surgery · proctology · abscess · incision and drainage · Gdańsk
An abscess is a localised collection of pus, most often associated with infection and inflammation. It may appear under the skin, in the groin, under the armpit, on the buttock, near the anus, in the area of a pilonidal cyst, in the breast, in a scar or in a post-procedure wound. Typical symptoms include increasing pain, swelling, redness, warmth of the skin, throbbing, tissue tension, pus discharge, fever or deterioration of general wellbeing.
Abscess treatment and diagnostics of purulent lesions are provided, depending on location, by: Piotr Rak, MD, PhD, Iwona Chruścicka, MD, PhD, Sara Godyńska, MD, Kamil Smok, MD and Justyna Szul, MD.
The most important answer
An abscess is a collection of pus that usually requires medical assessment and often incision and drainage. Ointments, sitz baths, warm compresses or antibiotics may sometimes reduce inflammation, but with a larger, painful or worsening abscess they are often insufficient because the pus is enclosed inside the abscess cavity. You should see a doctor especially quickly if the abscess is near the anus, in the groin, on the face, in the breast, after a procedure, in a person with diabetes or reduced immunity, or if fever, chills, severe pain or rapidly spreading redness appears.
What is an abscess?
An abscess forms when the body walls off an infection and creates a cavity filled with pus. Pus contains, among other things, bacteria, inflammatory cells, dead tissue and inflammatory fluid. From the outside, an abscess may look like a painful lump, swelling, a red raised area or a tense, throbbing inflammatory mass.
An abscess may appear after skin damage, shaving, abrasion, an ingrown hair, an infected sebaceous cyst, folliculitis, a pilonidal cyst, injury, injection, procedure or in the course of diseases around the anus. Some abscesses form deeper and are not always clearly visible on the skin.
Typical symptoms of an abscess
- increasing, throbbing pain,
- redness and warmth of the skin,
- swelling, a hard inflammatory mass or a painful lump,
- a feeling of pressure or tissue tension,
- pus discharge or an unpleasant smell,
- tenderness to touch, sitting or movement,
- fever, chills or weakness,
- enlarged lymph nodes near the infection,
- recurrence of similar lesions in the same area.
See a doctor urgently if:
- the pain increases quickly or makes sitting, walking or sleeping difficult,
- the abscess is near the anus, in the groin, on the face, in the breast or near the genitals,
- you have fever, chills, weakness or feel unwell,
- redness spreads quickly or red streaks appear on the skin,
- you have diabetes, reduced immunity, oncological treatment or immunosuppressive medication,
- the abscess appeared after a procedure, injection, injury or in a wound,
- the lesion is large, very painful, deep or recurrent,
- bleeding, skin necrosis or a very unpleasant smell appears,
- the abscess affects a child, pregnant woman or elderly person.
Different abscess locations — where can it appear?
1. Skin or subcutaneous abscess
It may appear practically anywhere on the body: on the back, abdomen, thigh, arm, neck, buttock, groin or under the armpit. Sometimes it begins from an infected hair follicle, ingrown hair, abrasion, bite or small wound. If it is small, superficial and without general symptoms, the doctor may recommend observation, but larger and painful abscesses often require incision and drainage.
2. Armpit or groin abscess
The armpit and groin areas are exposed to friction, shaving, moisture and infections of hair follicles. Recurrent painful lumps and abscesses in these areas may also suggest chronic inflammatory disease of the apocrine glands. In such situations, it is important not only to drain the abscess, but also to determine why the lesions recur.
3. Buttock abscess
A painful abscess on the buttock may be a skin abscess, an infected sebaceous cyst, a complication after injury or injection, but it may also be related to a pilonidal cyst or a perianal abscess if it is located closer to the natal cleft or anus. Location is very important when choosing the right doctor and further treatment.
4. Perianal abscess
A perianal abscess usually causes severe pain around the anus, a painful lump, swelling, redness, difficulty sitting, pain during bowel movements, sometimes fever and pus discharge. This is one of the locations that should not be waited out. Treatment often involves incision and drainage, and delay may increase the risk of an anal fistula.
