Abscesses can be treated in a number of different ways including:
- a drainage procedure
The treatment you receive will depend on the type of abscess and how large it is.
Some small skin abscesses may drain naturally and get better without the need for treatment. Applying heat in the form of a warm compress, such as a warm flannel, may help reduce any swelling and speed up healing.
However, the flannel should be thoroughly washed afterwards and not used by other people to avoid spreading the infection.
For larger or persistent skin abscesses, your GP may prescribe antibiotics to help clear the infection and prevent it from spreading.
Sometimes, you may need to wash off all the bacteria from your body to prevent re-infection, known as decolonisation. The skin is disinfected using additives in the bath or shower and an antibiotic cream is used inside the nose.
In most cases, antibiotics alone will not be enough to clear a skin abscess and the pus will need to be drained to clear the infection. If a skin abscess is not drained, it may continue to grow and fill with pus until it bursts, which can be very painful.
If an abscess is allowed to burst and drain of pus on its own, there is also a risk that it will not drain properly, causing the abscess to return or the infection to spread.
Incision and drainage
If your skin abscess needs draining, you will probably have a small operation carried out under anaesthetic. The type of anaesthetic used will depend on the size and severity of your skin abscess. However, it is likely you will have a local anaesthetic,where you remain awake and the area around the abscess is numbed.
During the procedure, your surgeon will make a cut in the abscess to allow all of the pus to drain out. They may also take a sample of pus for testing to confirm which bacteria caused the infection. Once all of the pus has been removed, the surgeon will clean the hole that is left by the abscess using a saline (salt) solution.
Your abscess will be left open so that any more pus that is produced can be drained away easily. If your abscess is deep, you may need to have an antiseptic dressing placed inside it to keep it open (gauze wick). The procedure may leave a small scar.
The pus must be drained from an internal abscess, either through surgery or by using a needle (percutaneous abscess drainage).
The method used will depend on the size of your abscess and where it is in your body. In most cases, antibiotics are used alongside drainage to help kill the infection and prevent it spreading.
Incision and drainage
If the internal abscess is small, your surgeon may be able to drain it using a fine needle. Depending on the location of the abscess, this may be carried out using either local or general anaesthetic.
During a drainage procedure using a needle, the surgeon may use ultrasound to help guide the needle into the right place.
Once the abscess has been located, your surgeon will make a cut in your skin over the abscess, before inserting a drainage catheter (a fine, plastic tube) into it. The catheter will allow the pus to drain out into a bag and it will be left in place until all the pus has been removed.
If your internal abscess is too large to be drained with a needle, or if needle drainage has not been effective in removing all of the pus, you may need to have surgery to remove the pus.
The type of surgery you have will depend on the type of internal abscess and where it is in your body. You may also need surgery if a needle cannot get to the abscess safely.
Possible complications of percutaneous abscess drainage include:
- needing to have surgery if the drainage tube cannot be placed in the abscess successfully during the procedure
- experiencing a shivering attack while the procedure takes place due to bacteria getting into the bloodstream (this can be treated with antibiotics)
Possible complications of skin abscesses include the spread of infection throughout the bloodstream, leading to more abscesses forming.