I have an abscess on my leg - antibiotics not working - what to do?

[skinissue]

I am at my wits end and would be very grateful for any help or advice.

I have a skin abscess at the top of my inner thigh measuring about 2.5 inches and it is very red, hot, angry, and most of all - painful.

Had this about 8 days and I am on a 7 day course of Flucloxaxillin - 1,000mg (4 tablets per day) so strong dose.

In short, it has not cleared up at all and is still pretty much the same size, redness, and swelling. It is perhaps around 10% less painful, but there is no 'head' or any part of it that looks as though pus will emerge, but a small part of the top of it looks as though it might be starting to yellow slightly and perhaps scab over.

It is so so painful as every time I walk it rubs against my other leg and sitting / standing / turning over in bed / bending / using the loo are all agony.

Questions:

• Do I need an incision and drainage?
• Are these procedures typically successful and what is the approximate recovery period?
• Should I go to my local A&E to get this done? Want to avoid my GP for personal reasons that I don't have the post length to get into right now.

Thank you in advance!

Not a medic but had recurrent issues with abscesses. They nearly always need draining if antibiotics aren’t kicking in. Never let the sun set on pus my doc said. See GP on the morning and get a referral to hospital. Also ask for swabs. Good luck.

My DS had an abscess in the inner thigh. He was given co amoxiclav (I think) for 7days. It cleared it up

I’ve just finished a 4 week course of antibiotics for a groin abscess. It was Flucloxicillin 500 mg.

It calmed down in week one, but it took 4 weeks for it to go fully.

Why haven't you popped it? Antibiotics won't do a thing if the boil is in place - I speak from personal experience.

Because popping it is terrible advice - that is more likely to spread the infection and I will not be able to get all of the tissue / pus out of it without squeezing it out and that can push the pus (infected fluid) down further into the body causing it to spread elsewhere.

Tonight, warm compressed as hot as you can bear & then sudocrem under a dressing, chances are it will either bring it to a head or burst it by morning. You will still need to see a doctor, but at least the pressure should release & make it less painful. If you have any Epsom Salts, make a paste with boiled water, put some on a dressing & cover overnight, it will draw the infection out.

Thank you. Will try this!

“If there’s pus about let it out”
It needs incision and drainage if soft and fluctuating.
Go back to GP.

OP I really don't want to come across as a drama queen but go to A&E, or at least back to the GP. I had a similar abscess and it turned out to be sepsis - I nearly died and was in hospital for two weeks. It was progressive so just got worse and worse until I collapsed and my DH called an ambulance. Apparently if I'd left it another day I'd be dead. My local pharmacy (who btw are generally very good) also prescribed antibiotics when I first went to show them it (mine was on my calf). Not gonna work with something like sepsis!

I'm obviously not saying that's what you've got but it really is worth having it properly checked.

Epsom salts in a hot bath will draw gunk to the surface.

@skinissue @mynameiscalypso Given the locations you’ve both described I would urge you both to look into Hidradenitis Suppurativa if either of your accesses are reoccurring (which I sincerely hope is not the case) if there is even a possibility you have it, be prepared to advocate for yourself as it’s so commonly mistaken for other conditions and diagnosis can take a long time. However if that does turn out to be the case for either of you it’s so helpful to know to then be able to ensure you’re getting the correct treatment that the accesses will actually respond to!

That's an overreaction. If a doctor lances it, he squeezes it, too. It needs to be squeezed regardless. It doesn't make a difference who does the squeezing. You're not doing anything a doctor wouldn't do. As long as you use gloves, antiseptic cream and sterilise the pin, and make sure you get the sac out (pretty easy to grab onto once the pus is gone out, I've done it myself and no reoccurance), it's fine. Most people are able to do this themselves with no issues or complications.

My advice (based on experience) take a hot shower. Get a cloth and use extra hot water (step out of the stream while you do this) then get the hot cloth and tuck it in between your leg and other bits and sort of hold it there. Obviously this shouldn’t be hot enough to burn you but just under that temperature. Cool off the water and take the rest of your shower repeatedly heating up the cloth as much as necessary. Aim for at least 10 min.

Then during the day take a few sitz baths (hot shallow baths) for between 10-20 min each time. One day of this should open it up. Big warning is that it’s most painful right before it opens.

If the bath or shower isn’t practical for whatever reason you can just hang out by the sink for hot water and hot compress it for 10-15 minutes several times during the day.

Long story but I usually get one of these a year and I had a 3 month run where I got 6 and they were all 5x as big. Think Brazil/walnut size (4-5cm).

I thought possibly HS too.

I feel your pain op. I have had a skin absess (back of the neck) only once and probably one of the most painful things I have ever had. Being drained (two big syringe fulls of greenish gunk) alongside antibiotics was the thing that worked.

It is quite a low dose. I’m a nurse and in hospital with patients with cellulitis it’s not uncommon for us to give 2g flucloxacillin a few times a day if infection is moderate

@CatEyeGlasses

I’ll third that. It’s what I have, didn’t know it had a name until this recent issue I’ve had with them.

This was cleanser was recommended to me by a nurse. I’m not sure if it was this that put an end to crop of them I was getting or if it was the topical antibiotic that got ahead of them. I don’t know if it’s available in the UK but in the US it’s called Hibaclense photo of ingredients in case this helps anyone.

Not a low dose - I am on 4,000mg per 24 hours

As someone who has had similar at this stage them antibiotics tend to do nothing. I had the no head thing and have a I&D twice. It’s ok, it’ll go away with support just need to get to A&E x

I don't want to scare you, but whe I had this it was because I had undiagnosed type 2 diabetes. By the time that was discovered, I was in a state of HHS. I had necrotizing fasciitis in the wounds, which needed to be debrided and I was in hospital for twelve days.

Go to A & E. It's better to know.

Pharmacists can prescribe antibiotics these days, so you could try that, it really you need to go to your GP. If there’s a particular doctor you’re avoiding, you can say so. But I think the best course is another round of antibiotics, before resorting to surgical intervention.

Unless you’re a medical professional or have experienced this before your opinion is invalid.

the site is 2.5cm, this is without knowing how deep it is too. Again as some who has experienced this, it needs draining it’s too far gone and the dose of antibiotics is extremely high that they have had. By day 5 it should have done something and it hasn’t. This person needs surgical intervention before it turns into something else.

Wouldn’t recommend castor oil or anything like that, you need to see a professional. I would call NHS 111 - they can book you in to your nearest minor injuries. I had an infection on my foot once, and my GP was pretty useless, but seeing another doctor in minor injuries did the trick as another antibiotic was prescribed. Also with the risk of sepsis, I wouldn’t hesitate. Good luck OP.

Go to A&E, the abscess site doesn't sound suitable for a minor injury to manage. A&E will refer you to the surgeons to perform/arrange I&D

Completely disagree . If it is an abscess it needs incision and drainage not just antibiotics. OP needs to see a surgeon and can access this via ED or her GP.

Swabs of the overlying skin are pointless as all you are testing is the mixed skin Flora. Complete waste of microbiology resources.

I think it’s reasonable to go to ED. ( Cons Surgeon) .

I am wondering though if this could be hydradenitis suppuritiva though??