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What are the Causes and Treatment Options for Perianal Abscess

Perianal Abscess treatment
Medically reviewed by Dr. Mandy Liedeman


A perianal abscess is a painful collection of pus that forms near the anus or surrounding area. The patient may define it as a boil near the anal canal. It is a common condition that can affect persons of all ages, but it is more common in men than women. Treatment for a perianal abscess typically involves draining the abscess and taking antibiotics to treat the underlying infection. This blog Discusses the causes, management and treatment of perianal abscesses in detail.

What Causes Perianal Abscesses?

Perianal abscesses are typically caused by an infection in the anal glands, which are small glands located near the anus. These glands produce a fluid that lubricates the anus and helps prevent infections. However, if the glands become blocked or infected, bacteria can build up and cause an abscess.

Other medical conditions that can increase the risk of developing a perianal abscess include:

  • Crohn’s disease or ulcerative colitis
  • Sexually transmitted diseases (STDs), such as chlamydia or gonorrhea
  • Diabetes
  • Weak immune system due to illness or medication
  • Certain cancers, such as leukemia or lymphoma

In some cases, a perianal abscess may also be caused by an injury or trauma to the area, such as a tear in the skin around the anus. Additionally, certain activities, such as frequent bicycle riding or horseback riding, may increase the risk of developing a perianal abscess.

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Who is at Risk for Perianal Abscess?

Perianal abscesses can occur in people of all ages and genders, but certain factors may increase a person’s risk of developing this condition. Some of these risk factors include:

History of an anal fistula 

People with an anal fistula are at increased risk of developing a perianal abscess.

Inflammatory bowel disease (IBD)

IBD, such as Crohn’s disease (CC) and ulcerative colitis (UC), can increase the risk of developing a perianal abscess.

Sexually transmitted infections (STDs)

Certain STDs, such as gonorrhea and chlamydia, can cause infections in the anal area that may lead to a perianal abscess.


People with poorly controlled diabetes are at increased risk of developing infections, including perianal abscesses.

Weak immune system

Patients with vulnerable immune systems, such as HIV/AIDS or undergoing chemotherapy, are at increased risk of developing infections.

Personal hygiene

Poor hygiene, such as inadequate wiping after bowel movements or not bathing regularly, can increase the risk of developing a perianal abscess.

Anal sex

People who engage in anal sex are at increased risk of developing perianal abscesses and other anal infections.


Being overweight can increase pressure on the anal area, which may lead to an abscess.

Chronic constipation

Straining during passing stool due to chronic constipation can elevate the risk of developing an anal abscess.

Colon cancer 

A perianal abscess may be a sign of colon cancer in rare cases.

Certain medications

Certain medications, such as immunosuppressants or corticosteroids, can weaken the immune system and elevate the risk of developing infections.

How to Diagnose Perianal Abscesses?

A perianal abscess is a collection of purulent debris (pus) in the tissue around the anus. It can be painful, tender, and swollen. Usually defined by the patient as a pimple near the anus, bump near the anal canal, or painful lump in the perineum. The following are the steps to diagnose a perianal abscess:

Physical Examination

A doctor will conduct a physical exam to evaluate the area around the anus for redness, swelling, or tenderness. They may use a gloved finger to check for tenderness and drainage.

Medical History 

A doctor will ask about any symptoms you may have, such as pain, fever, or discharge. Some history questions that may be asked are as follows.

  • When did you first notice the symptoms?
  • Any pain or discomfort in the area around your anus?
  • Any swelling or redness in the area?
  • They may ask for fever or chills.
  • Question about recent bowel movements or changes in bowel habits?
  • Have you had any other medical conditions or surgeries related to the anus or rectum?
  • Have you been diagnosed with any illnesses that may affect your immune system, such as HIV or diabetes?
  • Are you taking medications that may affect your immune system, such as steroids or chemotherapy?
  • Have you had any recent infections or illnesses?
  • Do you have a family history of perianal abscesses or other conditions that affect the anus or rectum?

