Pus under the skin


Purulent inflammations of the skin are also called pyoderma and are usually caused by pest bacteria such as streptococci and staphylococci. Pus is a yellowish secretion, which consists of melted tissue and inflammatory cells and is indicative of a bacterial infection. Pus under the skin usually appears as a painful, yellowish collection of secretions surrounded by reddened and irritated skin, which can lead to abscess. The causes and accompanying clinical pictures are manifold.

Causes of the formation of pus

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

An often caused by staphylococcal disease, which usually affects the skin of toddlers in the area between the chin and nose, is the impetigo contagiosa. This causes itchy, slack blisters with honey-yellow crusts, which are highly contagious.

As a skin appendages, infection of the hair follicle can also lead to small accumulations of pus under the skin, which are referred to as boils or carbuncles, depending on their severity. These impress as small or larger, melting "pimples" on reddened skin (boils), usually with a hair in the center. The cause may be an immune deficiency of the body, eg due to diabetes mellitus.

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

If deeper layers of the skin and the underlying connective tissue are affected, it is called a phlegmon. This manifests itself mostly through a blurred, areal and painful reddening of the skin, which may be accompanied by fever and malaise. Immediate antibiotic and possibly surgical treatment is essential. Formed by an inflammatory Gewebeinschmelzung pus, which is surrounded by a capsule in the sequence, it is called an abscess.

The pimple

The "pimple" is a colloquial term for the dermatological term whelk. A pustule is a localized pus build-up under the skin that is mostly due to a bacterial infection. Pustules can occur in a variety of skin diseases, but the best known is the association with acne.

In acne, there are various causes such as hormonal and plant-related factors to excessive hornification of the hair follicle. This leads to the backwater of sebum and the formation of blackheads. Ignite these blackheads and it comes to excessive colonization with acne bacteria (Propionibacterium acnes), it comes to "pus" (pustules). They can spread anywhere on the body in the nose, on the back or in the mouth, pimples on the stomach are also not uncommon.


The diagnosis of pus under the skin is usually the doctor as a gaze diagnosis. He is helped by the typical signs of inflammation such as redness, pain, overheating and swelling. In some cases, a smear is needed to accurately classify the causative bacterium and to test which antibiotic can be used (resistance testing). In rare cases, such as an abscess, expansion under the skin and spreading to other structures may be necessary by ultrasound or other imaging techniques (CT, MRI).

Accompanying symptoms

If there is an accumulation of pus under the skin, the surrounding skin is often red and swollen. Often, the pain of swelling and inflammation causes severe pain. It can also cause swelling of lymph nodes in the outflow area of ​​the inflammation. If general symptoms such as fever, chills, fatigue or malaise occur, this is a sign of systemic spread of the inflammation to the whole body. In this case, be sure to consult a doctor, as there is a threat of blood poisoning. Other symptoms may vary depending on the underlying condition. Thus, the pustules and blisters in impetigo contagiosa accompanied by intense itching, whereas in acne further skin lesions such as blackheads (comedones) occur.

The therapy of pus under the skin

Treatment of pus buildup under the skin depends on the particular condition.

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

The Impetigo contagiosa is treated by antibacterial ointments and antibiotics in tablet form, also due to the high risk of infection on strict hygiene such as regular hand washing should be respected. Boils and carbuncles are usually treated with antibiotics.

In addition, nail bed infections, abscesses and deep inflammations such as phlegmon must usually be repaired surgically by puncture with a needle, an incision (cut) or a more complex procedure. However, an independent manipulation (expressions or the like) by the patient himself must be foreseen (see below). The above measures should be carried out promptly, since in the worst case, the spread of the pathogen on the bloodstream (blood poisoning) threatens.

Should I express or puncture pus under the skin?

Pus build-up under the skin should never be expressed or pierced on its own, whether it be a simple "pimple" or an abscess. Non-sterile manipulation of the inflamed area of ​​the skin can cause additional bacteria to enter the skin and aggravate the inflammation. In addition, it can lead to a carryover of the bacteria via the bloodstream. This is particularly threatening in the case of furuncles in the facial area, in whose expressions the bacteria can be directed via blood vessels towards the brain and there trigger a threatening sinus vein thrombosis (blood clots in the veins of the brain). Lastly, expressions can cause unsightly scars. If it is necessary to puncture a pus accumulation (eg abscess) or to relieve it by a puncture, this should always be done under sterile conditions by a doctor.

Home remedy for pus under the skin

In the case of harmless, slightly pronounced buildup of pus under the skin, such as the onset of nail bed inflammation or acne pimples, treatment with home remedies may be tried first. In the case of pronounced symptoms, abscess formation, phlegmon or impetigo contagiousness, however, home remedies are in no case sufficient, as they threaten serious complications such as blood poisoning. As anti-inflammatory measures, for example, disinfectant-impregnated envelopes can be tried werden.Auch healing earth, chamomile or arnica are natural measures against inflammation of the skin. Cooling envelopes can have a pain-relieving effect. Generally, it should not be manipulated on the inflamed skin, a "squeezing" or piercing is absolutely to be avoided.

Complication abscess

An abscess is a collection of pus surrounded by a capsule that results from the melting of inflamed tissue. An abscess in the skin can be a complication of various inflammations of the skin (boils, carbuncles) or surgery and injections. Pathogen is in most cases the bacterium Staphylococcus aureus. Clinically, an abscess characterized by a redness and painful swelling, which can be accompanied by fever and chills. In the laboratory, elevated levels of inflammation can be detected. An abscess must always be treated with antibiotics and, as a rule, relieved by a puncture or surgical removal. Spontaneously an abscess heals slowly or not at all, because the bacteria are surrounded by a capsule. There are further complications such as blood poisoning, so that immediate medical treatment is indicated.


The duration of an accumulation of pus under the skin depends crucially on the cause, expression and treatment. While single, harmless pimples (pimples) spontaneously heal in the course of a few days even without treatment, it behaves very differently with more threatening clinical pictures. Thus, an abscess or a phlegmon without adequate antibiotic therapy and surgical relief heals very slowly or not at all. Even with larger boils, Karbunkeln or Nagelwallentzündungen an antibiotic therapy should necessarily take place, since otherwise threatened in the worst case, a life-threatening blood poisoning.

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