Abscess incision and drainage (Incision and drainage of a skin abscess)
A small procedure to cut open a skin abscess so the trapped pus can drain out, relieving pain and helping the infection settle.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It is a small procedure to cut open an abscess and drain the pus, which usually relieves pain quickly.
- Antibiotics alone usually cannot clear an abscess once pus has collected, so drainage is the main treatment.
- The wound is often left open to heal from the bottom up and can take days to a few weeks; some need dressing changes.
- An abscess can come back, especially if there is an underlying cause, so ask what caused it and how to reduce the chance of it returning.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Relieves the pain and pressure of a trapped collection of pus, often quickly
There is spreading soft-tissue infection (cellulitis) without a drainable pus collection, which may need antibiotics first.
The area is sore but the pressure pain often improves once the pus is out. Take simple painkillers and keep any dressing clean and dry as advised.
Clear advice on dressing changes and a route to a nurse if changes are needed.
The area is sore but the pressure pain often improves once the pus is out. Take simple painkillers and keep any...
There may be ongoing ooze. You may need dressing changes, either yourself, by a practice or district nurse, or at...
The wound gradually fills in from the bottom. Dressing changes often continue for larger cavities. Soreness...
Smaller wounds are usually healed; larger cavities can take longer to close fully. A scar remains.
What is incision and drainage of an abscess?
A skin abscess is a painful lump filled with pus, caused by infection. Common sites include the armpit, groin, buttock and around the bottom (a perianal abscess).
Incision and drainage is a small procedure to cut open the abscess so the pus can drain out. Releasing the pus relieves the pressure and pain and helps the infection settle. Antibiotics alone usually cannot clear an abscess once pus has collected, because they do not penetrate it well, so drainage is the main treatment.
Small abscesses can often be drained under local anaesthetic in a clinic or emergency department. Larger or deeper abscesses, or those in sensitive areas such as around the bottom, may need a general anaesthetic in theatre.
Draining the abscess treats the collection of pus. It does not always remove the underlying cause, so some abscesses can come back or need further treatment, especially if they are linked to a cyst, a hair-follicle problem or a tract under the skin.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Drainage under local anaesthetic
For many smaller, accessible skin abscesses. The skin around the abscess is numbed, a small cut is made and the pus is drained, usually in a clinic or emergency department.
Drainage under general anaesthetic
For larger, deeper or very painful abscesses, or those in sensitive areas such as around the bottom, where full numbing with local anaesthetic is difficult. Done in theatre.
Perianal or perineal abscess drainage
An abscess near the back passage is usually drained in theatre. The surgeon checks for any tract (fistula) connecting to the bowel, which may need further treatment later.
Drainage with wound packing
For some larger cavities the wound is loosely packed with dressing material that is changed over the following days. Packing is not routinely needed for small abscesses.
Preparing for your procedure
- Expect to be seen fairly urgently, as a painful abscess usually needs draining without long delay.
- Tell the team about all medicines, especially blood thinners, and any allergies, including to antibiotics or dressings.
- Mention diabetes, a weak immune system or any condition that affects healing.
- If a general anaesthetic is likely, you may be asked not to eat or drink for a period beforehand.
- Arrange a lift home and someone to stay with you if you are having sedation or a general anaesthetic.
- Plan for some time off and easy access to the area for dressing changes, depending on where the abscess is.
What happens
For a small abscess under local anaesthetic, the skin around it is numbed with an injection. The clinician makes a small cut over the abscess, lets the pus drain, and may gently clean out the cavity. A sample of pus may be sent to the laboratory to identify the bug. The wound is usually left open to keep draining, sometimes with a loose dressing or pack inside.
For larger or deeper abscesses, the same is done under general anaesthetic in theatre so the area can be fully opened and cleaned without pain.
A simple drainage often takes about 15–30 minutes. The wound is normally left open rather than stitched closed, so it can heal from the inside out and the infection does not get trapped again.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- There is spreading soft-tissue infection (cellulitis) without a drainable pus collection, which may need antibiotics first.
- A very deep or complex collection that needs imaging and specialist surgical planning rather than simple drainage.
- The lump is not actually an abscess (for example a tumour or vascular lump), so the diagnosis needs confirming first.
- An unwell patient with signs of serious infection who needs urgent hospital assessment, not just a clinic procedure.
