Doctor's Notes on Skin Abscess Overview
A skin abscess is a small collection of pus within the skin. A skin abscess is sometimes referred to as a boil. A skin abscess can occur anywhere on the body. There can be many causes of skin abscesses, including an ingrown hair, splinters or foreign objected that have become lodged in the skin, or plugged sweat glands.
The first symptom of a skin abscess is a red and tender area on the skin. The area becomes hard, firm, and more painful or tender. Eventually, there is softening of the tissue at the center of the hard area with pus formation. Pus is composed of white blood cells that fight the infection. Associated symptoms can include spontaneous drainage or weeping of pus from the area.
Skin Abscess Overview Symptoms
The symptoms of a skin abscess vary depending on the location of the abscess, but in general, individuals will experience the following:
- A painful, compressible mass that is red, warm to the touch, and tender.
- As an abscess progresses, it may "point" and come to a head. Pustular drainage and spontaneous rupture may occur.
- Most abscesses will continue to worsen without care and proper incision and drainage. The infection can potentially spread to deeper tissues and even into the bloodstream.
- If the infection spreads, fever, nausea, vomiting, increasing pain, and increasing skin redness may develop.
Skin Abscess Overview Causes
Skin abscesses are typically caused by either an inflammatory reaction to an infectious process (bacteria or parasite) or, less commonly, to a foreign substance within the body (a needle or a splinter, for example). Abscesses may develop because of obstructed oil (sebaceous) or sweat glands, inflammation of hair follicles on the body or scalp, or from minor breaks and punctures of the skin. Abscesses may also develop after a surgical procedure.
The infectious organisms or foreign material cause an inflammatory response in the body, which triggers the body's immune system to form a cavity or capsule to contain the infection and prevent it from spreading to other parts of the body. The interior of the abscess liquefies, and pus develops (which contains dead cells, proteins, bacteria, and other debris). This area then begins to expand, creating increasing tension and inflammation of the overlying skin.
The most common bacterial organism responsible for the development of skin abscesses is Staphylococcus aureus, although various other organisms can also lead to abscess formation. With the emergence of methicillin-resistant Staphylococcus aureus (MRSA), health care providers must now consider this organism as the possible cause when a skin abscess is encountered.
A major risk factor for developing skin abscesses includes a weakened immune system (either from chronic diseases or from medications), because the body's ability to fight infection is decreased. The following conditions are risk factors for developing abscesses and for getting recurrent or multiple abscesses:
Acne is a common skin condition that affects the face, neck, chest, upper arms, buttocks, and back. These are the areas that have the most oil glands. Teenagers are the group most affected by acne, but it can happen to anyone of any age. Men, women, children, older adults, and even babies can get acne. Blackheads and whiteheads are two types of acne. When inflammation goes deep into the skin, cysts or nodules may develop. Acne is a common beauty concern for women who have fluctuating hormones. Clear skin is possible for everyone if you follow a basic good skincare routine for your unique skin type.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.