Causes of an abscess in the groin
Abscesses are caused by bacteria. Staphylococci usually enter the body via the skin barrier and are then attacked by immune cells. If the bacterial load is too high, the body forms a protective cavity around the intruders to prevent further spread.
During the process of decomposition, pus develops, which then increasingly fills the cavity and forms a swollen abscess cavity. Staphylococci that are on the skin are also always deposited on hair cells. This often represents the point of entry.
For example, if hair grows into the skin, the bacteria cause inflammation and thus penetrate the body. Untreated wounds can also be an entry point through which bacteria can enter the body and form an abscess if the immune system is weak. Such wounds can also be caused by constant friction, e.g. by clothing that is too tight or overhanging skin folds in cases of severe overweight.
Symptoms and diagnosis
Smaller abscesses usually regress by themselves once the body has killed the invading bacteria. Complications are very rare with a normal immune system. In complicated cases, the body can also react to a developing abscess with general symptoms.
This is a duct formed by an abscess that reaches into the depths of the body and through which the bacteria can enter the inside of the body and cause further damage. Fistula tract formation usually requires surgical treatment, as the body and the immune system are no longer able to counteract the germs. An abscess under treatment can last up to 2-3 weeks, after surgical treatment the symptoms will soon improve after removal.
The diagnosis is usually made by the doctor’s eye. In case of doubt, the abscess can be determined by an ultrasound examination. If the abscess is opened to drain the pus, a smear is usually taken to determine the bacteria and their response to antibiotics.
Treatment of the abscess in the groin
Smaller abscesses do not need to be treated and regress within a few days. In the case of larger or long-lasting abscesses, which may also be reddish and painful, a medicinal or surgical measure should be taken to ensure rapid healing. Medication would first be applied to the swollen area with a pulling ointment (only for non-inflamed abscesses and without general symptoms).
In the case of inflamed abscesses, an antibiotic would be used to treat even smaller abscesses. In this case preparations like amoxicillin for 5-10 days or cefuroxime for 7 days would be used. In the case of larger abscesses with a large pus cavity, surgical splitting should be performed, possibly in combination with antibiotic treatment.
In this context it is important to check the vaccination status. Here, special attention should be paid to the presence of tetanus. If there is no tetanus, the vaccination should be refreshed, as these tetanus bacteria can enter the wound via dirt and soil.
In principle, abscess treatment can be carried out by a general practitioner (family doctor). He treats the abscess area with medication and also carries out incision treatment. Larger splits and surgical clearing are usually carried out by the general surgeon.
This tar-based paste (e.g. Ichtholan®), which has been developed on the basis of tar, will, with regular use, pull the pus out of the abscess cavity, which will soon lead to a swelling of the abscess height. It is important that this measure is not used in the case of inflamed abscesses or very painful abscesses or abscesses with accompanying symptoms such as fever, chills and deterioration of the general condition. You can find more information here: Pulling OintmentFor larger abscesses, surgical treatment should be performed.
Surgical treatment may merely involve piercing the abscess cavity from the outside and catching the emerging pus, but may also involve a major surgical removal of the abscess. In order to avoid the danger of a replica, it may become necessary, especially in the case of larger abscess cavities, to hollow out the pus including the abscess cavity with a scalpel. Sometimes a local anaesthetic is sufficient.
In the case of large abscesses, but especially if a fistula duct is present, sometimes a general anaesthetic is necessary. The operation is always accompanied by antibiotic medication in order to avoid corresponding inflammation after the operation. Before a major operation to remove an abscess is performed, ultrasound is used to find out the exact extent of the abscess cavity. It can also be shown here whether there is also a deep spread of the abscess due to a fistula tract. If visibility is poor, it may also be necessary to perform a CT of the groin area.