Treatment - Abscess

Treatment depends on the type of abscess and how large it is.

The main treatments for an abscess include:

• antibiotics
• a drainage procedure
• surgery

Skin abscesses

Some small skin abscesses may drain naturally. They may get better without the need for treatment.

Applying heat may help reduce any swelling and speed up healing. For example, a warm compress such as a warm flannel. The flannel should be thoroughly washed after. To avoid spreading the infection, it should not used by other people.

For larger or persistent skin abscesses, your GP may prescribe an antibiotic. This will help clear the infection and prevent it from spreading.

You may need to wash off the bacteria from your body to prevent re-infection. Use an antiseptic soap for most of your body and an antibiotic cream for the inside of your nose.

Antibiotics alone may not be enough to clear a skin abscess. The pus may need to be drained to clear the infection. If a skin abscess is not drained, it may continue to grow and fill with pus until it bursts. This can be painful and can cause the infection to spread or come back.

Incision and drainage

You may have a skin abscess that needs draining. If so, you'll probably have a small procedure under a local anaesthetic.

During the procedure, the surgeon cuts into the abscess, to allow the pus to drain out. They may also take a sample of pus for testing.

When the pus has been removed, the surgeon will clean the hole with sterile saline (a salt solution).

The abscess will be left open but covered with a wound dressing. This means if any more pus is produced it can drain away easily. If the abscess is deep, an antiseptic dressing may be placed inside the wound to keep it open.

The procedure may leave a small scar.

Internal abscesses

The pus usually needs to be drained from an internal abscess. This is done with a needle in the skin (percutaneous abscess drainage) or with surgery.

The way it is done will depend on the size of your abscess and where it is in your body.

You will usually be given antibiotics at the same time. This will help kill the infection and prevent it spreading.

Percutaneous drainage

If the internal abscess is small, the surgeon may be able to drain it using a fine needle. This will be done with either a local or general anaesthetic, depending on where the abscess is.

The surgeon may use ultrasound scans or CT scans to help guide the needle into the right place.

The surgeon drains the pus using the needle. They may make a small incision in your skin over the abscess. Then they insert a thin plastic tube called a drainage catheter into it.

The catheter allows the pus to drain out into a bag and may be in place for up to a week.

This procedure may be carried out as a day case procedure. This means you'll usually be able to go home the same day, but you might need to stay in hospital for a few days.

Percutaneous drainage may leave a small scar.

Surgery

You may need to have surgery if:

• your internal abscess is too large to be drained with a needle
• a needle cannot get to the abscess safely
• needle drainage has not been effective in removing the pus

The type of surgery you have will depend on the type of internal abscess and where it is in your body. Generally, it involves making a larger incision in your skin to allow the pus to be washed out.