symptoms, your dentist will examine your teeth, mouth and gums, and may tap the affected tooth to determine your level of pain. You may have X-rays or a CT scan to locate the tooth or teeth affected and determine the extent of the infection.
The goals of treating a tooth abscess are to clear the infection, prevent or reduce complications, and prevent permanent tooth loss. Your specific treatment will depend on the severity of your infection and the size of the tooth abscess.
A tooth abscess will not go away on its own and, left untreated, can cause serious and even life-threatening complications, such as sepsis.
Your dentist will assess the severity of your tooth abscess and recommend treatment including:
- Prescription antibiotics to fight the infection
- Removal of the infected tooth or teeth
- Root canal to remove infected tissue and drain the abscess
- Surgery to drain the abscess
While you await your appointment or during recovery from a treatment procedure, you can relieve symptoms at home with:
- Over-the-counter pain relievers to reduce pain and fever
- Warm saltwater rinse to soothe pain
Skin Abscess Treatment at Home
Mild skin abscesses may drain on their own, and you can help “open” the abscess by applying a wet, warm compress to the affected skin several times a day. Make sure to wash your hands thoroughly before and after applying the washcloth, and use a new cloth each time to avoid spreading the infection or reinfecting your skin.
Never try to puncture or squeeze a skin abscess yourself. This can lead to complications, including further spread of the infection deeper into your body.
When to See a Doctor for Skin Abscess
If a mild skin abscess does not improve on its own, or if your infection symptoms are more severe (or worsening instead of improving), you need to see a doctor for prompt medical treatment of your abscess.
Call your doctor if your symptoms include:
- Fever or chills
- Increased pain, redness, warmth and swelling around the abscess
- Pain or discomfort elsewhere in your body
- Red streaks near or around the affected area (from the infection spreading into the lymph system, which is part of your immune system)
Your doctor will examine the affected skin to diagnose an abscess. Depending on the severity of the infection, treatment options for skin abscess include:
- Antibiotics to clear the infection
- Drainage, either through aspiration (a small needle placed in the abscess) or incision, in which the doctor uses a scalpel to cut the abscess open
- Surgery, when the abscess has spread beyond the skin deeper into the body
In cases when the abscess is drained or removed, the doctor may send a sample of the pus for analysis to determine the source of the infection. If the infection is caused by MRSA (methicillin-resistant Staphylococcus aureus) or another type of staph infection, your doctor may prescribe additional antibiotics or treatments. You may also need to monitor the wound for any additional pus or signs of reinfection.
Most skin abscesses can be treated successfully, with few complications. Some procedures may leave a small scar.
What are the potential complications of an abscess?
The complications of an abscess vary widely depending on the cause and location. A small skin abscess treated promptly usually does not result in any permanent complications other than a small scar. However, a large abscess or an abscess in an organ can affect underlying tissue or organ function and may possibly cause serious and permanent damage.
Because an abscess can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you to reduce the risk of potential complications including:
- Brain or spinal cord injury
- Liver damage
- Nerve damage resulting in weakness or tingling
- Sepsis (body wide inflammatory response to an infection anywhere in the body)
- Spread of infection (localized or into the blood)
What do abscesses look like?
An abscess on the skin appears as a red, swollen lump that may be oozing pus or liquid. It is often warm to the touch and may have red streaks near or around it.
Skin abscesses at first may appear to be other dermatological conditions, such as pimples, boils or insect bites. However, if the area continues to become red, swollen, warm to the touch, or painful, see your doctor to determine if you have an abscess.
Internal abscesses are more challenging to detect since you cannot see them without imaging. However, take note of symptoms including pain inside your body, a fever, chills, loss of appetite, and a general sense of not feeling well—particularly if these symptoms persist. See your doctor right away if you suspect you may have an internal abscess.
How can you prevent abscesses?
Good hygiene is the best way to prevent skin abscesses from forming, as most skin abscesses are the result of bacteria infecting the skin through a wound, hair root, or blocked sweat or oil gland.
Follow these daily habits to minimize bacteria on your skin and reduce the chances of skin infection:
- Avoid sharing towels, washcloths, razors or other items that come into contact with your skin.
- Establish a habit of handwashing among family members.
- Take caution when shaving to avoid nicks and cuts. If you do cut yourself, treat the wound promptly.
- Wash your hands regularly and thoroughly.
When you have a wound, take extra care to keep it clean. Wash the cut with soap and warm water, then bandage the wound securely to keep it clear of dirt and bacteria. Change bandages or dressings often to ensure the area stays clean and dry.
If you have a chronic condition, such as diabetes, that can increase your risk of skin infections, talk to your doctor about specific steps you can take to prevent abscesses. You may need to perform daily “skin checks” to detect broken skin or any signs of infection.
If you do develop a skin abscess, you can prevent complications and the spread of the infection by seeking prompt medical treatment from your doctor. Do not squeeze or “pop” an abscess yourself, as this can drive the infection deeper into the skin.
If you wipe away pus that has oozed from a skin abscess, immediately throw away the tissues or wash the cloth you used to prevent the spread of bacteria, and wash your hands thoroughly. Do not use any shared items or go to communal places like gyms or swimming pools until your abscess has been effectively treated and is completely healed.
Internal abscesses are typically a complication of another condition, and therefore are more difficult to prevent. You can reduce your risk of many health conditions by:
- Eating a balanced, nutritious diet
- Exercising regularly
- Maintaining a healthy weight
- Not smoking or quitting smoking
- Seeing your doctor for annual physicals and routine screenings