Patient education: Skin abscess drainage (The Basics)

What is a skin abscess? — A skin abscess is a painful bump that forms when pus collects under the skin (picture 1). It looks like a pimple, but it is usually much larger. Skin abscesses often form when there is a cut or nick in the skin and bacteria from the skin's surface gets in. An abscess can be caused by an ingrown hair, or from close contact with someone who carries a certain type of bacteria.

The infection causes the skin to become swollen and painful. It also makes the skin look red or darker in color.

Less often, a skin abscess might be caused by another type of germ, like a virus, fungus, or parasite.

To treat a skin abscess, a doctor or nurse makes a small cut on the surface of the abscess to drain the pus. This is called "incision and drainage." In some cases, they will use a needle to drain the pus instead.

How do I know if my abscess needs to be drained? — Your doctor or nurse will decide after looking at your abscess and learning about your symptoms. Most abscesses need to be cut and drained. But if the abscess is small (less than 3/4 inch, or 2 cm, in size) or draining pus on its own, it might not need to be drained.

How do I prepare for abscess drainage? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

●Imaging tests – These create pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before your procedure. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during abscess drainage? — When it is time for the procedure:

●You will get a shot of numbing medicine in the area around the abscess. This is so you do not feel pain during the procedure.

●The doctor might use an ultrasound to see the collection of fluid under your skin.

●To let the pus and fluid drain from the abscess, the doctor will usually make a small cut on the surface of the abscess. They might use a tool to "probe" or feel inside the abscess. This is to make sure that there are no hidden pockets of pus.

●The doctor might rinse out the abscess.

●The abscess might be packed with gauze, or a small drain might be put in – These help additional pus drain from the abscess. But they are not always needed.

●The doctor will cover the area with a piece of clean, dry gauze.

Some people get "sedation" for draining an abscess. This involves getting medicine to help them relax. If you are having sedation:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get sedatives – These are medicines to make you relax and feel sleepy.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

What happens after abscess drainage? — The staff will talk with you about how to care for the drained abscess.

If you had sedation, you might be taken to a recovery room. The staff will watch you closely as your sedatives wear off. As you recover from sedatives, you might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

What are the risks of skin abscess drainage? — Your doctor will talk to you about all of the possible risks and answer your questions. Possible risks include:

●Not draining the abscess completely – If this happens, the abscess might not heal completely or might even grow larger.

●Damage to any nearby structures, such as nerves or blood vessels

●Pain – Pain can come from the shot of numbing medicine, the incision or needle going in, the probing, or the packing.

●Scarring – The incision will heal with a scar. Your doctor will try to make the scar as small and unnoticeable as possible.

More on this topic

Patient education: Skin abscess drainage – Discharge instructions (The Basics)
Patient education: Skin abscess (The Basics)
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Patient education: Skin and soft tissue infection (cellulitis) (Beyond the Basics)