How To Drain An Abscess

Hey, Preppers,

Abscesses, sometimes known as Boils or Furuncles, are areas where an infection has caused an accumulation of pus. Pus is the debris left over from your body’s attempt to eliminate an infection; it consists of white and red blood cells, live and dead bacteria, and inflammatory fluid.  The most common bacterial culprits are Staphylococcus Aureus and Staphylococcus Pyogenes.  These organisms are thought to occur naturally on the skin of ¼ of the general population.

What Causes Boils?

The tendency to boils may be related to issues with hygiene or a foreign body lodged under the skin, but could just as easily be hereditary in nature.  I know a number of families in which multiple members suffer from this condition.  Other risk factors include Diabetes, chronic skin conditions, weakened immune systems (like those on dialysis), and intravenous drug use.  Those prone to abscesses may benefit by regularly cleansing with Chlorhexidine (Hibiclens) or other antibacterial soaps.

Abscesses may form anywhere that there is an infection.  They can be found in deep organs, such as an inflamed appendix, in the breasts of new mothers, or in areas of diseased gums and teeth.  The most common location, however, is just below the skin, most commonly in the armpits, groin, thighs, buttocks, and face (severe acne).  The average person has many glands and hair follicles that can become blocked and infected.  Although microscopic, these infected glands can give rise to abscesses the size of baseballs.  Once they reach a certain size, significant pain due to pressure and inflammation is likely.  This is especially true around the area of the buttocks.

The body’s immune response has a tendency to wall off infections.  This effort by your immune system to isolate the infection is praiseworthy, but the walls of the abscess make it difficult for antibiotics to penetrate inside and kill the remaining organisms.  In these cases, modern medical care must be accessed to eliminate the problem.  But what if the aftermath of a catastrophe leaves you without this option?  You might have to intervene by performing a procedure we call “Incision and Drainage”.

Boils and Their Treatment in Crisis Medicine

Before you resort to this sort of intervention, make every effort to use non-invasive techniques.  The most successful of these would be the application of moist warm compresses to the abscess.  This should be performed several times a day for at least 20 minutes each time.  Over time, the boil should “ripen” and come to a white or yellow “head”.  With any luck, it will then drain on its own. This can take a week in some circumstances, but the compresses should speed the process considerably.  Don’t forget to wash the area frequently with an antiseptic cleanser, such as Chlorhexidine (Hibiclens).  Some use Witch Hazel for this purpose.

If the abscess fails to blaze a trail to the surface by itself, you have reached the point where you must seek professional medical help.  If this no longer exists, you can still deal with the issue.  You will need:

  • Soap and Water
  • Towels (preferably sterile)
  • Antiseptic
  • Ice
  • A scalpel (#11 blade), needle, or knife blade (sterile)
  • Gauze
  • Gloves
  • Your choice of dressing tape
  • Triple Antibiotic Ointment

First, wash your hands with soap and water and put on your gloves.  Place ice on the head of the abscess and wait a short time for some numbness to occur. Then, apply your antiseptic (Betadine, alcohol, etc) over the area to be incised or “lanced”.  Isolate the area with drapes or towels. If your scalpel or other instrument isn’t sterile, place it under a fire until it turns red.  Let it cool off. Have some gauze ready to catch the pus as it drains; it is filled with bacteria, and you don’t want to spread the infection.  Dispose of the gauze immediately afterward.

Then, using the tip of your scalpel, pierce the skin over head of the abscess, where it is softest (this will hurt). The bigger the opening, the more easily the boil will drain. The pus should drain freely, and your patient will probably experience immediate relief.  Although some question its effectiveness, apply some triple antibiotic ointment to the skin surrounding the incision and cover with a clean bandage.  Clean the site and change the dressing frequently.

Alternative to antibiotic ointments include Lavender Oil, Tea Tree Oil or even raw unprocessed honey. If you have oral antibiotics available, begin a course of Clindamycin (300mg three times a day  x 7 days for adults – available in veterinary equivalents).  Clindamycin is acceptable for those allergic to Penicillin.

Very large boils, once incised and drained, are sometimes kept open so as to allow continuous drainage.  Often, a wick made of thin gauze with dilute Iodine solution  (“Iodoform”) is inserted to kept normal immune response from closing the abscess wall.  This insertion requires some practice, so reserve this technique only for the worst cases.

