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What is a heroin abscess?

Answered by Dr. David Zoeller M.D. 4

An abscess is a mass beneath the skin that is filled with pus, bacteria, and debris. Abscesses form when bacteria get underneath the skin and cause an infection.

People who use heroin get abscesses from shooting up because the needle puncture introduces bacteria into the skin and surrounding tissue. The bacteria causes an infection within the layers of the skin or just underneath the skin’s surface.

Picture of heroin abscess forming underneath the skin

The bacteria that cause abscesses can come from:

  1. The surface of the skin at the site of injection
  2. Syringes that are used or dirty
  3. The drugs themselves or contaminants

Abscesses are common among IV drug users. Substance Use & Misuse Medical Journal reports that one in three IV drug users had a recent abscess. (See the heroin veins article for more on other issues with IV drug use).

Even though they are closely associated with heroin use, shooting up any drug can cause an abscess underneath the skin.

Page Topics
Identifying an Abscess | Risks | Symptoms | Caring for an Abscess | Abscess Pus | Treatment

What does an abscess look like in an IV heroin user?

Abscesses from heroin use start as a small, raised bump that is slightly redder than the surrounding skin. As the infection gets worse, the bump grows larger with a round or oval shape and a distinct center.

At the center, the abscesses look like a pimple, and some of the pus within may be visible. You should never pop an abscess, though, because it can cause serious damage to your skin.

Stages of Heroin Abscesses

If the abscess is not drained and treated, the infection will spread to the surrounding tissue. The skin around the abscess usually becomes a darker red, eventually turning purple, green, and even black as the infection worsens and the tissue decays.

Is an abscess from IV drug use serious?

Yes, an abscess is an active infection in the body, and they are dangerous if they are not treated right away. Fortunately, when they are properly treated with antibiotics, abscesses heal within a few weeks.  

Abscesses do more than just damage the skin. They spread bacteria throughout the body, causing infections in the blood, heart and other vital organs.

The side effects from a heroin abscess include sepsis, skin death and endocarditis

What are heroin abscess symptoms?

Most symptoms occur in the area where the heroin was injected, including:

  • Redness
  • Swelling
  • Warmth
  • Itching
  • Pain
  • Pus discharge

If you ignore the infection and it gets worse, the bacteria will eventually spread throughout the body. You may notice systemic symptoms, such as:

  • Chills
  • Fever
  • Swollen lymph nodes
  • Increased heart rate

Not all abscesses require medical attention. However, once the infection reaches a certain point, it requires antibiotics and treatment from a medical professional.

Signs & SymptomsWhat to Do
– Minor redness and swelling immediately after injection
– No bump or raising
This is not an abscess. Stop injecting in the area and use a warm compress. Keep the skin clean with soap and water.
– Injection site is bright red and raised above the skin
– Surrounding area is swollen,
itchy or painful
Stop injecting in the entire limb. Keep the area clean with soap and water. Watch closely for any changes.
– Abscess is larger than 1/4 inch diameter, and getting larger
– Injection site is red hot and very painful
Get treatment from a medical professional. They can help score and drain the abscess to prevent the infection from getting worse or spreading.
– Chills, fever or swollen lymph nodes
– Limb becomes pale or blue
Go to the Emergency Room immediately. The infection is spreading and could already be impacting your vital organs.

Can you do heroin abscess drainage at home?

Do not pop an abscess or attempt to drain it at home. Lancing and draining should always be done by a medical professional. Doing it yourself could cause further damage to the skin and make the infection spread faster.

Unfortunately, many people who inject heroin avoid going to the doctor to treat an abscess because of the stigma and cost.

To temporarily relieve abscess pain and swelling:

  • Stop injecting in the area
  • Use a warm compress
  • Elevate the limb
  • Stay hydrated

What is abscess pus from heroin?

Pus is a liquid made up of white blood cells that helps protect your body against bacterial infections In a heroin abscess, pus forms inside of the cavity to fight the infection.

