Skin or Soft Tissue Abscess

What is a skin or soft tissue abscess?

An abscess is a pocket of infected fluid with a thick wall around it. Skin or soft tissue abscesses occur when bacteria get into tissue below the outer layer of skin. Often abscesses occur when hair follicles or sweat glands get infected or after minor scrapes or puncture wounds.

How does it occur?

Most of the time an abscess forms when bacteria enter a break in the skin. For example, an abscess might develop when a hair becomes ingrown or when the skin is scratched or poked with something sharp. As more bacteria grow (multiply) in the skin or soft tissues, the body responds by forming a wall around the area to keep the bacteria from spreading. The bacteria in this pocket continue to multiply and as they do, the pocket becomes more swollen. Some of the bacteria may get through the wall and cause an infection of the tissues around the abscess or even get into the blood and infect other parts of the body.

What are the symptoms?

The symptoms of an abscess in the skin or soft tissues are:

• swelling
• redness
• pain.

If the skin around the abscess has become infected, the redness may spread toward the center of the body and you may have a fever, body aches, and tiredness.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine the area that is red and swollen.

How is it treated?

The treatment for an abscess is usually to cut it open and drain it. This is called an incision and drainage, or I&D. Infection from the abscess may spread to the surrounding tissues and even into the bloodstream. To help treat or prevent spread of the infection, your healthcare provider may prescribe antibiotics as part of the treatment. The abscess itself has to be cut open and drained because the thick wall around it will not let antibiotics get through to fight the infection in the abscess.

When an I&D is done, first your healthcare provider cleans the skin over the abscess and injects an anesthetic into the skin to make it numb. He or she then cuts open the abscess, and the pus drains out. This drainage of pus often decreases the pain right away because it relieves the pressure caused by the fluid.

Your healthcare provider then packs the pocket with gauze. One end of the gauze is in the abscess and the other end is left sticking out through the cut in the skin. This allows the pus that forms in the abscess to drain out. It also prevents the skin from healing back over the abscess and sealing it off again. The gauze packing is changed every day or two. Your body will fill in the pocket where the abscess was with new tissue. Once the abscess is filled in, the packing is removed for the last time and the skin is allowed to heal and close up.

How long will the effects last?

The time it takes for an abscess to heal depends on how big it is and how fast you heal. Sometimes it takes only a couple of days, but sometimes it takes weeks.

How can I take care of myself?

• Follow your healthcare provider's instructions for taking care of the abscess at home.
• If your provider prescribes antibiotics, take them exactly as you are directed.
• If the gauze comes out before it is supposed to, you may need to visit your provider to get it replaced so the skin does not heal shut too soon.
• If you have medicine for pain, make sure to take it before you see your health provider to get the abscess repacked. It may hurt a little to take the gauze out and replace it.

How can I help prevent a skin or soft tissue abscess?

• Clean your skin as soon as possible after you are scratched or poked.
• If you think you may be developing an abscess, see your healthcare provider as soon as possible.