Understanding Abscesses: Common Types, Prevention, and Treatment
If you've ever had an abscess on your skin, gums, or elsewhere on (or in) your body, you know how dangerous and painful it can be. And because an abscess can resemble a pimple or a boil, you might be tempted to squeeze or pop it. But before you do, read this article to learn how to deal with an abscess safely, and why you should never pop one yourself.
Abscesses can form when your immune system fights off an infection caused by a virus, bacteria, or fungus that entered your body through a cut, an ingrown hair, or some other damaged tissue. Your immune system mobilizes to deal with the infection, and during this process some of the tissue dies, forming a tiny pus-filled cavity at the centre of the inflamed tissue.
Like a boil (or furuncle), usually associated with an infected hair follicle, an abscess is a cavity of infected tissue anywhere on or in the body, but an abscess is larger and deeper and likely to spread infection if not treated with care. A small boil (>1 cm/.5 inch in diameter) can resolve on its own, but it can also grow into a larger abscess if disturbed. If you squeeze it or press on it, the infection can spread to deeper tissues and may even enter your bloodstream. This is why it’s best not to try to drain a boil or an abscess yourself. Instead, have it treated by a medical professional who can ensure proper I & D (incision and drainage) technique.
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What does an abscess look like?
The appearance of an abscess can differ depending on where it develops. Usually, an abscess presents as a tender, inflamed, pink to red, taught, spongy, compressible mass that is painful to the touch. Liquified dead cells, bacteria, and debris make up the pus at the centre of the abscess. As your immune system fights the infection, it kills more cells, generating more pus. This creates pressure under the skin and further inflammation in the surrounding tissues.
Sometimes the abscess will “point”—appear as a white dot on the surface; this presentation can mislead you into thinking it’s a whitehead pimple. Even though some pus has accumulated at the top, there may be more pus, debris, and bacteria below the surface.
Why does an abscess develop?
Typically, an abscess forms when bacteria that reside on the skin get into the body through a cut or otherwise damaged tissue, and pus develops in a closed cavity. Abscesses can also form around hair follicles and oil glands, which are natural openings in the skin that sometimes become blocked or clogged. The Staphylococcus aureus bacteria is a common culprit, but certain parasites, viruses, and fungal infections can also lead to abscess formation. When the immune system is impaired, even a minor wound can lead to infection.
You are more likely to develop an abscess when your immune defence system is weak or impaired. People with cancer, diabetes, HIV, sickle cell disease, Crohn's disease, ulcerative colitis, and peripheral vascular disorders are at a higher risk of developing abscesses, as are people who have had chronic steroid therapy, chemotherapy, severe burns, or other severe trauma, and those who suffer from alcoholism or IV drug abuse. Obesity, poor circulation, poor hygiene and dirty environments, and exposure to certain types of skin infections are additional risk factors.
Abscess types
Abscess can form anywhere on your body, but are mostly found in the skin, in the teeth and gums, in the external genitalia, and sometimes also inside the body.
Skin abscess
By far, the most common type of abscess forms in the skin because the skin is our first line of defence and is exposed to more damage than any other organ. An abscess may form anywhere, but the most common areas are the armpits, groin, back, buttocks, and other places that tend to become sweaty or oily.
If left untreated, a skin abscess can progress into gangrene. If you have diabetes or any other condition that obstructs blood flow, you should be especially cautious. These conditions put you at a higher risk of developing gangrene due to an untreated infection.
How do you treat an abscess on the skin?
A boil or small abscess, less than 1 cm (.5 in) in diameter, can be encouraged to point and rupture on its own by applying a warm compress or heating pad. Put some sterile gauze between the heat source and the infected area to protect it, then apply heat to the affected area for 10-20 minutes 2– 4 times/day for up to two weeks. This may encourage the abscess to rupture and drain of its own accord. If so, clean the area with water and soap and cover it with a clean bandage.
Do not try to pop it like a pimple, because you might inadvertently spread the infection. If you use a needle or other sharp object to pop the abscess, you may damage a blood vessel and introduce the infection into your bloodstream, potentially leading to sepsis (blood poisoning).
If the abscess doesn’t resolve within two weeks, or if it seems to be getting worse, seek medical assistance. Warning signs include an abscess that is larger than 1 cm or continues to grow, fever, red streaks that may indicate spreading infection. Be sure to see your doctor if you are immune compromised in any way.
Your healthcare provider will perform an I & D procedure to drain the abscess by making a small incision, and will probably prescribe a course of antibiotics to clear the infection from your system and some antibiotic ointment to apply topically to the site of the wound.
How to prevent an abscess on the skin?
To prevent skin abscesses, it’s important to maintain good personal hygiene. Always wash after sweating or if your skin gets greasy easily. Wear loose-fitting clothes made from natural fabrics such as cotton or linen as they allow sweat to evaporate more quickly. If you tend to get abscesses from ingrown hairs after shaving, try soft trimming or laser hair removal to manage your body hair.
