Skin Abscess – A Patient Guide
Often in clinical practice, I encounter patients who have developed skin infections. Sometimes the skin infection can be serious enough to require admission to the hospital.
These infections that require admission usually ends up being skin abscess.
What Is A Skin Abscess?
A skin abscess is essentially an infection of the skin where there is space accumulated under the skin. It is very similar to a pimple but is significantly larger and is seen deeper under the skin.
Where Are Skin Abscesses Usually Seen?
The most common site of skin abscess development is the groin, armpits, buttocks, and extremities.
However, I have seen patients develop abscesses on the scalp and on the back as well.
Symptoms And Signs
In mild cases, skin abscesses will just be a collection of pus with some redness of the skin surrounding it. It can be painful when pressed and can be warm to the touch.
In severe cases, the skin abscess can spread rapidly from the original area and affect a large area around it. This can become extremely painful and can lead to fever and severe fatigue.
I recently treated a patient who had a skin abscess of the inner thigh and who came to the clinic with severe giddiness and low blood pressure. This is because the infection had spread to the bloodstream and was affecting the normal working physiology of the body.
If the skin abscess spreads to nearby areas it can lead to a condition called cellulitis, which I shall discuss in a separate article.
Who Develops A Skin Abscess? Risk Factors.
Skin abscesses can develop in literally anyone. However, they tend to be more serious in patients who have a history of type 2 diabetes and those who do not maintain adequate hygiene.
What Causes A Skin Abscess?
Skin abscesses are caused by bacteria. The most common bacteria that cause infection are Staphylococcus aureus and streptococcus.
Investigations
It is easy to diagnose an abscess through clinical examination alone. They range between 1 to 3 cm in size but may become larger as I have discussed above.
Sometimes on the surface, they have a tiny yellow spot which is the pus that is trying to come out.
Patients who have a skin abscess require a blood test that will help determine the presence of infection within the bloodstream. Those who have diabetes will require a blood sugar test as well.
In some patients, an ultrasound scan or a CT scan may be required to determine the depth and true size of the abscess.
If pus starts to come out of the skin abscess, then a wound swab will be sent out to the lab for analysis.
Treatment Of Skin Abscess
The primary treatment for managing skin abscesses is incision and drainage i.e. a surgical procedure. A small abscess can dissolve with simple antibiotics and warm compression.
Larger abscesses can be difficult to treat as an outpatient and are best managed in a hospital setting.
Intravenous antibiotics will be administered to the patient and once the abscess has ‘calmed down‘ then the surgical procedure will likely be needed.
The surgical procedure is called incision and drainage. The surgeon, under anesthesia, will make a small cut on the top of the abscess to allow the pus to come out.
Once the pus comes out, the surgeon will insert their gloved index finger or a device to clean out all the bus from within the abscess cavity. Addressing will be and then applied to allow any remaining bus to get soaked into the dressing.
After discharge, patients may require ongoing antibiotic treatment along with regular dressings.
Complications
If an abscess is left untreated then it can spread rapidly and make the patient seriously ill. It is always best to seek advice early so that simple treatments can help resolve the condition completely.
Dr Vivek Baliga is a medical practitioner and the director of a diagnostic center – Baliga Diagnostics – in Bangalore. He specializes in diabetes and heart disease, and is a visiting consultant in Internal Medicine at corporate hospitals. He is married and has one son.
