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Skin Abscess: Causes, Symptoms, Diagnosis, Prevention And Treatment

A skin abscess is a boil or bump-like infection on the skin's surface filled with pus or translucent fluid. The infection is often caused due to the bacteria Staphylococcus . An abscess is often painful, red, and swollen and occurs mostly in the armpits, inner thighs, genitals, chest, buttocks and face of a person. However, it can occur in any part of the body like fingers, eyes, knees and foot [1] .

In many cases, skin abscess goes away on its own but in some cases, medications are needed to heal it after draining out the infectious pus. If left untreated for long, it may result in the failure of the organ upon which it has appeared.

Causes Of Skin Abscess

The common cause of skin abscess is a bacterial infection due to Staphylococcus bacteria. They enter into the body through a hair follicle or wound and cause the infection. Following are the main causes of infection caused by the Staphylococcus bacteria:

  • Coming in contact with the staph infection through close contact with the infected person [1]
  • Skin diseases like eczema or acne
  • Weaken immune system, in case of HIV [2]
  • Diabetes [3]
  • Poor hygiene [4]

Other causes of skin abscess include the following:

  • Inflammation of hair follicle, especially on the scalp [5]
  • Obstructed sweat gland
  • Surgery

Boils On Scalp: Causes, Symptoms And Treatment

Symptoms Of Skin Abscess

The symptoms of skin abscess depend on the area on which it has developed. However, the common symptoms of abscess are as follows:

  • A boil which is red in colour, tender, and warm to touch [1]
  • Swelling in the infected area
  • Chills [6]
  • Nausea
  • Pain in the infected area
  • A build-up of pus on the skin's outer surface [1]
  • High temperature

Risk Factors Of Skin Abscess

Low immunity is the main risk factor for developing skin abscess. Other factors responsible for the recurrent occurrence of skin abscess are as follows:

  • Chemotherapy [7]
  • Lupus
  • Diabetes [3]
  • HIV [2]
  • Sickle cell disease
  • Severe burns
  • Crohn's disease [8]
  • Severe trauma [9]
  • Alcoholism
  • Chronic steroid therapy [10]
  • Tattoos [11]

Complications Of Skin Abscess

Sometimes, the skin abscess will break and drain on its own without causing any serious complications. However, one must consult a doctor if [1]

  • the sore becomes larger than half an inch,
  • the sore becomes painful,
  • the sore is located in rectal or genitals,
  • the person gets a fever of 100.4 °F or above,
  • the skin abscess occurs during pregnancy and
  • the abscess returns in a few days.

If the aforementioned conditions are not treated, a person may experience complications like the following:

  • The spread of the staph infection to the brain and spinal cord.
  • The infection may spread to the inner lining of the heart.
  • Sepsis [12]
  • Gangrene [13]
  • Osteomyelitis, bone infection
  • New abscess formation

Diagnosis Of Skin Abscess

To diagnose the skin abscess, a doctor will first ask for the medical history of the patient along with visually analyzing the affected area followed by the following questions [14] :

  • When the abscess started
  • Any injury to the area in which abscess if formed
  • Any underlying medical conditions
  • Medicines prescribed for the condition
  • Allergies
  • Signs of fever [6]

Then the doctor will send the sample of the pus for testing to identify the exact bacteria causing the infection. If two or more abscesses are present, a urine test is suggested.

Treatment Of Skin Abscess

Several methods for treating skin abscess are as follows:

  • Home treatment: At first, the doctor may suggest applying heat to the area in which abscess is formed to shrink it and drain the pus automatically formed inside it.
  • Antibiotics: Here, the doctor will prescribe antibiotics such as cephalexin and dicloxacillin if the abscess/boil is more than one and present in the area where the risk of complications is more. If the cause of the infection is MSRA bacteria, the doctor may go for other antibiotics [15] .
  • Drainage: This method is considered when the abscess does not heal even after the above mentioned two methods. Here, the doctor will numb the area around the abscess and cut it to drain out the pus [16] .
  • Percutaneous abscess drainage: This method is applied when the abscess is present internally. A needle is inserted to the internal abscess area using image guidance and infected fluid is drained out with the help of a needle [17] .

