Abscess • How to treat the boil

In the case of an abscess, bacteria penetrate the tissue through the smallest injuries to the skin and trigger inflammation. As a rule, an abscess under the skin is extremely painful, and the affected area swells and turns red. The boil needs space. Therefore, a cavity develops, the so-called abscess cavity, which in turn is surrounded by a capsule. The body forms this capsule as a protective cover and as a demarcation from the surrounding tissue so that the pathogens cannot spread.

An abscess often develops just under the skin, but it can also form on the gums or internal organs such as the intestines. If pus and bacteria get into the blood, in the worst case they can cause blood poisoning (sepsis).

Important! Never tackle an abscess yourself, for example by trying to “squeeze out” it like a pimple. They can do more harm by damaging the capsule and causing the pus with the bacteria to pour into the tissues. Better to see a doctor and have the abscess professionally opened.

At a glance:

Recognize and treat skin diseases

Abscess causes: this is how the boil develops

An abscess can develop anywhere on the body. An infection with bacteria is always the trigger for the boil. Most of them are staphylococci, first and foremost Staphylococcus aureus. These germs are often normal inhabitants of the skin and an integral part of the skin’s flora. The smallest skin injuries, such as those that occur in the genital area when shaving, or an abrasion on the arm that is not adequately cared for, serve as the entry point for the pathogen. The organism reacts to the intruders with an inflammatory reaction – an abscess develops.

Risk factors for abscesses

Doctors know various risk factors that promote the formation of abscesses. These include, for example:

Sometimes an abscess forms out of nowhere with no apparent cause. The accumulation of pus can be harmless and harmless, but it can also be a real health hazard – depending on the size, location and location of the abscess.

Symptoms: This is how you recognize an abscess

Abscesses can only measure a few millimeters and resemble a pimple, but can also take on significantly larger dimensions. An abscess usually develops in the skin. Any part of the body can be affected, such as the face, neck, upper body, arms or legs. The boil can also form in less obvious places, such as the nose, mouth (gums), genital area or anus (anal abscess). Abscesses that develop on and in the organs, for example in the glands, the liver, the bones, in the brain, intestines, in the chest and lungs, are particularly dangerous. Then the risk of blood poisoning (sepsis) is high. The organ can also suffer permanent damage.

Typical abscess symptoms are:

• Skin abscess: The affected skin area is swollen, reddened, feels warm and extremely sensitive to the touch due to the inflammation. The abscess can also be painful without pressing on it. Sometimes the collection of pus can be seen as a white point. Chills, fever, and general malaise may develop as symptoms of the infection spreading.

• Anal abscess: It causes severe pain that makes even normal sitting down impossible.

• Internal abscess: This is more difficult to recognize because it initially runs without symptoms. Only when the abscess is ripe, bursts and the pus pours into the body, do those affected develop a fever, chills and a strong feeling of illness. These are warning signs that the infection is spreading – blood poisoning (sepsis) can occur, which can lead to a failure of all organs. Sepsis is life threatening and must be treated immediately.

Diagnosis: when to see a doctor with an abscess?

Under no circumstances should you work on an abscess with your fingers or sharp objects! Do not squeeze or squeeze the affected area of ​​skin or prick the boil. If the abscess is extremely painful and getting bigger, you should definitely see a doctor.

This also applies in the following cases:

• General feeling of illness, fever and chills: These symptoms indicate that the bacteria have gotten into the bloodstream – there is a risk of blood poisoning.

• Red, painful stripe under the skin that originates from the abscess: This indicates that the pathogens have spread from the tissue to the lymphatic ducts – the ducts become inflamed and lymphangitis occurs, which must be treated in good time.

• Abscesses in the head, neck and ears: the focus of the infection is near the brain. This means that there is a risk of bacteria getting there and causing very dangerous bacterial meningitis.

• Abscesses in the anal area: This region of the body is naturally populated by numerous bacteria. If the abscess is not treated properly, it can spread, become chronic, or lead to fistulas. Small passages form through which bacteria can penetrate further into the tissue and thus into the body. Chronic inflammation develops.