Dr. Bones

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53 Responses to “How To Drain An Abscess”

  1. William Keyes says:

    great info…

  2. Durak Ironhyde says:

    Is the treatment of a sebaceous cyst the same as dealing with an abscess? 

    • Dr. Bones says:

       Hi Durak,

      Yes, especially if the cyst becomes infected.  If not, the urgency in dealing with it is less and depends more on the level of discomfort experienced.

      Dr. Bones

      • ncbill says:

        I have a SC on my back for years.

        It has only become infected a couple of times – had it drained, dermatologist injected something to try and break down the internal ‘walls’.

        Deep enough he didn’t want to try and excise it to avoid damage to the surrounding tissue.

        • Dr. Bones says:

          Hi ncbill,

          If a sebaceous cyst is not infected and not huge, most doctors will take a wait and see attitude towards it, unless it is disfiguring.

          Dr. Bones

  3. Kris says:

    Crushed Garlic works well for skin infections also, I have had MRSA abscesses multiple times and am now able to treat them if I get to it early enough by just putting a crushed garlic clove on and open abscess.

    • Dr. Bones says:

       Hi Kris,

      Assuming that you thoroughly cleaned the clove of garlic beforehand, you’re absolutely right.   Garlic has proven antibacterial properties.

      Dr. Bones

  4. David Decker says:

    This is awesome stuff!! I have been dealing with these for a long time. About a year after my wife and I got married she started getting them and our oldest daughter has had a couple. I always just let them run their course and deal with the pain. But sometimes has lasted over a month and my wife doesn’t have that kind of tolerance. She went to the ER and had hers lanced and this is exactly what they did (i volunteered to do it but she wouldn’t let me). The only thing I found to really work good on them is a drawout salve. What are your thoughts on this? Its not the quickest but has worked for me.

    • Setanta54 says:

      i was going to post about salves and even crushed garlic/lemon as that draws things out as well–i wouldn’t play with them by lancing either–they will open and drain with a little coaxing and those prone to them should really investigate their diet and see if eliminating the usual suspects,drinking more water clears things up-

    • Dr. Bones says:

       Hi David,

      Always start with the least invasive method.  I would use the salve with warm moist compresses and see what happens…

      Dr. Bones

  5. ABrady says:

    Very nice! I just wanted to add that I learned you can go with the “wick” procedure with honey on it as well!

    • Dr. Bones says:

       Hi Brady,

      Honey has known antibacterial properties, make sure you go with raw unprocessed if you do this.

      Dr. Bones

  6. tony says:

    LOL followed link from Quayles site thought the story was about Congress or a higher office.

  7. Janet Arrigo says:

    Kudos Dr. Bones:

    Your advice is helping more people than you could possibly know.

    Be aware and be prepared!

    Right on Dr. Bones – WRITE ON!

    Respectfully,  Yoda@magnifiedview.com
    @magnifiedview:disqus 
    http://www.magnifiedview.com/2010/09/17/yodas-little-known-tactics-to-avoid-being-a-target/

    • Dr. Bones says:

       Thanks Janet!

      Yoda’s magnifiedview.com is a blog with lots of good info for preppers, check it out!

      Dr. Bones

      • Janet Arrigo says:

        Noble Healer good Doctor Bones:

        We intuit that a YouTube and EBook is in your future.

        Right on Dr. Bones – WRITE ON!

        Cordially, Jarrigo@magnifiedview.com

      • joseph pedra says:

        Hey i have had about 20 of them 4 on my neck 1 on my armpit 1on my knee one on my leg one on my finger one on my ass three on my inner thigh two on my right arm two on my left arm it got in my bicep and this time they told me since i have a medal plate in my neck wit two screws and a bone fusion they said bacteria might be going to my plate and hiding there then it just spreads and i get a boil abscess please reply also never had these until after my plate was put in about 4 years after

        • joseph pedra says:

          Also they had to surgicaly open it up and stuck her two fingers up in my arm i got lanced two days before this the dr said he got it all used a qtip with honey i believe and when he sent me home instantly my muscle was throbbing moving pulsating lanced it on the bend of elbow arm muscle swelled up after 2 days went back cuz wick removal so much puss drained out my arm and it smelled so horrid never smelt anything like it so they made me wait 2 days i have 14 inch biceps and they measured my left bicep it was 22 inches i had to be put under and cut open a 4 inch line from the first lance and stitched up put 12 feet of wick in my arm my muscle is still sore dont have full use of my arm most painfull thing ever worse then shattering my neck they had me on 2hour shot of dilated plus three perk 5s no tylenol and fetynol for sleep but i didnt sleep for 5 days cuz pain was so bad they said i got lucky they almost had to remove my muscle

  8. Dietoyesterday says:

    Another wonderful means of “ripening” the boil is very thin slices of raw potato. Slice a cleaned potato into very thin slices (I even grate it sometimes), layer on top of the abscess then cover with plastic. It works magic. Also great for blocked milk ducts of breastfeeding women :) Draws everything right out.

    • Dr. Bones says:

       Hi Diet,

      yes, it’s like a moist compress…

      Dr. Bones

      • joseph pedra says:

        Would like your info on my post been two several drs but cant tell me why it happens they say just bacteria it can happen to anyone i shower everyday twice. a day i use dial anti bacterial shower gel im very clean until my last visit they said could be the plate and screws in my neck infection may not go all away and sits in my neck till i get a wound or it just spreads through my blood any idea please help me asap ty

        • Dr Bones says:

          It sounds as if you have a condition called “Suppurative Hydradenitis” where people get multiple abscesses, mostly in armpits, groin, and other “crease” areas. It’s possible that your plate is acting like a foreign object in your body; these can always be a source for infection. I’m very sorry that you have to deal with this condition, it must be terrible.

          Make sure that your doctor has placed you on every possible antibiotic that could treat this, even the IV ones. Many people go through active phases and then quiet phases with this, and I hope that your condition becomes less active over time.

          all the best,

          Dr. Bones

  9. Glassman says:

    Another topical antibacterial/antiviral ‘ointment’ is unprocessed coconut oil.  

  10. Technicalsoldier says:

    Hi

    Hi Doctor

     

    I want to add my recent experience.

    7-01-2012 Sebaceous Cysts on neck infected while cutting firewood,
    etc. (dirty hands?)

    7-05-2012 Go to VA doctor. 
    He gives me two types of antibiotics for cellulitis (infection)

    7-06-2012 Go to traditional Chinese medicine doctor; no
    relief, things getting worse

    7-07-2012 Go to urgent care doctor, now have abscess, massive
    infection setting, cut and drain

    7-08-2012 Go back to urgent care, infection still there, but
    little change

    7-09-2012 Go to hospital ER, still infected, they lance and
    put in wicks

    7-10-2012 Go to hospital ER as directed again, still
    infected, they change bandage and wicks        

    7-11-2012 Told to come back today for exam, may be admitted
    to hospital this time.

     

    As you can see things are getting out of hand in a
    hurry.  Looks like I might need to have
    this operated on in a big way now; no half steps this time around.  I never thought this would get this bad.  I’m still on the antibiotics and now pain
    pills because they are cutting deeper and deeper into my neck over the previous
    cuts.  This hurts to say the least as
    they have to press out the infection again and again.  Thanks for the information.  I wish I had your information before all this
    happened.

     

    Technical Soldier

     

    • Dr. Bones says:

       Hi Tech,

      I have emailed you privately to discuss your situation further.  I’m truly sorry for what you’re going through.

      Dr. Bones

  11. Lindasemler says:

    I suffered from boils for a few years and the most effective treatment I found was the use of SLIPPERY ELM.  It was contained in Throat Coat Tea by Heavenly Celestials.  Slippery Elm draws out the boil and opens it up, no lancing needed.  I would place the wet, warm tea bag on the boil and within twenty minutes it would open and drain.
    Thank you for your web site.

  12. Mlair11 says:

    Awesome information.  Thank you.  There is another way to lance a boil that I’d like to share.  Make a paste of castor oil and baking soda.  Apply it liberally to the boil and cover it with a bandaid.  It will ‘lance’ it and drain it.  Repeat the process everyday until it has drained.  I’ve done it myself and it works really well. 

  13. Kingjamesbbq says:

    Hi 
     I love your site and all of the great information you have.

    I was wondering about the hot cup method. You lance the boil and then place a warm cup over the boil and as the cup cools it draws out the puss. I have seen this done several times with no ill effects.