Dental abscess
Dental abscesses can form on the gums, inside the teeth, or in the bone that holds the teeth. Bacteria can enter through the gaps between your teeth and gums or proliferate in the soft pulp in the centre of a tooth. When this happens, you may notice the following symptoms:
- throbbing pain
- swelling of the infected area
- sensitivity when touched
- fever
- bad taste and smell in the mouth
A dental abscess requires an urgent visit to your dentist. It won't clear up on its own and must be drained by a professional. If you wait too long, the nerve in your tooth may be damaged or die, eventually blocking blood flow to the tooth and causing it to fall out. If the nerve is damaged, you might feel better for a while because the pain has stopped, but if the abscess itself isn’t dealt with it can quickly spread to the surrounding tissue and cause a more serious infection.
Depending on the area where the abscess is located, your dentist might drain it through a small incision, treat the root canal, or in more severe cases, surgically remove the damaged tissue. Once the abscess has been removed, you will need to take a course of antibiotics and use a special antiseptic mouthwash to prevent further infection.
How to prevent dental abscesses?
To prevent dental abscesses:
- maintain proper dental hygiene
- brush your teeth at least twice a day and floss thoroughly
- visit your dentist regularly for cleaning and check-ups
- don’t smoke, as smokers are more susceptible to dental abscesses and related complications
- eat a healthy diet and limit sugar to prevent the build-up of dental plaque
Genital abscess
Vaginal boils usually form in the skin folds of the pubic area or on the labia are usually caused by the Staphylococcus aureus bacteria, which is commonly one of the many microorganisms found in the skin’s microbiome. However, when you are feeling poorly and your immune system isn’t working as well as it should, S. aureus can cause trouble. It can get into a hair follicle or oil gland when you shave or if you experience excessive sweating and oil build-up. Vaginal boils feel like small painful balls within the soft tissue. Most often they clear up on their own, but if they grow large or last longer than two weeks, they must be lanced or drained by a doctor.
Genital herpes and some STIs can present similarly; they look like small pimples at first and can leak yellow pus, but herpes sores remain small and tend to develop in clusters. If you are unsure about sores developing on your genitals, it’s best to see your doctor.
How to treat and prevent vaginal boils?
You can try the warm compress method to encourage a boil to drain on its own, but if it doesn’t resolve or seems to be getting worse, go see a medical professional for help.
You can prevent vaginal abscesses by maintaining proper intimate hygiene, by wearing loose-fitting underwear made from breathable natural fabric, and by avoiding sharing clothes or towels with others because vaginal boils can be contagious.
Internal abscess
Internal abscesses are less common than external abscesses, but they tend to be more serious and can be life-threatening.
An internal abscess can develop in:
- the abdominal organs such as the lungs, kidneys, liver, etc.
- the spinal cord
- the brain
This usually happens after surgery, trauma, or infection—viral, bacterial, or fungal—in the nearby tissue. Unfortunately, internal abscesses are more difficult to spot than lumps on your skin.
The symptoms accompanying an internal abscess depend on where it is located. An abdominal abscess can lead to fever, abdominal pain, nausea, vomiting, difficulty breathing, and persistent cough; a spinal abscess may spark fever, provoke back pain, and cause neurological problems; and a brain abscess can cause headaches, visual impairment, confusion, and other cognitive difficulties.
A brain abscess, or intracranial infection, is a particularly dangerous type of abscess. Unfortunately, brain abscesses have been on the rise in young children in recent years. Experts believe this may be due to a rise in ear infections and respiratory viruses that progress from the upper respiratory system into the brain.
How to treat internal abscesses?
Any internal abscess must be addressed immediately because, if left untreated, it can lead to further infection and damage to the organs, nerves, or brain.
Treatment varies depending on where the abscess is located but typically involves a round of antibiotics to control the infection. A minor surgical procedure may sometimes be necessary to drain the abscess and remove damaged tissue.
There is little you can do to prevent an abscess in your internal organs, spinal cord, or brain, but taking good care of yourself and following your doctor’s recommendations after a surgery or trauma, and when you are sick, helps a lot. When you pay attention to early symptoms you can seek treatment quickly, nipping the problem in the bud.
Can an abscess heal on its own?
Small abscesses on the skin or in the vagina can resolve on their own or with the help of a warm compress. Larger abscesses, or any abscess accompanied by fever or red streaks, should be treated by a doctor.
Dental and internal abscesses are unlikely to resolve on their own and should be treated as urgent. If the abscess bursts, it will infect the surrounding tissue, and can spread to your bloodstream, causing a much more serious problem.
Why do I keep getting abscesses?
Abscesses develop for a variety of reasons. The leading cause is a weakened immune system; however, skin abscesses can also develop because of poor hygiene, shaving with a dull blade, or some other external injury. If you regularly develop abscesses, please visit your doctor to discover the underlying cause.
Final words
Although an abscess might not seem serious, it can cause severe consequences. If you develop an abscess anywhere on your body, check in with your doctor to prevent escalation of the infection.
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