Can a perianal abscess in children heal by itself?

Written by Li Jiao Yan
Neonatology
Updated on September 21, 2024
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Although they are all perianal abscesses, each child's condition is different. The size of the perianal abscesses varies; some are as small as a grain of rice and may heal on their own, but there are also larger ones the size of a walnut, or even cause the entire buttock area to become swollen and red. Such cases require hospitalization, especially for younger children who also exhibit systemic symptoms like fever. They generally require hospital treatment. Meanwhile, it is recommended that parents take good care of the baby's perianal area, maintain a healthy diet and bowel habits, avoid diarrhea and constipation, ensure cleanliness around the anal area, and use soft, non-irritating wet wipes when cleaning the area to avoid friction injuries that could lead to infections, as the skin of small infants is very delicate.

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Written by Yu Xu Chao
Colorectal Surgery
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Can a perianal abscess burst on its own after it forms pus?

After an anal abscess becomes purulent, one should not attempt to rupture it on their own. If purulence occurs, it is advised to perform local disinfection under a doctor's supervision, followed by incision and drainage or pus aspiration to prevent further infection. Attempting to rupture it on your own can easily lead to further aggravation of the local infection. After an anal abscess becomes purulent, the choice of incision location is crucial; once cut, it is necessary to maintain unobstructed drainage to avoid subsequent infection or even necrotizing fasciitis. In clinical practice regarding anal abscesses, it is advised to visit a colorectal surgery department at a hospital as soon as the abscess is detected, to undergo procedures such as incision and drainage or radical surgery of the anal abscess to avoid the later development of anal fistulas or necrotizing fasciitis. Post-surgery, medications such as red oil gauze strips, anal cleansing solutions, and aureomycin ointment are recommended for dressing changes.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days does the skin around an anal abscess fall off?

During the acute phase of a perianal abscess, if rubber band ligation surgery is performed, the duration of the rubber band falling off generally depends on the location of the lesion. For superficial local perianal abscesses, the rubber band typically falls off within one to ten days. For high-position complex perianal abscesses or those accompanied by anal fistulas, the falling off of the rubber band might take about ten days. In some cases where the rubber band falls off slowly, it may require a doctor's dressing change and assistance to weaken or detach the local rubber band. Do not pull off the rubber band yourself to avoid injuring the local sphincter, which could lead to decreased or abnormal tightness around the anus.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do if there is pus draining from a perianal abscess?

When a perianal abscess occurs, there is typically pus or an enclosed abscess under the skin. If the perianal abscess ruptures and drains pus, it may have developed into an anal fistula. Once a perianal abscess forms an anal fistula, surgical treatment should be carried out as soon as possible. The surgical methods for treating perianal abscesses and anal fistulas mainly include incision drainage debridement surgery and incision with seton placement. After the surgery, due to substantial secretion from the local wound, it is essential to disinfect and change dressings regularly and to monitor the wound daily. It is crucial to prevent excessive granulation or pseudohealing at the local site, which could encapsulate the infection and prevent complete recovery, potentially leading to recurrence in the future.

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Written by Yu Xu Chao
Colorectal Surgery
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Can an anal abscess without pus be treated without surgery?

Perianal abscesses require surgical treatment even if there is no pus present, as early-stage perianal abscesses are primarily characterized by pain and noticeable lumps near the anus, with the lumps typically being hard. This condition is mainly considered to be an infection and inflammation of the anal glands, which then infects the surrounding tissue, leading to the development of lumps. Surgical treatment should be undertaken as soon as possible even in the absence of pus, because as the infection worsens over time, it may lead to the formation of pus. Early treatment can be advantageous as the infected area is not very extensive, thus resulting in a smaller surgical wound. For early-stage perianal abscesses, a one-time radical surgery may be chosen to remove the internal opening and the infected tissue thoroughly, followed by postoperative care using medicated substances such as erythromycin ointment gauze, anal washes, or mupirocin ointment to promote healing of the surgical wound.

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Colorectal Surgery
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Can a perianal abscess be completely cured?

The primary cause of perianal abscesses is the repeated inflammatory stimulation near the dentate line of the anus, leading to infection. As the infection worsens, localized foci of infection form, resulting in the formation of pus and abscesses. Once a perianal abscess has formed, the patient will experience severe pain and will require prompt surgical treatment. If a definitive one-time surgery for the perianal abscess is chosen, it can be completely treated. Post-surgery, simply changing the dressing on the local wound will suffice, and the wound is expected to fully heal and recover. However, if an incision and drainage surgery was performed for the perianal abscess, a fistula may have already formed, requiring a second surgery for cutting and threading the fistula.