Abscesses and Boils

Bump Description | Bump Creation | Bump Prevention | Bump Treatment | Further Reading

Brief: This page is about abscesses and boils; bumps which can appear on body piercings suffering from a minor skin infection. These bumps appear quite frequently on fresh piercings.


TL;DR – Too much information? For a shorter version try our quick reference guide here.

Abscesses and Boils

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An abscess or a boil (which is a less deep type of abscess) is typically caused by a minor ‘skin’ infection. It is normal with this type of bump to not always see the symptoms associated with infections. They are quite often misdiagnosed as hypertrophic scars but actually tend to appear much faster than they do.


Description

The bumps usually appear quite soon after being pierced or after the piercing is damaged enough to be reopened (usually shown by bleeding), usually within 2 weeks. They usually appear and grow quite quickly, over a few days and can sometimes leak fluid.

They tend to be a red-pink colour and can have a white or yellow head if they are a boil (this usually signifies that they are about to pop) or sometimes have a dark or scabby looking head if they are a deeper abscess.

Often they can start out hard like a pimple but then become soft and full of fluid like a water-balloon, sometimes they can feel like they are full of pressure or have a tight / straining feeling.


Creation

Staphylococcus aureus is usually the form of Staphylococcus bacteria that forms these infections. It is a very common type of bacteria which tends to live on people’s skin naturally and is harmless to the person who has it. It often lives on animal’s skin too.

Common places of high concentrations of ‘dangerous’ Staphylococcus aureus can include; the bathroom, on towels & bedding (where there tends to be a lot of dead skin), on other people or pets, and in the kitchen where meat or eggs are stored and prepared. The bacteria itself is spread by unclean hands, unclean surfaces including bedding, clothes and towels and even, in some cases, through the air.

Once the Staphylococcus gets into the piercing wound it begins to kill off the local cells which causes your body to produce an inflammatory response (swelling and increased blood flow) and summon immune cells (white blood cells etc) to fight off the invaders.

The temperature around the wound may increase as the body tries to ‘cook’ the bad bacteria and pus forms as bacteria-killing white blood cells (known as neutrophils) are used up in the fight and die (along with the bacteria they are fighting). Pus tends to be different colours due to the different types of bacteria that die. It is often green because the neutrophils produce a green antibacterial protein known as myeloperoxidase while they fight.

The bump itself is formed by the healthy tissue near the infection as a defensive measure to keep the infectious materials (i.e. pus) from going anywhere else. The problem with this method is that by enclosing everything the body accidentally shuts off most (if not all) of the immune cells from reaching and attacking the bacteria in the pus. This hinders the body in properly sorting out the infection by itself and sometimes means that even antibiotics cannot get into the bump without it being popped first (See below). 

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Prevention

Prevention is especially important in cartilage piercings like the upper or inner ear as they heal slowly because they do not have a direct blood flow of their own. This means it can be easier for an infection to turn nasty in cartilage as immune cells take longer to get to the infection, giving the bacteria time to do their work. The best way to avoid infection is to keep everything that may come into contact with your piercing as clean as possible:

Thinking about where you get pierced. Getting a piercer with a good reputation. Not all body piercers keep their studios in top hygienic conditions even if they have passed inspections!

Avoiding piercing guns. It is best to avoid getting pierced with a gun as they cannot be sterilised and the jewellery they use can cause dead skin, bacteria and other things to collect near the piercing, which can cause infection. Piercers who know the industry well will not use a gun. More information about piercing guns can be found here.

Keeping things clean. Washing all your bedding, towels and any clothes that are close to your piercing fairly frequently. Regularly wiping down objects like ear-phones, phone handsets and glasses and other things that come near to the piercing with an antibacterial wipe or cleaner also helps. In addition to this cleaning cups or containers used to clean the piercing with antibacterial soap, washing up liquid or cleanser is a good idea.

Keeping the piercing dry. Dry the piercing after cleaning or bathing with something disposable (like kitchen roll) to avoid contamination from towels or cloths. Keeping the piercing as dry as possible in-between cleanings is also vital – you can always substitute a shower for a salt water soak instead of having bathed and soaked more than twice in one day.

Not swimming or taking a bath. Avoiding bodies of water like the sea, shared bathtubs, pools, jacuzzis, lakes and rivers for at least the first two weeks. If need to use a bath clean it with an antibacterial cleaner before use and consider adding a few tablespoons of sea salt to create a good environment for the piercing.

Boiling your cleaning water. Making an effort to boil your piercing cleaning water in a microwave. Kettles, water heaters and boilers often hold bacteria unless thoroughly cleaned. Boiled water is not ‘sterile’ or even ‘distilled’ but it does contain a lot less bacteria than it once did.

Not touching your piercing. Not touching your piercing unless you have cleaned your hands (preferably with antibacterial soap) first will really help you to avoid contaminating it accidentally. Not fiddling with your piercing is important to avoid problems like hypertrophic scarring too.