    Will this work in a shtf scenario?

    • Dr Bones says:

      The suction effect of the warm cup will help draw out the pus and would be an acceptable method if the pus does not drain naturally.
      There is a chance of burning the skin if the rim of the cup is too hot, however, and you may occasionally see a bruise from the suction.
      Thanks for the kind words and support!

      all the best, Dr. Bones

  14. […] an antibiotic ointment all over the world. It was used long before we had all this chemical crap. How To Drain An Abscess | Doom and Bloom (TM) and read this here on honey Honey as an Antibiotic Ointment: Sweet Treatment for […]

  15. Soni says:

    Hi Doc

    I have an abscess on my face.
    Monday was 1cm x 1cm
    A&E doctor have me antibiotics pencillin
    I am taking for 7 days.
    Wednesday I saw my GP
    From reading on the Internet this antibiotics doesn’t work that well.
    I am worried they will have to cut open my face.
    I also have pilonidal sinus and have to have operation. This is continually leaking and am tired of putting ban adage on this as every time I shower becomes wet so I don’t bother no more.

    Warm moist compress method
    How do I do ? Just use a flannel dipped in hot / warm water
    Do I have to wash the flannel each compress ?
    Please I urgently need your advice
    Thanks very much
    Soni

    • Dr Bones says:

      Hi Soni,

      Make sure you wash out the flannel each time, it would even be better to use something like gauze that you can dispose of each time. Have you doctor take a “culture” of the drainage and send it to the lab, as it will identify the bacteria and the specific antibiotics that will kill it. These issues plague many people and are real trouble if they are allowed to fester.

      all the best,

      Joe Alton, M.D., aka Dr. Bones

  16. Jaime says:

    I have an abscess that is right below eyebrow but above my eyelid. I went to a clinic n they prescribed me clindamycin 300mg and doxycycline 100 mg then referred me to a eye surgeon because it was so close to my eye. This was on a Thursday saw eye dr day after a Friday he said to take antibiotic for a few days n on Tuesday was in so much pain in my eye I went back n he scheduled the procedure at a hospital for Thursday a week after starting antibiotics. It slowly began to drain and I’m keeping clean antibacterial soap n hibiclens n it’s going down only dark blood drains should I cancel the procedure or go for proper packing as it was grape size at its peak? I am still talking antibiotics for three more days.

    • Dr Bones says:

      Hi Jaime,

      If an office procedure is planned, finish the antibiotics and have the doctor examine you before the procedure. Oftentimes, enough progress towards healing is accomplished to avoid the procedure.

      Best of luck,

      Dr. Bones

  17. Julie Ann says:

    For sebaceous cysts instead of lancing it try using a heating pad or hot water in a bottle… It will bring it to a head and then start to drain… May take a couple of times

    • Dr Bones says:

      Yes, this should be the first course of action before lancing a cyst. If it doesn’t work, then incision and drainage may be appropriate.

      all the best,

      Dr. Bones

    • Cherie Duncan says:

      Julie ann , so does this really work??

  18. Beatris says:

    Hi doctor,

    I got an absses on my butt cheek, I have had 2 surgerys done already and I still have some drainage after 1 month from my last surgery.. This has been a nightmare what can I do to dry it out. I don’t think I need a 3rd surgery I’m frustrated I need help…

    • Dr Bones says:

      Hi Beatris,

      Antibiotics and incision/drainage are standard treatments for your condition. If they have failed, more extensive surgery may be able to remove the abscess in its entirety. Discuss this option with your physician, as there are pros and cons to the procedure.

      Thanks,

      Joe Alton, M.D., aka Dr. Bones

  19. Steve says:

    Hey dr bones i have an abscess on my left butt cheek. it was extremely painful and was burning. it was starting to fause low grade fevers so i went to see a dr. about it and she said that they wouldn’t b able to lance and drain it due to it not being soft in the center of it. 24 hrs after this it opened on its own and started the draining process on its own. I’m pretty sure i was bit by a spider because after it opened up there are 2 little openings that are right next to each other. they have puss emitting from both holes followed by blood but then after squeezing it and i see blood i see the puss coming out on its own again. now I’m guessing that sqeezing it is why it looks bruised. So my question to you is this…should i keep proceeding to squeeze out the infection or just let it drain on its own? Also since its a open wound i applied triple antibiotic ointment to the site and put a bandage over it. is it ok to use the antibiotic ointment? also whatvelse do you reccomend that’ll clear up the infection faster and heal it? Anything but going to the dr or the er because i had one 2 years ago and the lanced and squeezed it so all they would most likely do is prescribe me antibiotics since its draining naturally. i have great relief and less swelling as well b4 opening it was extremely painful and if i accidentally touched it id wince in painvright away. its not that big either its only about the size of a quarter. if you can give me any info or suggestions id greatly appreciate it…thank you i look forward to hearing from you soon.