Delay or rearrange if…
- You are very unwell with a high fever or signs the infection is spreading and need urgent assessment.
- You are on blood thinners that need reviewing before a procedure.
- A general anaesthetic is planned and you have not followed fasting instructions.
- Imaging is needed first to define a deep or complex abscess.
- Your diabetes or immune problem is poorly controlled and needs review.
Alternatives to discuss
- Antibiotics alone if there is infection but no pus collection yet (drainage is still needed once pus forms).
- Allowing a very small abscess to be managed conservatively under review in selected cases.
- Needle aspiration in specific situations, though this is generally less effective than open drainage.
- Specialist referral and definitive surgery for recurrent abscesses or those with an underlying cause such as a fistula or hidradenitis.
- Treating the underlying skin condition to prevent further abscesses.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Relieves the pain and pressure of a trapped collection of pus, often quickly
- Treats the infection more effectively than antibiotics alone once pus has collected
- Lets a sample of pus be tested to guide any antibiotics
- Reduces the chance of the infection spreading
- Can usually be done quickly, sometimes under local anaesthetic as an outpatient
Risks & complications
- Soreness and some ooze or bleeding from the wound for a few days
- An open wound that needs dressing changes while it heals
- A scar where the abscess was drained
- The wound taking days to a few weeks to heal fully
- The abscess coming back, especially if there is an underlying cause
- Continuing or spreading infection needing antibiotics or further drainage
- A small piece of the cavity not healing, needing further treatment
- Bleeding that needs attention
- A deeper or more serious infection, particularly with diabetes or a weak immune system
- A persistent tract (fistula) forming, especially with perianal abscesses
- Damage to nearby structures depending on the site of the abscess
The biggest issue is that drainage treats the pus but not always the cause, so some abscesses return. Abscesses linked to a cyst, hair-follicle disease (such as hidradenitis) or a tract near the bowel are more likely to recur or need further treatment. People with diabetes or a weak immune system need careful follow-up because infection can be more serious. Ask what is thought to have caused yours.
Published figures to discuss
Recurrence and complication rates vary widely depending on the cause and site of the abscess, the bug involved and underlying health. The figures below are cautious and should be read as ranges, not promises.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Abscess recurrence after simple drainage | Reported in roughly 15–40% across studies | Higher when there is an underlying cause such as a cyst, hidradenitis or a fistula; varies by site. | Incision and drainage — StatPearls (NCBI)ncbi.nlm.nih.govPublished figure |
| Fistula after perianal abscess | Around one third in recent cohorts (about 34–35%), with published rates varying by follow-up and abscess type | A tract to the bowel can form and may need a separate procedure; follow-up is important, especially if discharge or recurrent swelling persists. | Incision and drainage — StatPearls (NCBI)ncbi.nlm.nih.govPublished figure |
| Antibiotics alone failing for a true abscess | Common | Once pus has collected, drainage is usually the definitive treatment; antibiotics are added for cellulitis, systemic illness or higher-risk patients. | Incision and drainage — StatPearls (NCBI)ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Pain usually eases soon after the pus is drained. The wound is often left open to heal from the bottom up, so it may need dressing changes and takes days to a few weeks to close over, depending on its size and site.
- Soreness that improves once the pus has drained
- Some ooze or discharge from the open wound for a few days
- Needing dressing changes while the wound heals from the inside out
- A scar at the drainage site once healed
Aftercare
- Take simple painkillers such as paracetamol as advised for the soreness.
- Follow the dressing advice you are given, and keep the area clean as directed.
- Attend any nurse appointments for dressing changes, or change dressings yourself if shown how.
- Finish any prescribed antibiotics and take them as directed.
- Keep the area clean and, for a perianal abscess, follow advice on bathing and keeping the area dry.
- Watch for signs the infection is spreading or coming back, and know who to contact.
- Go back if the wound stops healing, keeps discharging or the lump returns.
- Simple painkillers at home
- Any prescribed antibiotics collected
- Spare dressings if you are changing them yourself
- Nurse or clinic appointment booked for dressing changes if needed
- A few quieter days planned depending on the site
- The clinic or out-of-hours contact number saved
Scars and how they heal
Because the wound is usually left open to heal from the inside out rather than stitched, it heals over by filling in, and a scar remains where the cut was made. The size of the scar depends on how big the abscess and cut were. Larger cavities leave larger scars. Sun protection can help a healing scar settle.
