What is a perianal abscess? Causes and treatment options

perianal abscess
Medically reviewed by Dr. Mandy Liedeman

Key takeaways

  1. 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. Causes of perianal abscess can be IBD, STD, diabetes, and weak immune system.
  2. Symptoms of perianal abscess are redness, inflammation, boils, extreme pain, and discomfort while walking or sitting. 
  3. Treatment options include draining the abscess and avoiding physical contact and antibiotics as prescribed by the healthcare provider for the correct diagnosis and treatment.


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. Causes of perianal abscess can be IBD, STD, diabetes, and weak immune system. In addition, treatment for a perianal abscess typically involves draining the spot and taking antibiotics to treat the underlying infection.

What is a perianal abscess?

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. In addition, treatment for a perianal abscess typically involves draining the spot and taking antibiotics to treat the underlying infection.

Hemorrhoids vs. Perianal abscess?

Hemorrhoids Perianal abscess
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 is a causative factor.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. 
Distinguishing feature between hemorrhoids and perianal abscess.
Consult one of our doctors online for discharge from the perianal area.

What causes perianal abscesses? Who is at risk?

Perianal abscesses are typically caused by an infection in the anal glands, which are small glands located near the anus. Moreover, 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:

1. Crohn’s disease or ulcerative colitis (IBD)

These diseases both are Inflammatory bowel diseases infecting the anal area differently, leading to the formation of perianal abscesses. Crohn’s disease can affect any part of the digestive system, from mouth to anus. It can affect the intestinal walls, causing inflammation leading to abnormal connections called fistulas between the bowel and other structures. 

Ulcerative Colitis is also one of the inflammatory bowel diseases in the large intestine, mainly the rectum. It can also lead to inflammation leading to abscess formation in the Anus.

2. Sexually transmitted diseases (STDs)

Sexually transmitted diseases, specifically gonorrhea and chlamydia, can cause Perianal Abscess. Proctitis is the inflammation of the rectum which is caused by these sexually transmitted diseases which can lead to pus formation and fluid discharge from the rectum. 

It’s good to get yourself checked for any pain or fluid discharge observed from the vagina, leading to a perianal abscess and pus formation. Sometimes untreated proctitis can also lead to pus formation and needs medical attention for treatment.

3. Diabetes

Patients with diabetes are also at greater risk for making perianal abscesses as the risk increases with the elevated levels of  HbA1c in diabetic patients. 

Seeking medical attention for any injury or cut when suffering from diabetes will help you get rid of any further complications of perianal abscess.

4. Weak immune system

A weak immune system can be caused either due to medical conditions or medications you are taking for any condition. 
A weaker immune system invites opportunistic diseases that affect your body one after another, taking a long time to get cured. Supplemental diet after any medical condition should be continued for the overall health of your body.

5. Leukemia or lymphoma

Leukemia and lymphoma can not directly cause a perianal abscess, but this condition weakens the immune system, making the body more susceptible to infections from the bacteria.

These conditions make one’s immune system weaker to be attacked by foreign objects, bacteria, and viruses.

Consult one of our healthcare experts online to get tested for perianal abscess.

6. Injury or trauma

Injury and Trauma, either physical or mental, can cause serious changes to the normal physiological process of the body, leading to different infections like perianal or rectal abscess formation, etc.

7. Frequent bicycle riding or horseback riding

Frequent bicycle riding can only be one of the reasons that might lead to pain, swelling, or redness in the anal area, causing perianal abscess formation. It’s good to cease any such activity if you observe redness, inflammation, or pain in the anal area and get yourself checked by the healthcare provider.

What are the symptoms of perianal abscesses?

Symptoms of a perianal abscess may include 

  • Pain
  • Swelling
  • Redness
  • fever 
  • The abscess may also cause drainage of pus or other fluids.

How to treat 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. Moreover, 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. The medication mostly prescribed by the healthcare provider is Cephalexin and Amoxicillin-clavulanate.

Pain Relief

Prescription of pain relief measures such as warm sitz baths or pain medications may help manage the pain. Over-the-counter medications, including Advil (Ibuprofen) and Tylenol (Acetaminophen), will help you deal with the pain relief.


The person will need to return for a follow-up examination to ensure that the abscess has healed correctly and that there are no complications because sometimes untreated conditions can lead to a relapse of the previous perianal abscess.

Consult virtual health provider now for an assessment of recurrent perianal abscess.


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

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

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. Furthermore, usually defined by the patient as a pimple near the anus, a bump near the anal canal, or a 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?

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.

Consult a doctor now to diagnose your perianal complaints.

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.

Consult with a healthcare provider now for an online to discuss the risk of complications of perianal abscesses.

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.

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. Also, 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 (Tylenol) and ibuprofen (Advil) 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 a few days to a week with proper treatment to heal, while more extensive or complex abscesses may take several weeks to recover fully.

Finally, 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.

Get an expert medical consultation from our virtual healthcare providers to get the right treatment.

FAQs About Perianal Abscess Answered by Your Doctors Online Team.

Is a perianal abscess serious?

Yes, It is. Perianal abscess is serious if left untreated because it is located on the anal verge and can lead to ischioanal or intersphincteric space, leading to severe pain.

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.

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. Moreover, the likelihood of a fistula forming can depend on the abscess’s size and location and the treatment’s promptness and effectiveness.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Sahnan, Kapil, et al. “Perianal abscess.” Bmj 356 (2017).
  • Whiteford, Mark H. “Perianal abscess/fistula disease.” Clinics in colon and rectal surgery 20.02 (2007): 102-109.
  • Marcus, Robert H., Robert J. Stine, and Martin A. Cohen. “Perirectal abscess.” Annals of emergency medicine 25.5 (1995): 597-603.
  • Makowiec, Frank, et al. “Perianal abscess in Crohn’s disease.” Diseases of the colon & rectum 40 (1997): 443-450.
  • Steele, Scott R., et al. “Practice parameters for the management of perianal abscess and fistula-in-ano.” Diseases of the colon & rectum 54.12 (2011): 1465-1474.

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