Also read:

Prevention Of Skin Abscess

Skin abscess can be prevented by the following methods [18] :

  • Maintain good hygiene
  • Shave cautiously to avoid the cut in pubic and underarms area.
  • If cut or injury takes place, wash it will mild soap and water and apply antibacterial cream. Also, apply bandages.
  • Don't share your personal belongings like towel, razor, and clothing.
  • Don't puncture the boil with dirty hands as it may spread the infection.
View Article References
  1. [1] Kobayashi, S. D., Malachowa, N., & DeLeo, F. R. (2015). Pathogenesis of Staphylococcus aureus abscesses. The American journal of pathology, 185(6), 1518–1527. doi:10.1016/j.ajpath.2014.11.030
  2. [2] Johnston S. L. (2008). Clinical immunology review series: an approach to the patient with recurrent superficial abscesses. Clinical and experimental immunology, 152(3), 397–405. doi:10.1111/j.1365-2249.2008.03640.x
  3. [3] Rosen, J., & Yosipovitch, G. (2018). Skin manifestations of diabetes mellitus. In Endotext [Internet]. MDText. com, Inc..
  4. [4] Peralta, D. P., Chang, A. Y., & Soto-Ruiz, E. (2017). A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History. Case reports in infectious diseases, 2017, 4765697. doi:10.1155/2017/4765697
  5. [5] [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Boils and carbuncles: Overview. 2018 Jun 14.
  6. [6] Sunderkötter, C., & Becker, K. (2015). Frequent bacterial skin and soft tissue infections: diagnostic signs and treatment. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 13(6), 501-526.
  7. [7] Kofteridis, D. P., Valachis, A., Koutsounaki, E., Maraki, S., Mavrogeni, E., Economidou, F. N., … Samonis, G. (2012). Skin and soft tissue infections in patients with solid tumours. TheScientificWorldJournal, 2012, 804518. doi:10.1100/2012/804518
  8. [8] Bollegala, N., Khan, R., Scaffidi, M. A., Al-Mazroui, A., Tessolini, J., Showler, A., … Grover, S. C. (2017). Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature. Canadian journal of gastroenterology & hepatology, 2017, 5124354. doi:10.1155/2017/5124354
  9. [9] Behera, B., Bhoriwal, S., Mathur, P., Sagar, S., Singhal, M., & Misra, M. C. (2011). Post-traumatic skin and soft tissue infection due to Aeromonas hydrophila. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 15(1), 49–51. doi:10.4103/0972-5229.78228
  10. [10] Youssef, J., Novosad, S. A., & Winthrop, K. L. (2016). Infection Risk and Safety of Corticosteroid Use. Rheumatic diseases clinics of North America, 42(1), 157–x. doi:10.1016/j.rdc.2015.08.004
  11. [11] Dieckmann, R., Boone, I., Brockmann, S. O., Hammerl, J. A., Kolb-Mäurer, A., Goebeler, M., … Al Dahouk, S. (2016). The Risk of Bacterial Infection After Tattooing. Deutsches Arzteblatt international, 113(40), 665–671. doi:10.3238/arztebl.2016.0665
  12. [12] Zhou, X., Su, L. X., Zhang, J. H., Liu, D. W., & Long, Y. (2019). Rules of anti-infection therapy for sepsis and septic shock. Chinese medical journal, 132(5), 589–596. doi:10.1097/CM9.0000000000000101
  13. [13] Thwaini, A., Khan, A., Malik, A., Cherian, J., Barua, J., Shergill, I., & Mammen, K. (2006). Fournier's gangrene and its emergency management. Postgraduate medical journal, 82(970), 516–519. doi:10.1136/pgmj.2005.042069
  14. [14] Subramaniam, S., Bober, J., Chao, J., & Zehtabchi, S. (2016). Point‐of‐care ultrasound for diagnosis of abscess in skin and soft tissue infections. Academic Emergency Medicine, 23(11), 1298-1306.
  15. [15] Golan Y. (2019). Current Treatment Options for Acute Skin and Skin-structure Infections. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 68(Supplement_3), S206–S212. doi:10.1093/cid/ciz004
  16. [16] Schmitz, G., Goodwin, T., Singer, A., Kessler, C. S., Bruner, D., Larrabee, H., … Bhat, R. (2013). The treatment of cutaneous abscesses: comparison of emergency medicine providers' practice patterns. The western journal of emergency medicine, 14(1), 23–28. doi:10.5811/westjem.2011.9.6856
  17. [17] Charles H. W. (2012). Abscess drainage. Seminars in interventional radiology, 29(4), 325–336. doi:10.1055/s-0032-1330068
  18. [18] Creech, C. B., Al-Zubeidi, D. N., & Fritz, S. A. (2015). Prevention of Recurrent Staphylococcal Skin Infections. Infectious disease clinics of North America, 29(3), 429–464. doi:10.1016/j.idc.2015.05.007
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