Skin abscesses can be painful — and sometimes a little scary. When they keep coming back in the same spot or show up in different areas of the body, it may be a sign that something more is going on. A healthcare provider can help figure out what’s causing the abscesses and recommend the best treatment. Getting the right care can also help reduce the chances of future abscesses.

Here’s what you need to know about the causes of an abscess. You and your doctor can work to figure out which cause applies to you.

What’s an Abscess?

An abscess is a painful, swollen pocket of pus. You can get an abscess almost anywhere on your body — including inside your mouth or even deeper in your body. Abscesses are fairly common under the skin. In these cases, they may appear as raised, swollen bumps that are tender or painful to the touch. The area may feel warm and change color — turning red, purple, or brown depending on your skin tone. The center of the bump might look white or yellow because of the pus inside. You may also have a fever or chills with abscesses.

Abscesses usually form because of an infection. When your body sends white blood cells to fight the infection, the area becomes inflamed, which can make a pocket form. The pocket fills up with white blood cells, dead tissue, cells from the infection you’re fighting, and fluid. This is called pus.

If left untreated, abscesses can lead to serious complications. An infection can spread to nearby areas or even into the bloodstream, leading to a life-threatening condition called sepsis.

It’s important to get medical care if you think you have an abscess. Watch for signs like fever, swelling, pain, warmth, or skin discoloration. If you notice fluid leaking from your skin and don’t know why — or if you’re feeling very sick, very quickly — seek medical care right away. Go to the emergency room if your symptoms are severe.

Infections

Skin abscesses are usually caused by bacteria, most often a type called Staphylococcus aureus (or staph). This is the same germ that causes many other common skin infections.

Some strains of staph have become resistant to certain antibiotics. This means that stronger or different antibiotics may be needed to treat them. These antibiotic-resistant strains are known as methicillin-resistant Staphylococcus aureus (MRSA) — named after an older antibiotic that’s no longer widely used. Even though methicillin isn’t commonly prescribed anymore, the term MRSA is still the standard name for this type of staph infection.

Bacteria usually enter your skin through an opening, such as a small cut, scrape, or insect bite. Sometimes, they can get in through a hair follicle. In some cases, an abscess forms after you've had a staph infection in another part of your body — the bacteria may spread through the skin or bloodstream. But often, doctors can’t find a clear way the bacteria got in.

People often ask, “Are abscesses contagious?” It’s a good question. Like many infections, the bacteria that cause abscesses can spread to others. This may lead to abscesses in someone else, or it could cause other health problems depending on where the infection starts. Because of this, abscesses are more common in crowded living conditions.

Other risk factors that may increase the chance of these infections are challenges with hygiene, ongoing skin conditions, and smoking. Skin-to-skin contact and sharing of personal items with someone who has a staph infection can also raise your risk.

You may be able to get fewer abscesses by washing your hands regularly and not sharing items that touch your skin, like razors, towels, or washcloths.

Many people ask, “How can I stop abscesses from coming back?” The best step is to talk with a doctor. If you’re getting abscesses because of a bacterial infection, they may recommend washing regularly with antibacterial soap, taking oral antibiotics, or using an ointment in your nose to kill bacteria. Doctors sometimes suggest this because the bacteria that cause abscesses often live in the nose.

Boils

Skin abscesses often start as boils. It can sometimes be hard to distinguish a boil from an abscess. Boils are usually closer to the surface of your skin and may be smaller than abscesses. They develop when part of your skin close to the surface, like a hair follicle, gets infected. Most of the time, boils are also caused by staph infections. If you have a lot of boils in the same area that join together, it’s called a carbuncle.

Folliculitis

Folliculitis happens when a hair follicle gets infected, so it’s considered a type of boil. It often begins as a small infection, showing up as skin discoloration or a tiny pus-filled bump at the base of a hair. In some cases, several hairs in one area can be affected.

Folliculitis can be caused by staph infections. Sometimes, though, people get folliculitis after being in hot tubs. These infections are usually caused by a bacterium called Pseudomonas aeruginosa.

If you think you have folliculitis and it’s not clearing up on its own, talk to a doctor. They may give you oral or topical antibiotics. If you have severe folliculitis or it keeps coming back, your doctor may take a skin sample. They can send the sample to the lab to find out what bacteria are causing the problem, so they can give you an antibiotic that will help.

Hidradenitis Suppurativa

Recurring abscesses could also be caused by an ongoing condition called hidradenitis suppurativa (HS). If you’re diagnosed with HS, it means your immune system and hair follicles are overreacting, which causes inflammation. That inflammation can lead to lesions that may turn into abscesses. You may also feel hard bumps, like cysts or nodules, under your skin. Eventually, your body may form connections between the abscesses and the surface of your skin, called sinus tracts.

HS isn’t an infection, and it’s not contagious like staph infections. It’s also not connected to poor hygiene. HS can be misdiagnosed because many of the symptoms look similar to folliculitis and boils caused by infections.

HS needs medical care. There are treatments that can help control the symptoms and help avoid serious complications.

Talk to a Dermatologist

Dermatologists are doctors who specialize in helping people with skin problems. They usually work with recurrent skin infections, like abscesses, and with HS, too. They’re your experts on how to prevent abscesses and can answer questions like, “What does it mean if an abscess keeps coming back?” They’ll know how to root out the cause of your recurring skin abscesses. Then, they’ll be able to get you the treatment you need to feel better as soon as possible.

Talk With Others Who Understand

On myHSteam, people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.

Do you have abscesses that go away and come back? What treatments work for you? Let others know in the comments below.