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Abscess

What is an abscess?

An abscess is a collection of pus in an encapsulated and newly formed cavity, which can form on or under the skin or the various layers of skin. It is usually triggered by bacteria. Many types of bacteria belong to the normal skin flora, but as soon as they penetrate into deeper skin layers without being able to escape, for example through a blocked pore or if they have penetrated into organs, such a collection of pus can develop. The body’s immune system then becomes active and an inflammatory reaction is triggered.

To prevent the infection from spreading, immune cells encapsulate the affected tissue from surrounding healthy cells. This produces pus inside the cavity, which consists of defence cells, dead cells and remnants of bacteria. Very rarely, these pus-filled cavities also occur without bacteria. They develop after major operations, for example, but sometimes without any known cause.

What causes it?

Mostly abscesses develop after inflammations and injuries of the skin, e.g. by sharp objects as well as shaving or in rare cases also by contaminated hypodermic needles. In these cases, germs enter the body. A collection of pus in or on the skin can also develop from a boil. This is an accumulation of fluid in a closed tissue cavity. The cause is often the fight against infections. After it is discovered, an abscess should be treated as soon as possible to prevent the infection from spreading further.

What triggers it?

The pus-filled cavities occur when the germs penetrate deeper into the skin and there is no drainage to the outside. This is the case, for example, when a pore is blocked by sebum or when a wound is contaminated and has been tightly closed. More rarely, these pus-filled cavities also occur without bacteria.

What are the symptoms?

When an abscess forms on the skin or subcutis, it is often visible to the naked eye. The affected area is visibly or palpably swollen and is accompanied by the typical signs of inflammation: redness, overheating and pain. If it occurs inside the body and cannot be recognised at first glance, pain and fever are often the only signs.

Which body parts are affected?

They can develop anywhere on and in the body. Most often they form on the skin, as this is the area that most often comes into contact with bacteria. However, it can also form inside the body such as in the brain, liver, or jaw. One speaks of a boil as soon as an abscess appears in the area of the hair root.

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How is it treated?

An abscess on the skin should be examined by a dermatologist. However, not every abscess that forms on the skin is dangerous. This depends on the size, the affected area of skin and any symptoms. In some cases, a doctor should be consulted immediately if symptoms appear on the face. Then there is a risk that the pathogens could reach the brain. If additional symptoms such as fever or chills appear, a doctor should also be consulted as soon as possible. This can be an indication of blood poisoning (sepsis).

The dermatologist is not the right contact person for all types of sepsis. For example, if you have a jaw abscess, you should see a dentist.

Treatment varies depending on the size, stage and location of the skin disease.

Treatment on the skin is more uniform. When the cavity is completely filled with pus, it is usually cut open under local anaesthetic to drain it. The wound can then heal.

If it is a very small abscess, surgical treatment may not be necessary because it can open on its own after a while and the fluid (pus) can drain out. So-called traction ointments speed up this process. However, they should only be used in consultation with a doctor.

Antibiotics can be used as a supportive treatment if the bacterial infection has not yet stopped. The choice of the appropriate antibiotic depends on the bacterium causing the infection and is made by the doctor treating the patient.

The treatment of internal pus accumulations is much more complex than the treatment on the skin and may require surgery in addition to intravenous antibiotics.

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