⚠ Get urgent help if…
- Spreading redness, swelling or heat around the wound
- Feeling hot, cold, shivery or generally unwell (possible spreading infection)
- Increasing pain rather than improving pain
- Heavy or persistent bleeding from the wound
- Pus building up again or the lump returning
- A wound that is not healing, especially if you have diabetes
- Difficulty passing urine or opening your bowels with a perianal abscess — seek advice
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the pus is drained, the pain settles, the infection clears and the wound heals over. Sending a sample of pus to the laboratory can confirm the bug and guide any antibiotics.
Drainage clears the collection of pus, but it does not always remove the underlying cause. Abscesses linked to a cyst, hair-follicle disease or a tract near the bowel can come back or need further treatment, which is why follow-up and finding the cause matter.
Many abscesses settle for good once drained. However, an abscess can return if there is an underlying cause that has not been dealt with, such as a blocked cyst, hidradenitis or a fistula near the bowel. If abscesses keep coming back in the same place, ask whether a further procedure or specialist referral is needed.
Follow-up & long-term care
You may be reviewed to check healing and the results of any pus sample, and to plan further treatment if a tract or underlying cause is suspected. For perianal abscesses, follow-up is important because a fistula can develop and may need a separate procedure later.
- Keep the area clean and dry while it heals
- Manage any underlying skin condition with your clinician
- Seek early advice if a new lump or swelling appears
- For recurrent abscesses, ask about investigating and treating the cause
Repeat, follow-on and what comes next
- Some abscesses need repeat drainage if pus collects again.
- Recurrent or underlying-cause abscesses (cyst, hidradenitis, fistula) often need a planned, more definitive operation later.
- Wound packing for larger cavities means several dressing changes rather than a single procedure.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear advice on dressing changes and a route to a nurse if changes are needed.
- A named contact and warning signs for spreading infection or a wound that will not heal.
- Results of any pus sample fed back, with antibiotics adjusted if needed.
- Follow-up for recurrent or perianal abscesses to check for an underlying cause or fistula.
- Extra care and earlier review for people with diabetes or a weak immune system.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is done under local anaesthetic in clinic or under general anaesthetic in theatre
- The size, depth and site of the abscess
- Theatre and facility fees if a general anaesthetic is needed
- Laboratory testing of the pus sample
- Dressings and the number of dressing-change appointments
- Any antibiotics, and follow-up to check healing or treat an underlying cause
- The surgeon's or clinician's fee for the procedure
- Anaesthetic and theatre or facility fees if a general anaesthetic is used
- Dressings and dressing-change appointments
- Laboratory testing of any pus sample
- Follow-up appointments and what they cover
- What happens, and any extra cost, if the abscess comes back or a fistula needs treating
On the NHS? Incision and drainage of an abscess is commonly done on the NHS, often urgently, because a painful abscess usually needs draining without long delay; private care may be used for speed or choice for non-urgent cases.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Implying antibiotics alone will fix an abscess once pus has collected.
- Not explaining that the wound is often left open and needs dressing changes.
- Not mentioning that the abscess can come back if the cause is not addressed.
- For perianal abscesses, not warning that a fistula may develop and need further treatment.
Marketing red flags
- Promising a single 'quick' procedure with no mention of dressing changes or recurrence.
- Suggesting antibiotics will avoid the need for drainage once pus has formed.
- No discussion of finding or treating the underlying cause of recurrent abscesses.
- Downplaying scarring or healing time for larger abscesses.
Choosing a specialist safely
- Check the surgeon is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What do you think caused this abscess, and is it likely to come back?
- Will it be done under local or general anaesthetic, and why?
- Will the wound be packed or left open, and how will the dressings be managed?
- Could there be a tract or fistula, especially if it is near my bottom?
- What should I watch for, and who do I contact if it gets worse or returns?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Why can't I just take antibiotics instead of having it drained?
Will it hurt?
Will the wound be stitched?
How long does it take to heal?
Can the abscess come back?
Do I need follow-up?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Abscess Incision and drainage — StatPearls (NCBI) RCS England — Commissioning guide: Rectal bleeding and perianal conditions Skin abscesses in adults: treatment — overview (UpToDate) Fistula development after anal abscess drainage — multicentre cohort (PMC)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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