In the case of pain, a lump or swelling near the anus, the patient should be referred to a proctologist. Details of this pathway should remain on the perianal abscess page.
5. Abscess associated with a pilonidal cyst
A pilonidal cyst, most often located in the natal cleft near the tailbone, may become infected and form a painful abscess. Symptoms include pain when sitting, swelling, redness, discharge of pus or blood and recurrent inflammation. In the acute phase, the most important step may be controlling the abscess, while planned treatment of the cyst is discussed after the acute condition has settled.
6. Breast abscess
A breast abscess may occur, among other situations, during breastfeeding, but also outside lactation. It presents as a painful, red, warm area of the breast, a lump, swelling, sometimes fever or feeling unwell. It requires diagnostics because similar symptoms may also occur in other breast diseases. In some patients, ultrasound, antibiotics, puncture or drainage may be needed — the decision is made by the doctor.
7. Abscess after a procedure or in a wound
If increasing pain, redness, swelling, purulent discharge, fever or wound separation appears after a procedure, injury or around a wound, prompt follow-up is needed. A wound abscess may require opening, cleaning, taking material for testing and dressings.
Can an abscess be squeezed?
No. Squeezing an abscess may push infected material deeper, damage tissues, spread inflammation and make later treatment more difficult. Self-puncturing lesions on the face, genitals, anus, groin, breast and post-operative wounds is especially dangerous.
If the abscess bursts spontaneously and starts to drain, it is still worth seeing a doctor. Sometimes spontaneous rupture does not empty the entire abscess cavity and the infection may recur.
What does abscess treatment look like?
Treatment depends on location, size, depth, general symptoms and the patient’s condition. Small, superficial lesions without fever can sometimes be observed, but a mature, painful or worsening abscess usually requires drainage.
Incision and drainage
The most common treatment involves incising the abscess and evacuating the pus. The doctor may rinse the abscess cavity, place a drain or dressing, and in selected situations collect material for microbiological testing. The wound after drainage is often not tightly sutured because it must allow further drainage and healing from the bottom.
Antibiotic
An antibiotic may be needed in the presence of general symptoms, fever, spreading inflammation, diabetes, reduced immunity, abscesses in selected locations or after medical assessment. An antibiotic alone may be insufficient if there is a closed cavity with pus in the tissues.
Dressings and follow-up
After drainage, dressings, hygiene and observation of pain, temperature, redness and the amount of discharge are important. The doctor may recommend a follow-up visit, dressing change, drain removal, further infection treatment or planned treatment of the cause, such as a pilonidal cyst, anal fistula or recurrent sebaceous cyst.
When does an abscess require a surgeon, and when a proctologist?
A skin, subcutaneous, wound-related, post-procedure abscess, or an abscess in the groin, armpit, trunk or limb usually requires surgical assessment. An abscess near the anus, anal pain, a lump near the anus, pus discharge from the anal area or suspected fistula is an indication for proctology consultation.
In practice, location determines the pathway: a general and oncological surgeon assesses abscesses of the skin, subcutaneous tissue, breast and wounds, while a proctologist assesses perianal abscesses, anal pain, perianal lumps and suspected fistula.
How should you prepare for the visit?
- note when the painful lump or swelling started,
- tell the doctor whether the lesion is growing quickly, has burst or is draining pus,
- check whether fever, chills or weakness are present,
- inform the doctor about diabetes, reduced immunity, oncological treatment and immunosuppressive medication,
- mention previous abscesses, pilonidal cyst, fistula, sebaceous cysts or procedures,
- do not squeeze, puncture or burn the lesion before the visit,
- bring culture results, ultrasound results, hospital discharge summaries or documentation of previous procedures, if you have them.
Patient pathway: from painful lump to appropriate treatment
This section does not replace service pages. It helps the patient recognise that an abscess requires assessment and choose the appropriate direction: surgery or proctology.
Increasing pain, swelling, redness, skin tension, fever or pus discharge.
Skin, groin, armpit, buttock, breast, post-procedure wound, anal area or pilonidal cyst.
