UNDERSTANDING SKIN ABSCESS

What is a skin abscess?

A skin abscess is a large, deep, pus-filled collection underneath the skin. It occurs when the body fights against infection.

It is mostly caused by Staphylococcus aureus, also known as “staph,” and methicillin-resistant Staphylococcus aureus (MRSA). These bacteria can be carried by the host (individual) without any symptoms. However, as soon as there is a portal of entry into the skin, such as through a cut or hair follicle, an abscess may form.

Risk factors that can lead to abscesses include a lack of personal hygiene, poor clothing, and poor diet, which can put an individual at risk of infection. Other risk factors include: Animal or human bite, IV drug use, steroid therapy and trauma.

An abscess can be warm and painful to touch. It can be situated at any part of the body, but the most common sites are the armpit and around the buttocks and anus.

signs and symptoms

Redness

heat

A hard or soft swelling

Fever may be present.

Management

Abscesses that are small in size (less than 5 mm or 0.2 in.) can be managed with a warm compress or an antibacterial. It may also drain on its own. However, when the abscess increases in size, there is a limited blood flow to the area due to the presence of increased tissue tension caused by the accumulation of pus and inflammation, thereby decreasing the efficiency of conservative management. Incision and drainage are performed to remove and drain the accumulated pus and inflammation, thereby relieving the pressure and managing the underlying infection.

After drainage, the cavity may be packed and covered to aid wound healing by secondary intention. A follow-up appointment is required to change the wound dressing and assess for repacking after 24 to 48 hours.

Situations where antibiotics might be required

Not all abscesses need draining. When there is no pus collection formed yet, antibiotics are used to treat and prevent it from creating an abscess

In the presence of fever, which may be a sign of a deeper infection than can be seen with the ordinary eye. Antibiotics may be required

Redness and warmth around the abscess site may be an infection of the upper layer of the skin, which is called “cellulitis.” Antibiotics may be prescribed.

Recurring abscess formation could be a sign of MRSA. The doctor may request a test to confirm he causative organism, and an antibiotic may be prescribed for this bacterium.

Caution:

When antibiotics are prescribed, it is essential to complete the entire course of the antibiotics as prescribed. Completing the course of treatment prevents the bacteria from becoming resistant to the antibiotics

Abscesses can lead to a life-threatening condition if left untreated

References

Baiu, I., & Melendez, E. (2018). Skin abscess. JAMA, 319(13), 1405-1405.

Nayak, J., Mishra, J. N., & Verma, N. K. (2021). A brief study on abscess: a review. EAS J. Pharm. Pharmacol, 3(5), 138-43.

Kanat, Z., & Sözen, S. (2023). Skin Abscess. In Abscess-Types, Causes and Treatment. IntechOpen.

Bowman, J. K. (2022). Abscess incision and drainage. Prim Care, 49(1), 39-45.

Assessed and Endorsed by the MedReport Medical Review Board