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 bump filled with pus — a thick fluid made up of white blood cells, dead tissue, and germs. Abscesses can develop almost anywhere on the body, including under the skin, in the mouth, or even deep inside the body.

When an abscess forms under the skin, it often appears as a raised, tender lump. 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 due to the buildup of pus inside. Some people also experience fever or chills, which can be a sign the infection is spreading.

Abscesses usually develop when the body is fighting off an infection. As white blood cells rush to the area, inflammation occurs and a pocket forms. This pocket fills with pus as the body tries to wall off the infection.

If left untreated, an abscess can lead to serious complications. The infection can spread to nearby tissues or into the bloodstream, causing a life-threatening condition called sepsis.

You should always seek medical care if you think you have an abscess. Watch for warning signs like swelling, warmth, pain, discoloration, or leaking fluid. If you suddenly feel very sick, or your symptoms are severe, go to the emergency room right away.

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 include:

• Hygiene-related factors, such as infrequent bathing or showering, touching or picking at inflamed skin, or reusing unwashed towels
• Ongoing skin conditions
• 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 or tunnels.

HS isn’t an infection, and it’s not contagious in the way that staph infections are. 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.

Join the Conversation

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.