Imaging Tests

An imaging test such as an ultrasound, CT scan, or MRI may be ordered to determine the extent of the abscess.

Blood Tests

These may be done to check for infection or other underlying health conditions.

Incision and Drainage

If a doctor suspects an abscess, they may need to drain it by making a small incision in the skin to release the pus. This is usually done under local anesthesia in a doctor’s office.


In some cases, a biopsy may be taken to determine the cause of the abscess or rule out cancer.

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What is the Best Treatment for Perianal Abscess?

The best treatment of a perianal abscess usually involves drainage of the abscess and antibiotics. Here are the steps involved in treating a perianal abscess:

Incision and Drainage

The doctor will make an incision into the abscess and drain the pus. This is usually carried out under local anesthesia, which numbs the area around the abscess. After drainage, the provider may pack the wound with gauze to prevent it from closing and facilitate healing.


If the abscess is large, has spread, or if the person has an underlying medical condition, antibiotics may be prescribed to treat the infection.

Pain Relief 

Prescription of pain relief measures such as warm sitz baths or pain medications may help manage the pain.


The person will need to return for a follow-up examination to ensure that the abscess has healed properly and that there are no complications.


Surgery may sometimes be necessary if the abscess is recurrent or associated with inflammatory bowel disease (IBD).

You must seek medical help promptly if you suspect you have a perianal abscess. Left untreated, a perianal abscess can lead to severe complications such as a fistula or sepsis.

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How to Prevent a Perianal Abscess from Returning?

Preventing a perianal abscess from returning can involve several measures. Here are some ways to prevent recurrence:

Practice Good Hygiene 

To avoid a perianal abscess returning, practice good cleanliness. After every bowel movement, wash the afflicted area with warm water and mild soap.

Increase Fiber Intake

Avoid Constipation, which can result in the growth of an abscess. Eat fruits and vegetables. Keep well hydrated.

Treat Underlying Conditions

An underlying medical condition such as Crohn’s disease is causing the abscess; treating the situation can help prevent a recurrence.

Avoid Trauma

Avoid trauma to the area around the anus, which can increase the risk of developing an abscess. This includes avoiding anal intercourse and using gentle wiping techniques after bowel movements.

Maintain a Healthy Weight 

Increased weight ( Obesity) is a risk factor for developing a perianal abscess. Maintaining a healthy weight can help prevent a recurrence.

Avoid Smoking

Smoking can compromise the immune system, making it harder to fight off infections. Quitting smoking can help prevent the recurrence of a perianal abscess.

Complications of a Perianal Abscess

A perianal abscess is a painful pus collection in the tissue surrounding the anus. If left untreated or improperly treated, a perianal abscess can lead to several complications, including:

Fistula formation

A fistula is an abnormal tunnel between the abscess, skin, or anus. This can cause ongoing pain, discharge, and infections.

Recurrence of the abscess 

If the abscess is not completely drained or if the underlying cause of the abscess is not addressed, it can recur.

Systemic infection

A perianal abscess can spread to other body parts and cause a potentially life-threatening infection. Symptoms may include fever, chills, and difficulty breathing. This can lead to sepsis.

Anal incontinence

In rare cases, damage to the anal sphincter muscles during surgery to treat abscesses can result in fecal incontinence.

Psychological impact

Chronic pain and discomfort can lead to anxiety, depression, and a decreased quality of life.

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How to Manage Perianal Abscess at Home?

It is crucial to remember that a perianal abscess needs drainage and antibiotics. You can try the following to help control the symptoms and encourage healing.

Keep the area clean

Clean the affected region gently with warm water and mild soap. To avoid irritating the skin, stay away from items that are harsh or scented. A sitz bath can also help to clean the region and lessen pain.

Apply warm compresses 

Use a clean, damp washcloth or towel to apply warm compresses to the affected area for 10-15 minutes daily. This can help reduce pain and swelling.

Take pain relievers 

Acetaminophen and ibuprofen are over-the-counter medications that can help decrease pain and inflammation.

