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Skin Abscess

What Is A Skin Abscess?

A skin abscess is a localized infection which manifests as a painful swelling that contains pus. It is usually located in the dermis and subcutaneous layers of the skin.


What Causes a Skin Abscess?

Abscesses are caused by:

1. Infection

Most abscesses are caused by infections. The most common causative organisms are bacteria like Staphylococcus aureus. Other bacteria that cause abscesses include Streptococcus pyogenes and beta-hemolytic streptococci.

These bacteria enter the body through minor cuts or bruises.

2. Foreign material

Pus filled abscesses can also develop due to the presence of foreign bodies like needles or thorns in the body.

Ingrown hairs can also cause abscesses to develop.

3. Obstructed sweat glands and sebaceous glands

Obstruction of sweat glands and sebaceous (oil) glands can also result in their contents becoming infected and a skin abscess forming.

4. Unknown causes

In some situations, the exact cause of a boil cannot be determined.

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What Are The Risk Factors For Developing An Abscess?

Risk factors for developing abscesses include:

1. Being a Staph aureus carrier

Skin or nasal carriage (carrying in the nose) of Staphylococcus aureus increases a person’s risk for developing abscesses.

2. Compromised immune systems

Persons with weakened immune systems have an increased risk for developing abscesses more frequently. This weakened immune system can be due to:

a. Medications like steroids (like prednisone and prednisolone) and chemotherapy drugs used to treat cancer.

b. Diseases like AIDS, malnutrition, diabetes, renal (kidney) failure

c. Hypogammaglobulinemia in which the body does not produce adequate amounts of antibodies to fight infections

3. Poor hygiene

Poor personal hygiene and living in a dirty environment increases a person’s risk for developing abscesses.

4. Substance abuse

Persons who abuse recreational drugs intravenously (in the vein) and those who abuse alcohol are at increased risk for developing abscesses.

5. Close contact with persons with abscesses

Persons who are in close contact with individuals with abscesses caused by bacteria like Staphylococcus aureus are at increased risk for developing abscesses.

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Where Do Abscesses Develop?

Skin abscesses can develop in any part of the body though they most commonly develop in the axillae (armpits) and the groin.

Skin abscesses can affect all age groups.


What Are The Symptoms Of An Abscess?

Symptoms of an abscess include:

A warm and tender area which ranges in color from pink to deep red.

As the infection continues, this area increases in size and becomes a firm and more painful swelling.

If not treated, the swelling becomes softer and fluctuant (compressible).

It eventually forms a head or develops a point through which it will break through the skin to pour out the pus.

Fever and chills are other symptoms which may be present.

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What Tests Are Done For An Abscess?

Investigations for patients with an abscess include:

1. Pus cultures can also be taken if the infection is extensive. These are done by swabbing the pus and sending it to the laboratory for examination to determine the bacteria causing the infection and the best antibiotics to treat it.


What Is The Conventional Medical Treatment For An Abscess?

The treatment for an abscess includes:

1. Incision and drainage (I & D)

This is a procedure in which the doctor numbs the affected area with a local anesthetic and then makes a small cut and drains the pus. A pack may be left inside to reduce bleeding and help with the healing. The resultant wound requires cleaning, dressing, repacking and bandaging until it heals. It usually heals in around 7-14 days depending on how large the abscess was.

2. Antibiotics

Antibiotics like flucloxacillin are given to control the infection.

3. Analgesics

Pain relieving medications are prescribed to manage the pain.


What Are The Home Remedies For A Skin Abscess?

Home remedies for an abscess include:

1. Heat application

In the very early stages, when the skin abscess is still small and not fluctuant, it can be treated with heat application from hot packs.

To apply a hot pack, pour some warm water into a bowl. Dip a face cloth in the water and wring of the excess water. Apply the wet cloth to the skin abscess for 30 minutes four times each day.

The application of heat to the area dilates or expands the blood vessels and this increases the supply of blood with the infection fighting WBCs to the area.

Once the boil becomes fluctuant, it has to be treated in the hospital by incision and drainage (I & D).

Do not attempt to drain it at home by sticking a needle into it as it may cause it to spread.

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What Are The Complications Of An Abscess?

Complications of an abscess include:

1. Cellulitis

This develops when the infection spreads to the surrounding tissues. It may be accompanied by fever, nausea, vomiting and other symptoms.

2. Sepsis

This develops when the infection spreads to the bloodstream.


What Is The Prognosis For An Abscess?

For most people, the prognosis for an abscess is usually excellent since they heal without any complications after they have been properly drained.

However, a few people, especially those with a compromised immune system develop complications which include:

1. Spreading of the infection to deeper tissues. This usually occurs with bacteria like the methicillin resistant Staphyloccus aureus (MRSA)

2. Spreading of the infection to the bloodstream

3. Developing recurrent abscesses


How Can An Abscess Be Prevented?

Abscesses can be prevented by the following measures:

1. Bathing with soap and water regularly and generally maintaining good personal hygiene

2. Avoiding cutting yourself when shaving the armpits or pubic area.

3. Seeking immediate medical attention once you notice any minor skin infections

4. Using antibacterial soaps to reduce the population of bacteria on the skin.

5. Using a loofah brush when showering for exfoliating or getting rid of the dead cells on the surface of the skin can help prevent plugging of the skin pores which can lead to infection.

6. Cleaning all cuts and bruises with warm salty water or just soap and water.

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