When should one consult which doctor? | Facial abscess

When should one consult which doctor?

An external abscess in the facial area can easily be detected. It is a very pressure sensitive, tense, reddened and overheated skin area. In most cases, a hard and slightly raised area in the middle of the abscess is noticeable.

Sometimes you can also feel the capsule that forms around the pus accumulation. If the inflammation spreads to the draining lymph channels in the facial area, there may also be swelling of the lymph nodes along the lower jaw or neck. If other symptoms such as fatigue, fever or chills occur, a doctor should be consulted urgently, as this is a sign that the body’s own immune system is not able to fight the invading pathogens on its own.

In this case, there is a risk that the pathogens will continue to spread through the bloodstream and can lead to a poisoning of the blood, a so-called sepsis. In the initial stage of abscess formation in the face, it is often sufficient to consult the family doctor. The doctor can prescribe ointments for local application which can contain the inflammation or, if the spread is already advanced, administer an antibiotic.

The treatment of an abscess on the face

An abscess in the facial area is usually a diagnosis of the gaze. In contrast to a normal pimple, an abscess in the face is accompanied by severe redness. If a laboratory diagnostic examination is carried out, an increase in the inflammation value (CRP) and an increase in white blood cells (leukocytes) is usually noticed.

In the case of abscesses that lie deep inside and spread far into the surrounding tissue, it is often advisable to carry out a further examination in the form of an ultrasound or computer tomography to assess the exact extent and spread or infiltration of neighbouring organs in the face. In the initial stage of an abscess in the face, a locally applied ointment is usually used. This can also be obtained without a prescription from a pharmacy.

The most commonly used ointment is a traction ointment, which is applied to the affected area of skin on the face and prevents further spread of the pathogens and curbs the inflammatory reaction. In addition, the pulling ointment leads to a further maturation of the abscess. The ingredients of the ointment lead to a widening of the vessels in the well perfused facial skin, which results in more defence cells being washed up to fight the invading bacteria.

The capsule of the abscess is loosened and melts and the pus can come to the surface. . Once the abscess is mature enough, it can be opened and split by a surgeon under sterile conditions.

It is important not to press or manipulate the abscess unnecessarily, as this can promote the possible spread of pathogens. If the abscess in the face is already more mature, surgical splitting (surgery) is the method of first choice for optimal treatment. Under sterile conditions, the surgeon makes an incision in the skin with the help of a small scalpel.

The capsule that has formed around the accumulation of pus is split and the pus can flow outwards. The opened wound cavity is then rinsed several times with saline solution and cleared out so that all pathogens, pus and cell remains are removed. The affected and inflamed surrounding tissue is also removed.

To avoid additional pain during the opening and because the skin is very thin and sensitive, especially in the facial area, the procedure is usually performed under a small local anaesthetic. The wound is initially not sutured so that the wound secretion that still develops can drain off and any pathogens that may still be present are not enclosed again by a capsule and form an abscess again. In order to avoid unnecessary disturbances of wound healing, the wound should be cleaned and the dressing changed at regular intervals.

Especially in the facial area, poorly healed wounds or even large scars are a clear cosmetic blemish which should be avoided as much as possible. An abscess in the face is associated with a high risk of carrying the germs that have entered the brain, especially in the area of the upper lip and the nose. Since these areas are particularly well supplied with blood and the vessels have a connection to the deeper lying vessels that run into the inside of the head, the risk of the germs being carried away is very high.

Therefore, in these areas of the face the risk of an abscess cleft must always be carefully weighed against the risk of initiating antibiotic therapy. The therapy which should be aimed at first is always the surgical opening and irrigation of the abscess in the face. As long as the pathogens have not spread to the surrounding tissue, antibiotic therapy is not absolutely necessary.

However, if surrounding structures are also affected, there is a risk that the germs can spread via the bloodstream and lead to blood poisoning or extend to the brain. Since an abscess is a disease caused by bacterial pathogens, the prescription of an antibiotic is suitable to fight the pathogens. It is important in antibiotic treatment to choose the right form of administration and a sufficient dosage.

In case of light, small and rather superficial abscesses on the face, sometimes an antibiotic ointment is sufficient, which can be applied locally. In order to be able to initiate a particularly efficient antibiotic treatment, which is precisely matched to the pathogen causing the disease, a smear should be taken and microbiologically examined while the abscess is being opened by the surgeon. If the pathogens have not yet been precisely determined, an antibiotic with a particularly broad range of action should first be administered.

In most cases, antibiotics from the subgroup of the so-called cephalosporins or dicloxacillin are used for this purpose. If the disease-causing bacterium has been precisely determined in the microbiological examination, a specific antibiotic can be selected that specifically eliminates the respective bacterium. Since abscesses in the face are in most cases based on the colonization with the skin germ Staphylococcus aureus and most staphylococci are resistant to penicillin, clindamycin, flucloxacillin or so-called macrolide antibiotics such as erythromycin can be used well.

The antibiotic therapy is usually carried out for about 7 days. Home remedies are also used to treat abscesses on the face. A particular natural medicine remedy, the so-called larch turpentine, is particularly successful in its application.

This is a balm made from the trunk of a larch tree and contains essential oils that have a germicidal effect. It promotes blood circulation and stimulates the body’s immune system. This leads to an intensification of the inflammatory reaction, but the abscess continues to mature so that it can drain to the outside.

Another household remedy with an antibacterial effect is black tea. A boiled black tea bag can simply be applied to the affected area of the face and left on for a few minutes. Besides killing the germs, black tea also relieves the inflammatory reaction and has a soothing effect on the affected skin areas.

Normal chamomile tea can also be used in this context. This also has a calming effect on the skin and reduces the inflammatory processes. The application of tea tree oil also has a particularly soothing effect and helps to kill off the pathogens.

Another well-tried household remedy for the treatment of abscesses are boiled onion slices. These are placed in a small bag or towel and can then be placed on the affected area of skin. The onion draws the inflammation out of the heavily stressed tissue and also relieves the strain on the surrounding skin and tissue.

Aloe vera leaves are said to have a good effect, especially in the early stages of the formation of an abscess on the face. They do not have a germicidal effect, but reduce the further growth and spread of the abscess.