A surgeon or proctologist assesses whether drainage, an antibiotic, culture, ultrasound or another test is needed.
Most often: incision and drainage, dressings, follow-up, and then treatment of the cause of recurrence.
Doctors dealing with abscesses depending on location
general and oncological surgeon
He consults and treats surgical lesions of the skin and subcutaneous tissue, including abscesses, infected sebaceous cysts, wounds and inflammatory conditions requiring surgical assessment.
Doctor’s profile →general and oncological surgeon
She consults surgical lesions of the skin, subcutaneous tissue, breast and wounds, including inflammatory conditions requiring diagnostics and surgical treatment.
Doctor’s profile →proctologist, surgeon
She consults patients with pain, a lump, swelling and suspected abscess in the anal area, as well as other proctological problems.
Doctor’s profile →surgeon, proctology
He consults and treats proctological diseases, perianal abscesses and inflammatory conditions associated with pilonidal cysts.
Doctor’s profile →proctologist, surgeon
She consults patients with anal pain, a lump, swelling, discharge and suspected abscess or fistula in the anal area.
Doctor’s profile →Do you have a painful lump, swelling or suspected abscess?
Do not squeeze the lesion. Book a surgical or proctological consultation — the location of the abscess determines the correct treatment pathway.
FAQ – abscess
Can an abscess be treated with antibiotics alone?
Sometimes an antibiotic is needed, but with a mature abscess it is often insufficient because the pus is enclosed in the abscess cavity. In many cases, incision and drainage are necessary.
Can an abscess be squeezed?
No. Squeezing may spread the infection, damage tissues, increase pain and make treatment more difficult. An abscess should be assessed by a doctor.
When is an abscess urgent?
Urgent assessment is required for an abscess with fever, rapidly increasing pain, spreading redness, an abscess near the anus, in the groin, on the face, in the breast, in a post-procedure wound, and an abscess in a person with diabetes or reduced immunity.
What is the difference between a skin abscess and a perianal abscess?
A skin abscess involves the skin or subcutaneous tissue in various locations. A perianal abscess is located near the anus and requires proctological assessment because it may be associated with an anal fistula.
What does incision and drainage of an abscess involve?
The doctor anaesthetises the area, incises the abscess, drains the pus, cleans the cavity and applies a dressing. Sometimes a drain, pus culture, antibiotic and follow-up are needed.
Can an abscess return after drainage?
Yes, especially if the underlying cause has not been removed, for example a pilonidal cyst, fistula, infected sebaceous cyst, chronic inflammation or skin disease. Therefore, after treating the acute abscess, further diagnostics or treatment of the cause is sometimes planned.
Who consults abscesses at Wyspa Medycyny Przyjaznej?
Skin, subcutaneous, wound and breast abscesses are consulted by Piotr Rak, MD, PhD and Iwona Chruścicka, MD, PhD. Perianal and proctological abscesses are consulted by Sara Godyńska, MD, Kamil Smok, MD and Justyna Szul, MD.
Related pages
This section explains the symptom and abscess locations. Details of specific services and procedures should remain on destination pages.
- Surgery
- Proctology
- Proctology consultation
- Perianal abscess – treatment
- Perianal abscess – symptoms and when to see a proctologist urgently
- Lump near the anus
- Anal pain when sitting
- Pilonidal cyst
- Skin lesion removal
- Surgical skin biopsy
- Piotr Rak, MD, PhD
- Iwona Chruścicka, MD, PhD
- Sara Godyńska, MD
- Kamil Smok, MD
- Justyna Szul, MD
Book a consultation — it is not worth waiting out an abscess
If you have a painful, red, growing lump, swelling, pus discharge or fever, consult a doctor. For the anal area, choose a proctologist; for skin, wound, breast or subcutaneous tissue — choose a surgeon.
The information on this page is educational and does not replace a medical consultation. An abscess may require urgent incision and drainage, antibiotic therapy, imaging diagnostics, culture, dressing follow-up or treatment of the disease causing recurrence. Diagnosis, urgency of management and treatment method are decided by the doctor after examination. Medical review is required before publication.