Wound Healing After an Opened Abscess: Tips, Care, and Aftercare

An abscess is more than just a collection of pus – it indicates that your body is actively fighting an infection. When the abscess is opened, either by a doctor or spontaneously, an intensive healing process begins. With careful care, the right understanding, and targeted measures, this process can be optimally supported: the wound can heal cleanly, infections are avoided, and scarring remains controlled.

What is an abscess?

An abscess is a localized infection under the skin, typically caused by bacteria such as staphylococci. ¹ The body reacts by accumulating pus to encapsulate the infection. If you feel an abscess developing, a drawing or abscess ointment, such as black ointments or the herbal, green drawing ointment ilon Classic, can help to contain the inflammation and support the drainage of pus. If the pressure becomes too strong, the infection progresses, and the abscess does not open on its own, intervention is often necessary.

Medical Opening of an Abscess

In the case of an abscess, the doctor opens the wound in a controlled manner under sterile conditions to allow the pus to drain. This reduces pressure, relieves pain, and actively initiates healing. Only with very deep abscesses is a drainage tube additionally inserted to ensure the continuous drainage of pus. ^2,3,4 Antibiotics are used if necessary.⁵

Spontaneous Opening

However, an abscess can also open spontaneously and naturally, and the pus escapes. This reduces the pressure, but often the opening is not sterile, which increases the risk of re-infection. Therefore, medical control is strongly recommended in this case as well. ^1,2

Opening the abscess does not completely solve the problem. Careful aftercare and proper wound treatment are crucial to avoid complications and promote healing.² Drawing or abscess ointments should no longer be used after opening, as they can irritate the wound and disrupt the healing process.

The Wound After Abscess Opening

The special characteristic of a wound after an abscess is that it does not heal like a smooth cut or surgical wound, but leaves a deep, irregular cavity that must heal from the inside out.

Small skin abscesses often only extend a few millimeters to 1–2 cm deep. Larger or longer-lasting abscesses can reach several centimeters deep and form branched pockets. This wound pocket was previously filled with pus and must therefore remain open so that residual secretions can drain safely. The tissue is pre-damaged by inflammation, often softer and irregular, which is why healing takes longer. At the same time, the risk of renewed bacterial colonization is increased, which is why careful hygiene, regular irrigation, and maintaining a moist wound environment are particularly important. The wound must also not be closed too early, as the abscess could otherwise refill.⁵

The treatment of an abscess wound differs primarily in that it must be kept open, cleaned, and specifically managed to be low in germs, so that the former pus cavity fills safely from the inside out, whereas a “normal” wound is usually closed and requires significantly less intensive aftercare. ²

The Wound Healing Phases After Abscess Opening

• Exudation or Cleansing Phase (approx. 1 – 4 days)

In this first wound healing phase, the body essentially “cleans up.” Immediately after the wound is opened, it begins to break down and remove invading bacteria and dead tissue. Typical for this period are increased fluid secretion (exudate), redness, and slight swelling – signs that the immune system is actively working.

The most important focus in this phase is germ control. Antiseptic solutions are particularly useful here: they reliably reduce the number of bacteria without impairing the natural drainage of wound exudate. This supports the cleansing process and promotes a healthy wound environment.

What can be recommended? Antiseptic solutions and breathable, absorbent wound dressings that allow for a moist, low-germ wound environment without hindering exudate drainage are best suited.

What should be avoided? In this phase, everything that hinders the drainage of wound exudate, dries out the wound, additionally irritates or contaminates it should be avoided – this includes dense coverings, manipulation of the wound, unsuitable cleaning agents, and unclean materials.^6,7

• Granulation Phase (Reconstruction Phase, approx. 3 to 10 days)

In this phase, the actual healing begins: the wound is gradually filled from the inside out with new, well-vascularized tissue, known as granulation tissue. This usually appears moist, shiny red, and slightly granular – a very good sign that the body is actively repairing. ^6,7

What can be recommended? For the care of opened abscesses, wound gels or ointments are suitable. They support a moist and protected wound environment – crucial for the uniform formation of new tissue, rapid healing, and the most inconspicuous scarring possible.

What should be avoided now? Avoid anything that dries out, irritates, or injures the fresh tissue – e.g., aggressive cleaning agents, pulling off bandages, or pressure on the wound. Slight itching is a good sign of healing. Under no circumstances should you scratch – instead, gently cool the area to relieve the itching and prevent renewed inflammation.

• Epithelialization / Repair Phase

In the epithelialization phase, the wound gradually closes from the surface. New skin tissue, called epithelium, grows from the wound edges into the open area and covers the former abscess cavity. Since abscess wounds are often irregularly shaped and deep, this process can take longer than with normal cuts or abrasions. Typically, the wound becomes increasingly dry, stable, and less sensitive, while the tissue adapts to the surrounding skin.^6,7

What can be recommended? To support this process, it is important to keep the wound protected and moist, for example, with light wound gels, as well as breathable dressings that prevent drying out. The skin edges should be gently cared for, and mechanical stress, pressure, or friction on the wound should be avoided.

What should be avoided? In the epithelialization phase after an abscess, one should avoid the wound drying out, adherent dressings being pulled off, aggressive cleaning agents or disinfectants being used, mechanical stress or friction occurring, and the fresh skin being exposed to direct sunlight.

Healing Duration of an Abscess Wound

The healing of an abscess depends on its size, location, treatment, and individual factors. Small abscesses usually heal faster, while larger ones take longer. Particularly hard-to-reach areas, such as the buttocks, can complicate treatment and delay healing.

Another crucial factor for the healing process is consistent adherence to medical recommendations. Hygiene measures must be carried out carefully to keep the wound clean. If this is not observed or the abscess does not heal completely, a new abscess can form, and healing can be significantly prolonged.²

What to do if an abscess wound becomes inflamed?

A renewed inflammation of an abscess wound is a warning sign that germs have re-colonized the wound or that the inflammation has not yet completely subsided. Typical signs include redness, warmth, swelling, pain, or recurring pus discharge. In this case, immediate medical attention should be sought.

Scarring in Abscess Wounds

A wound care that is guided by the healing phases optimally supports the body and reduces the risk of noticeable scars.

Risk factors for noticeable scars:

• Deep or large abscesses: Greater tissue damage often leads to larger scars.
• Infections or delayed healing: Inflammation promotes excessive scar tissue.
• Unfavorable wound care: Too early stress, lack of moisture, or non-sterile care can increase the risk of scarring.

Measures for scar reduction⁸:

• Moist wound environment: Hydrogels or special ointments.
• Protecting the wound: Avoid pressure and aggressive friction.
• UV protection: Sun exposure can make scars darker and more noticeable.
• Late treatment: Silicone gels or patches can smooth scar tissue.

Tips for everyday life

Keep the wound clean and moist, avoid pressure, friction, or scratching, and protect it from direct sunlight. Thorough hand washing before each touch helps prevent infections. Pay attention to warning signs such as redness, swelling, pain, or pus – in such cases, immediate medical attention should be sought.