Pus under the skin

definition

Purulent inflammation of the skin will also appear Pyoderma and are usually caused by pus bacteria such as streptococci and staphylococci. Pus is a yellowish secretion that consists of melted tissue and inflammatory cells and is indicative of a bacterial infection. Pus under the skin usually shows up as a painful, yellowish accumulation of secretion surrounded by reddened and irritated skin, which can lead to abscesses. The causes and accompanying clinical pictures are diverse.

Causes of the development of pus

The causes of accumulations of pus under the skin are usually infections with pus bacteria such as staphylococci and streptococci.

Impetigo contagiosa is a disease that is often caused by staphylococci and that mostly affects the skin of small children in the area between the chin and nose. This results in itchy, flaccid blisters with honey-yellow crusts that are highly contagious.

As a skin appendage, an infection of the hair follicle can also lead to small accumulations of pus under the skin, which, depending on the severity, are referred to as boils or carbuncles. These appear as small or larger, melting “pimples” on reddened skin (boils), usually with a hair in the center. The cause can be a weak immune system, e.g. be through diabetes mellitus.
Also read: boil

On the finger or toe, pus appears under the skin in the form of a nail ulcer (circulation, panaritium). This is a painful infection of the nail bed with an accumulation of pus, which is usually caused by the penetration of bacteria through the smallest injuries, such as with a manicure.

If deeper layers of the skin and the underlying connective tissue are affected, it is called phlegmon. This usually manifests itself as a blurred, extensive and painful reddening of the skin, which can be accompanied by fever and a feeling of illness. Immediate antibiotic and possibly surgical treatment is essential. If pus forms as a result of inflammatory tissue melting, which is subsequently surrounded by a capsule, it is called an abscess.

Read more on the subject at: Pus in / on the finger - you should pay attention to this!

The pimple

The "pimple" is a slang term for the dermatological term pustule. A pustule is a localized collection of pus under the skin, most often due to a bacterial infection. Pustules can occur in the context of a wide variety of skin diseases, but the best known is the association with acne.

In acne, various causes such as hormonal and genetic factors lead to excessive cornification of the hair follicle. This leads to a backlog of sebum and the formation of blackheads. If these blackheads become inflamed and there is excessive colonization with acne bacteria (Propionibacterium acnes), "pus pimples" (pustules) occur. They can spread anywhere on the body, including the nose, back or mouth, and pus pimples on the stomach are also not uncommon.

diagnosis

The doctor usually makes the diagnosis of pus under the skin as a visual diagnosis. The typical signs of inflammation such as redness, pain, overheating and swelling help him here. In some cases, a smear is necessary in order to precisely classify the causative bacterium and to test which antibiotic can be used (resistance testing). In rare cases, such as an abscess, it may expand under the skin and spread to other structures using ultrasound or other imaging techniques (CT, MRI).

Concomitant symptoms

If there is an accumulation of pus under the skin, the surrounding skin is often red and swollen. Often there is severe pain due to the tension from the swelling and inflammation. Swelling of lymph nodes in the drainage area of ​​the inflammation can also occur. If general symptoms such as fever, chills, fatigue or a feeling of sickness occur, this is a sign that the inflammation has systemically spread to the whole body. In this case, a doctor should definitely be consulted as there is a risk of blood poisoning. Further symptoms can occur depending on the underlying disease. The pustules and vesicles of impetigo contagiosa can be accompanied by severe itching, whereas other skin changes such as blackheads (comedones) occur in acne.

Therapy of pus under the skin

The treatment of an accumulation of pus under the skin depends on the respective clinical picture.

Pimples in the sense of acne should be treated by the dermatologist with disinfectant and antibiotic creams and, if necessary, tablets.

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Impetigo contagiosa is treated with antibacterial ointments and antibiotics in tablet form, and because of the high risk of infection, strict hygiene such as regular hand washing should be observed. Boils and carbuncles are usually treated with antibiotics.

Inflammation of the nail bed, abscesses and deeper inflammations such as phlegmon also usually have to be repaired surgically by puncturing with a needle, an incision (cut) or a more complex procedure. Independent manipulation (expressions or similar) by the patient himself must be avoided (see below). The above-mentioned measures should be carried out promptly, as in the worst case the pathogen could spread via the bloodstream (blood poisoning).

For more detailed information on this topic, see: Pus pimples on the face - how do I get rid of them quickly?

Should one squeeze pus under the skin or prick it?

Accumulations of pus under the skin should never be squeezed out or pricked independently, regardless of whether it is a simple "pimple" or an abscess. Non-sterile manipulation of the inflamed area of ​​the skin can lead to more bacteria getting into the skin and making the inflammation worse.In addition, the bacteria can be carried over via the bloodstream. This is particularly threatening in the case of boils in the facial area, when they are expressed the bacteria can be conducted via blood vessels towards the brain and there can trigger a threatening sinus vein thrombosis (blood clots in the veins of the brain). Lastly, ugly scars can arise from pressing. If it is necessary to puncture an accumulation of pus (e.g. abscess) or to relieve it with a prick, this should always be carried out by a doctor under sterile conditions.

Home remedies for pus under the skin

In the case of harmless, slightly pronounced accumulations of pus under the skin, such as incipient inflammation of the nail bed or acne pimples, treatment with home remedies can be tried first. In the case of pronounced symptoms, abscess formation, phlegmon or impetigo contagiosa, home remedies are in no case sufficient, as serious complications such as blood poisoning threaten. For example, envelopes soaked with disinfectant can be tried as anti-inflammatory measures. Healing clay, chamomile or arnica are also natural measures against inflammation of the skin. Cooling compresses can relieve pain. In general, the inflamed area of ​​the skin should not be manipulated, "squeezing out" or piercing must be avoided.

You can find more information on this subject here: Home remedies for acne

Complication abscess

An abscess is a collection of pus surrounded by a capsule, which is caused by the melting of inflamed tissue. An abscess of the skin can arise as a complication of various inflammations of the skin (boils, carbuncles) or as a result of operations and injections. In most cases the pathogen is the bacterium Staphylococcus aureus. Clinically, an abscess is reddening and painful swelling, which can be accompanied by fever and chills. Increased inflammation values ​​can be demonstrated in the laboratory. An abscess must always be treated with antibiotics and usually also relieved by a puncture or surgical removal. An abscess heals spontaneously only slowly or not at all because the bacteria are surrounded by a capsule. There is a risk of further complications such as blood poisoning, so that immediate medical treatment is indicated.

Duration

The duration of a pus accumulation under the skin depends largely on the cause, severity and treatment. While individual, harmless pustules (pimples) heal spontaneously in the course of a few days even without treatment, the situation is significantly different with more threatening clinical pictures. An abscess or a phlegmon heals only very slowly or not at all without adequate antibiotic therapy and surgical relief. Even with larger boils, carbuncles or inflammation of the nail walls, antibiotic therapy should be carried out, otherwise in the worst case there is a risk of life-threatening blood poisoning.