    • Dr Bones says:

      Hi Steve,

      If the abscess is open, I wouldn’t squeeze it much but I would apply warm moist compresses to let the fluid “run”. Sitting in a warm bath is good, as well. Wash the area with antibacterial soap frequently and use the antibiotic ointment. It should go away over time as long as it remains open. Here are reasons to return to the ER:

      You start running a fever.
      You have swollen lymph nodes.
      The skin around the boil turns red and is spreading.
      The pain becomes severe.
      The boil does not drain.
      A second boil appears.

      Get better soon!

      Joe Alton, M.D.

      • Mindy says:

        Hi, I’m kind of in the same situation, I went to urgent care 6 days ago, he squeezed the life out of them, their on my shins, he prescribed my antibiotics, and told me to keep them covered with gauze! So I’ve done that and it’s still draining with the two holes as above stated like spider bite, but the skin all around the area is white where the larger part of the abcess was! Is this normal? Or should I be concerned at all!? And how long will the draining last? He did not pack it.

        • Dr Bones says:

          Hi Mindy,

          hmm, I’d know more if I could see it but if it’s really white, there may be some tissue that isn’t getting circulation due to pressure from below or lack of circulation. I would have your doctor look at it, sometimes this tissue is no longer viable and needs to be excised, a procedure known as “debridement”, usually a minor procedure in a case like this.

          get better soon,

          Joe Alton, M.D., aka Dr. Bones

          • Mindy says:

            Thank you, that’s exactly what they did, they left it open so it will continue to drain and they want to see me daily! Hopefully it gets better soon, I’m tired of lookin like a walker from the walking dead! Lol good thing it’s on my leg and I can hide it! ;)

  20. allzz says:

    I am Juvenile diabetic type 1, I have an abcess on my knee. Which I played and broke it up but nothing came out of it. After two days it became double in size and next day it starts oozing out. The pus doesn’t come out but its just yellow water that was coming out I applied a bandage and took antibiotics that doctor gave me, which was ampicillin /cloxacillin 250 mg. It drained out but there is still yellowish stuff thats in between and blood oozes out wen I try to squeeze out leftover yellow pus from it. It pains when I walk or stretch my leg. Please help.

    • Dr Bones says:

      Hi Alizz,

      I think you might be handling it too much and may have gotten re-infected. Have your physician check it out, as you might need another course of antibiotics.

      Joe Alton, M.D., aka Dr. Bones

  21. Lisa says:

    This is an awesome article. I’ve had a few abscesses/boils myself and the info on this page has helped. I just shared the main link on FB. Thanks so much for posting this!

  22. Valerie says:

    A huge cyst appeared on my back 2 days ago, never had one in my life (42). A Dermatologist sliced it open with scalpel, squeezed stuff out, collected samples for culture, and put a bandaid on it. I have prescription cream and antibiotics prescribed, but I feel this wasn’t handled well and he gave me no instructions. This guys highest rating online is 2 stars, and was closed briefly for negligent/fraudulent behavior (so I find out now). I have no idea whether to keep it bandaged, or anything for that matter. He first diagnosed it as a aborted shingle, I had to tell him that NO, I’ve had shingles, this isn’t a shingle. Shouldn’t a Dermatologist know more about these things than I do? Due to his lack of hygiene in the office and lack of info given by him to me, I fear this infection may return if I’m not treating it correctly. I plan to have it all removed to deter recurrence later after I find another Dermatologist to handle it.

    • Dr Bones says:

      Gee, Valerie, that’s awful, I’m so sorry. Keep a close eye on the cyst for continued drainage and spreading redness and, for goodness’ sake, find another doctor.

      all the best,

      Joe Alton, M.D.

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