One of the advantages to working in an urgent care center is being able to
send patients out of the office feeling much better than when they came in.
Treating  abscesses is one of the most common problems that I am able to
give immediate relief. The most common location is back and neck, followed
by buttocks and inner thigh. The back and buttock are not very easy places
for patients to treat themselves and are often the size of my fist by the
time I see the patient. My patients also report having used tar or heat to
bring their infections to a head with no success. Many abscesses also have
deep roots. It takes alot of time and compression to get them completely
drained. It is really hard to believe that a topical would save me time from
doing this procedure. It is also hard for me to believe that my patients
would not be angry with me for not lancing the infection.

I have treated a few abscesses on the chest wall. Usually they are not as
big because the patients see them and don't let them go so long without
treatment. I have recently had to refer two chestwall/breast abscesses to a
breast surgeon because of the deep tracts that I was unsuccessful at
draining. One was a man. His lump was below nipple and the other was a
nonlactating female. Her fistula extended into the chestwall.

Most of my patients have healed up well with a 2mm incision. I use lidocaine
to numb the area. An abscess treated with incision does not need antibiotics
unless there  is a cellulitis also. Buttock abscesses usually get
antibiotics because the location and high risk of contamination. After the
drainage my patients can resume doing whatever activity they like.

Denise Punger MD FAAFP
Hobe Sound Fl---very hard to type with a 2 year old pulling at my clothes.
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