Surface (skin) abscess

An abscess is an infection leading to a collection of pus usually due to the blockage of glands in the relevant area of the body. An abscess may also arise from an infected skin cyst. A superficial abscess can occur in any part of the body. Common places include abscess around the back passage (peri-anal abscess), around the upper midline of the buttock cheeks (pilonidal abscess) and breast abscess. If left untreated the abscess will not go away on its own. It may sometimes drain through the skin with pus and form a tract (fistula), but may also lead to significant spread of infection to the skin around the area leading to significant loss of skin. Infection can also spread to the bloodstream becoming life-threatening. If you have diabetes, excess weight, take medication which dampened your immune system such as steroids you are more prone to the infection spreading.

Symptoms

The common symptoms of an abscess are:

• swelling,
• redness and
• pain around the affected area.

Symptoms of fever or generally feeling unwell indicate that infection may be spreading into your blood stream.

Diagnosis

A careful history of your symptoms will be taken and you will be examined to confirm the diagnosis and exclude other conditions. Usually the diagnosis should be able to be made through the examination but sometimes additional tests such as blood tests, ultrasound scan, an MRI or CT scan may be required to confirm the diagnosis if the presentation is not typical or a deeper abscess is suspected or to exclude other pathology such as Crohn’s disease, hydradenitis suppurativa (inflammation of the skin) or cancer. Sometimes an examination under anaesthetic is required to establish the diagnosis.

Treatment options

Sometimes at the very early stages antibiotic treatment may be able to treat the abscess but this will need careful monitoring. If symptoms persist though surgery usually under a general anaesthetic is required to cut open and drain (incision and drainage) the abscess. The most appropriate treatment option will be discussed with you at an individualised basis.