One of the services we offer at The Urgent Care at Vermont is incision and drainage of abscesses. An abscess is a pocket of pus typically caused by bacterial infection. The pus is made up of living and dead cells, germs, fluid, and dead tissue. Abscesses are painful and may develop anywhere in the body, though they are more common in some areas than others.
Types of Abscesses
Abscesses come in many forms. They can develop on or under the skin, inside the mouth, or around an organ.
Skin Abscesses
Skin abscesses or cutaneous abscesses develop right under the skin. These are common and usually easy to treat. There are a few different types depending on where they form:
- Armpit abscess: these occur when pus collects in the armpit. A common cause is a condition called hidradenitis suppurativa, which results in red, tender bumps in the armpit skin that can become abscesses over time.
- Breast abscess: while breastfeeding, an untreated breast infection can lead to abscesses.
- Anorectal abscess: an abscess can form in the skin around the anus or rectum.
Mouth Abscesses
Several different types of abscesses can affect the inside of the mouth:
- Gingival abscess: also called a gum abscess, this type develops in the gums and doesn’t usually affect the teeth.
- Periapical abscess: an abscess can form at the tip of a tooth’s root due to dental injuries or cavities.
- Periodontal abscess: usually the result of periodontitis or advanced gum disease, an abscess can affect the bones and tissues supporting the teeth.
- Tonsil abscess: a pocket of pus can form behind a tonsil, particularly during adolescence or young adulthood.
- Peritonsillar abscess: also called a quinsy, this is a buildup of pus between the tonsils and the throat wall.
- Retropharyngeal abscess: this is an abscess at the back of the throat, which can form when lymph nodes there become infected.
Internal Abscesses
A third, less common category of abscesses are those that develop on the spinal cord, brain, and other organs. They are usually harder to diagnose and to treat.
- Abdominal abscess: puss can build up inside the belly near the liver, kidneys, pancreas, or other organs.
- Spinal cord abscess: an infection on the spine may cause pus to build up in and around the spinal cord.
- Brain abscess: this is a rare buildup of pus in the brain if bacteria from an infection elsewhere in the head or bloodstream enters the brain.
What Causes an Abscess?
A bacteria called Staphylococcus is usually the culprit behind an abscess. The immune system sends white blood cells to go fight it when it enters the body, causing inflammation and the death of nearby tissue. Pockets form around the site and fill with pus, creating an abscess. More rarely, viruses, parasites, and fungi can cause abscesses.
Abscess Symptoms
Skin abscesses are easy to see, often appearing red, raised, and swollen, sometimes with a yellow or white center where the pus is visible through the skin. It may feel tender and warm to the touch and be accompanied by pain, fever, and chills. An oral abscess may cause a severe toothache and cause symptoms like fever, difficulty swallowing, and difficulty opening your mouth.
Deeper skin abscesses or internal abscesses can be harder to detect because they aren’t visible. Symptoms may relate to the affected body part, such as:
- Fatigue
- Pain and tenderness
- Fever
- Chills
- Excessive sweating
- Loss of appetite
- Weight loss
Treating Abscesses
We can diagnose a skin abscess with a physical examination. The size and location will determine the most appropriate treatment. Small abscesses or abscesses near the surface of the skin may resolve on their own with a warm compress. You may be prescribed an antibiotic. Don’t attempt to drain or burst an abscess at home, as that will only spread bacteria to other areas and the abscess will likely come back.
Some abscesses are large enough to require surgical drainage under local anesthetic. We will make a tiny incision, drain and remove any pus, dead tissue, and debris, and clean and bandage the area. The incision will heal on its own, and will often leave a small scar.