Not letting others touch your piercing. Even if they have washed their hands with antibacterial soap other people can contaminate your piercing. Their skin, salvia and other fluids contain natural bacteria which are different to yours and are not killed off by antibacterial soap alone. If someone else needs to touch your piercing they should clean their hands and wear gloves.

Being careful around pets. Trying not to let animals sleep in your bed or on towels or clothes which will be close to the piercing since they will carry different bacteria to humans which may cause us problems.

Changing your toothbrush. Changing your toothbrush (or toothbrush head) to a new one if you have a mouth piercing of any kind will limit the bacteria you introduce. You could also consider using a UV toothbrush cleaner regularly during this time as they can kill off a lot of bacteria.

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Treatment

Home Treatment   |   Professional Treatment

Infections should always be treated with care and if you are worried you should always visit a doctor. We are no substitute for professional medical advice and all our tips should be considered ‘first aid’ or ‘home remedies’ not medical prescription or diagnosis of any kind! Some minor skin infections can be treated at home but if you are experiencing problems such as a raised body temperature, feeling sick or feeling dizzy or even just very worried it would be best to bypass a home remedy and go straight to a medical professional.


Home Treatment

We recommend the following steps when attempting to treat an abscess or boil at home:

      • Use hot salt water soaks (see here). They help to drain the piercing of anything nasty stuck underneath it, reduce swelling and (most importantly) encourages more healing cellsinto the area by increasing circulation to the piercing.
      • After soaking the piercing, be sure to rinse to remove excess salt and dry it thoroughly on something disposable – like a paper towel. This keeps the piercing from remaining moist, which is what bacteria like.
      • Then apply an antiseptic spray, liquid, oil or gel (like Savlon spray, TCP, Tea tree oil or Germolene gel). where possible because they are not easily absorbed and can get trapped inside the piercing, causing additional problems.
      • While we don’t recommend antiseptic products for general healing they are essential in treating an infection because they help to destroy ‘bad’ bacteria. You should soak and apply antiseptic twice a day.

If after a few days the piercing bump seems no better or if it gets worse while you are treating it then you should consult a medical professional as soon as possible and get professional treatment.

If your piercing is very sore you can also add in chamomile tea to your soak as it is a natural anti-inflammatory, analgesic (pain killer) and is generally very soothing so will help to reduce your discomfort. It may also be worth taking an anti-inflammatory pain killer such as ibuprofen (read the patient information leaflet or talk to a pharmacist first) to make yourself more comfortable as well.


Professional treatment

Usually piercing infections are very minor and doctors tend to prescribe an antibiotic cream (Like Fucidin) or antibiotic pills which will help your body to fight the infection by stopping the bacteria from multiplying and eventually killing off the bacteria all together. You can support your treatment by doing the following:

      • Make sure the piercing is clean before using antibiotic cream. Adding in some antibacterial / antiseptic liquid or soap into your salt water soak, and using it before the cream, will help to strip the jewellery of bacteria and clean the outside of your skin. This gives the cream a good dirt-free base to start working from. You should be liberal with the creamwhen you apply it- try to coat the jewellery as well as the piercing hole. Antibiotic creams are safe to get inside your piercing.
      • When using antibiotic tablets use the home treatment cleaning too. It is really important to finish all of your tablets even if you feel better. If you don’t you risk allowing the infection to form resistance to that strain of antibiotics, potentially causing a much worse infection.
      • Do not use antibiotics on other bumps, cuts or grazes when your treatment has finished unless instructed to by your doctor. You won’t know for sure that the wound you are using it on is infected and you could interfere with the normal healing process. Additionally, instead of protecting you from infection, overusing antibiotics can cause your body to develop resistancesto them – making them useless to you when you really need them.

If your abscess is particularly large or bad then it may need to be lanced before antibiotic treatment. Essentially this means the bump will be popped with a piece of sharp, sterilie, equipment and the pus will drained away. The area will then be properly cleaned.

      • It’s a simple procedure that is usually done at the doctor’s office and doesn’t take long.
      • Do not pop bumps yourself, you could make an infection worse. Nothing is truly sterile unless it has gone through a medical autoclave even if it has been burned, boiled or had alcohol applied!

In particularly severe cases you may be asked to remove the piercing all together. This is not necessarily because the doctor thinks your piercing is ‘stupid’ or ‘wrong.’

      • Jewellery has pores, just like in your skin, and infectious bacteria can linger in them.
      • The jewellery is not part of your body and there is no blood supply to bring the antibiotics into the jewellery pores and kill off the infection properly.
      • It is important, however, not to remove jewellery without medical treatment – you could cause the infection to be trapped under the skin and have no where to drain.
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Further Reading

If you would like to learn more about abscesses themselves we recommend the following sources:

  • Our guide to piercing infections. Which has more tips on avoiding them and discussing symptoms and ways of spotting a piercing infection.
  • The NHS help page on Staphylococcal infections. It goes through treatments and symptoms in detail and we found it very helpful.
  • The PubMed entry on boils which recommends soaks and compresses and explains how they help with abscesses as well as going into some detail about how the boils themselves form. 
  • Medical News Today’s guide to what pus does and why it forms in an infection.
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