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Skin Abscess and Pilonidal Abscess

An abscess is a localized collection of pus under the skin. This occurs secondarily to a bacterial infection. Common areas for abscess formation are the armpits, genital areas, buttocks, and the lower extremities. An abscess usually starts as a plugged skin gland, cyst, or a folliculitis infection that progresses.

Puncture wounds or other injuries to the skin, often thought to be trivial at the time of injury, can form painful abscesses several days later.

In the upper portion of the buttock crease, there may be a persistent congenital cyst (pilonidal cyst). Pilonidal cysts are not present in all people, but those who have this normal variation are predisposed to recurrent abscess formation in this area. A definitive surgical procedure (minor) must be performed in order to remove the cyst.

Abscess formation may also occur adjacent to the anus. This is known as a perianal abscess.

Treatment of Abscess

Treatment involves incision and drainage. This procedure involves the use of an injectable local anesthetic with subsequent incision of the abscess, allowing it to drain. Frequently, a packing of gauze is left in its place for 1-2 days. The packing is then removed, allowing the abscess cavity to heal (and close) over the course of several weeks. Soapy tub soaks to this area after the packing is removed can help keep the cavity clean. Antibiotics may be indicated in some cases.