Avoid constipation 

Constipation straining can exacerbate the abscess and postpone recovery. Eat a diet rich in fiber, consume lots of water, and, if necessary, think about taking a bowel softener.

Monitor for signs of infection. 

Keep an eye on the abscess and monitor for signs of infection such as fever, increased pain or swelling, or drainage of pus. If you notice any of these signs, seek medical attention immediately.

How Long Does it Take for a Perianal Abscess to Heal?

The healing time for a perianal abscess can vary depending on the size and severity of the abscess, as well as the individual’s overall health and immune system function. In general, smaller abscesses may take few days to a week with proper treatment to heal, while more extensive or complex abscesses may take several weeks to recover fully. 

After the abscess has been drained and treated with antibiotics, it is important to continue good hygiene practices and follow any additional treatment instructions provided by a doctor to promote healing and prevent the abscess from recurring. 

Hemorrhoids vs. Perianal Abscess?

These are both conditions that can affect the anal area, but they are different conditions with distinct causes, symptoms, and treatments.


Hemorrhoids are inflamed and swollen veins in the rectum and anus. Straining during bowel movements, chronic constipation or diarrhea, pregnancy, obesity, or sitting for long periods acts as a causative factor. Hemorrhoids can be internal (inside the rectum) or external (outside the anus). Symptoms of hemorrhoids may include itching, pain, swelling, and bleeding during bowel movements.

Perianal abscess

On the other hand, a Perianal abscess is a localized infection that forms in the tissue around the anus. Bacteria enter through a small cut or tear in the skin around the anus and cause it. Symptoms of a perianal abscess may include pain, swelling, redness, and fever. In some cases, the abscess may also cause drainage of pus or other fluids.

While both conditions can cause discomfort in the anal area, perianal abscess requires prompt medical attention and treatment, as it can lead to severe complications if left untreated.

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FAQs About Perianal Abscess Answered by Your Doctors Online Team.

How serious is a perianal abscess?

A perianal abscess can be a serious condition if left untreated or not appropriately treated, as it can lead to the formation of a fistula, sepsis, or other complications. The recommendation is prompt medical care and drainage of the abscess to prevent further complications.

Is a perianal abscess hard or soft?

The texture of a perianal abscess can vary depending on its stage and severity. An abscess is a collection of pus or purulent debris that can feel soft or firm to the touch. It may also be warm, tender, and swollen.

Is it bad if a perianal abscess bursts?

If a perianal abscess bursts, it can provide some temporary relief from pain and pressure, but it is not a recommended treatment. The burst abscess can spread the infection to other body parts, leading to complications such as fistulas or sepsis. It is crucial to seek urgent medical care to properly drain the abscess and manage the infection to prevent further complications. In addition, the drainage of the abscess can be messy and unpleasant, so it is better to have it treated by a healthcare professional.

Will a perianal abscess go away with antibiotics?

Antibiotics alone may not be enough to treat a perianal abscess, as it is a pocket of pus that requires drainage to heal fully. However, antibiotics may be prescribed to help control the infection and prevent it from spreading. Drainage of the abscess is necessary for effective treatment. The healthcare provider may also recommend other measures to relieve symptoms and promote healing, such as warm compresses and pain management.

What are the chances of a perianal abscess becoming a fistula?

The chances of a perianal abscess becoming a fistula are relatively high, as the abscess can create an abnormal tunnel between the anal gland and the skin around the anus. The likelihood of a fistula forming can depend on various factors, such as the abscess’s size and location and the treatment’s promptness and effectiveness. If left untreated or not adequately treated, a perianal abscess will likely progress to a fistula, which can be more complicated to manage.

Should you pop a perianal abscess?

No, it is not recommended to pop or squeeze a perianal abscess, as it can cause the spread of infection to other body areas and lead to complications such as fistulas or sepsis. A perianal abscess requires prompt medical attention, including drainage and antibiotics, to properly treat the infection and prevent further complications.

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