Recognize external abscesses

A doctor can often recognize the abscess based on its appearance: The skin is reddened, swollen and feels warm or hot. Pain on touch or pressure on the skin area is also typical. Symptoms such as chills, fever and a general feeling of illness confirm the abscess diagnosis. In the case of recurring abscesses, acne inversa must be clarified.

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Imaging for internal abscesses

An abscess on internal organs such as the intestines and lungs or on the chest can only be recognized using imaging procedures that bring light into the interior of the body. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI, magnetic resonance imaging) are used to diagnose abscesses. These methods show the exact location and size of the pus collection.

Blood test for inflammation levels

A blood test will show whether the inflammation levels are increased. The so-called C-reactive protein (CRP) is determined. This inflammation marker proves that there is inflammation in the body, but not where it is. An increased number of white blood cells is also an indication of inflammation.

Determine the pathogen with a smear

In addition, a swab of the pus with a cotton swab helps to track down the causative bacterial species. The sample is analyzed in the laboratory and the pathogen is determined. Often staphylococci (mostly Staphylococcus aureus) or streptococci can be detected.

Correct therapy for abscesses

Basically, it is better to see a doctor if you have an abscess. This is especially true if the pus has built up near the brain, such as the face, mouth, or throat. The bacteria can spread to the brain and cause considerable damage there. Abscess treatment depends on how big the boil is and where it is on the body. The general rule is: The pus has to get out!

Pull ointment against minor abscesses

Pull ointments are proven remedies for inflammatory skin diseases and help with smaller abscesses. As the name suggests, the ointment pulls out the inflammation, it accelerates the maturation and emptying of the abscess. Pull ointments relieve the pain and the feeling of pressure, have an antibacterial and anti-inflammatory effect. They slow down the production of sebum and promote blood circulation. The ointments can contain different active ingredients in different dosages. Sulphonated shale oil in the form of the active ingredient ammonium bituminosulphonate (Ichthammolum) is often used. Some pull ointments are available – depending on the dosage – without a prescription in pharmacies or online mail order shops.

The pull ointment ensures that the abscess drains by itself after a while. Then it is best to clean the skin area with a wound disinfectant and cover it with a plaster. Most of the time, everything heals completely in a few days. If the pain remains and the area around the wound is still red or if the wound fills up again, you should (again) see a doctor.

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Surgically remove larger abscesses

Larger abscesses are usually opened with a scalpel. Depending on the size and location, the surgical procedure is carried out under regional or general anesthesia. Often a small incision through the skin is enough, the abscess capsule opens and the pus can drain away through a drain. The drainage ensures that bacteria are not carried over into the neighboring tissue and cause blood poisoning. Then the doctor cleans the wound thoroughly and removes inflamed tissue.

The wound is not sutured, but treated openly. This means that any remaining fluid and bacteria have no chance of encapsulating themselves again and causing another abscess. The wound should be examined, cleaned and bandaged regularly until it has completely healed. A second surgical procedure is sometimes necessary for larger abscesses. Also antibiotics: ingestion, risks and side effects are often used in addition in this case.

Course and chances of recovery from abscesses

An abscess usually heals without any problems. However, you will need a little patience for this, as the healing process can take a few days to weeks. The course depends on where the boil is and the extent of it. Internal abscesses on organs are more dangerous than superficial skin abscesses and usually take longer to resolve. Timely and effective treatment (see above) is also important to get rid of the abscess. Abscess: Help against the boil

Can you prevent an abscess?

You can hardly prevent an abscess. However, the following tips reduce the risk of developing an abscess:

• Treat minor injuries, such as cuts from shaving or scrapes after a fall, adequately. If you disinfect the wound, bacteria have less chance of penetrating through the skin.

• Do not wear clothing that is too tight, which constricts the skin. Constant rubbing and rubbing on the skin also increases the risk of inflammation and abscesses.

• Eat a diet rich in fiber, which protects against constipation, for example. Digestive problems are often a risk factor for anal abscesses.

• In the case of recurring abscesses, you should ask a doctor for advice – they can be an indication of diabetes mellitus.

• If you strengthen your immune system, bacteria and other pathogens will have a harder time. A healthy diet with lots of vitamins and minerals as well as sufficient exercise stimulate the immune system.