If an abscess needs to be drained, doctors make an incision and drain out the pus, then pack the open wound with gauze and allow it to heal.

Abscesses that aren’t treated can rupture, causing pus to leak out. This creates an open wound that is even more vulnerable to infection.

Image of Pus Draining from a Heroin Abscess

How long can an abscess from shooting up go untreated?

Do not let heroin abscess or infected meth sores go untreated. Infections can spread throughout the body within days. If you start treating the infection as soon as it arises, the abscess will heal with minimal damage to the skin.

Heroin abscesses are a symptom of a much bigger problem – heroin addiction. Treating your abscess means treating the addiction that caused the abscess in the first place too.

Get help for your physical symptoms and address the underlying factors that are causing addiction in the first place.

Top Heroin Rehab Centers

  • Heroin Addiction Rehab Center in Tennessee – people fly from across the country
  • Heroin Rehab in Kentucky
My scars tell a story. They remind me of when life tried to break me but failed.

JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the fields and their own personal recovery.

  • Baiu, I., & Melendez, E. (2018). Skin Abscess. JAMA, 319(13). https://doi.org/doi:10.1001/jama.2018.1355

    Callahan, T., Schecter, W., & Horn, J. (1998). Necrotizing Soft Tissue Infection Masquerading as Cutaneous Abscess Following Illicit Drug Injection. Archives of Surgery, 133(8), 812–818. https://doi.org/doi:10.1001/archsurg.133.8.812

    Fink, D. S., Lindsay, S. P., Slymen, D. J., Kral, A. H., & Bluthenthal, R. N. (2013). Abscess and self-treatment among injection drug users at four California syringe exchanges and their surrounding communities. Substance use & misuse, 48(7), 523–531. https://doi.org/10.3109/10826084.2013.787094

    Gilbert, A.R., Hellman, J.L., Wilkes, M.S. et al. Self-care habits among people who inject drugs with skin and soft tissue infections: a qualitative analysis. Harm Reduct J 16, 69 (2019). https://doi.org/10.1186/s12954-019-0345-z

    Lavender, T. W., & McCarron, B. (2013). Acute infections in intravenous drug users. Clinical medicine (London, England), 13(5), 511–513. https://doi.org/10.7861/clinmedicine.13-5-511

    Murphy, E. L., DeVita, D., Liu, H., Vittinghoff, E., Leung, P., Ciccarone, D. H., & Edlin, B. R. (2001). Risk Factors for Skin and Soft-Tissue Abscesses among Injection Drug Users: A Case-Control Study. Clinical Infectious Diseases, 33(1), 35–40. https://doi.org/https://doi.org/10.1086/320879

    NIDA. 2021, April 13. What are the medical complications of chronic heroin use?. Retrieved from https://www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use on 2021, June 11

    Pieper, B., & Hopper, J. A. (2005). Injection drug use and wound care. The Nursing clinics of North America, 40(2), 349–363. https://doi.org/10.1016/j.cnur.2004.09.010

    Russell, F. M., Rutz, M., Rood, L. K., McGee, J., & Sarmiento, E. J. (2020). Abscess Size and Depth on Ultrasound and Association with Treatment Failure without Drainage. The western journal of emergency medicine, 21(2), 336–342. https://doi.org/10.5811/westjem.2019.12.41921

Disclaimer

All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.

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  • Karen says:
    October 3, 2021 at 9:56 pm

    Can a previous Heroin addict suddenly have a heroin abscess that’s requiring an I&D with antibiotics or is this a current use? It started about 2 weeks ago and After today it got really bad and she had to go to the emergency room. Trying to get real answers here on if this can occur in remission or is it current?

    Reply
    • Shannon says:
      November 8, 2021 at 6:08 am

      You only get an abscess if you’ve done something to cause it..bacteria won’t just appear under the skin confined in that one spot..if the person is run down from the way abstinence hits you for six when you first start abstaining then i would expect them to be prone to things like spots and sores until their immune system bounces back,but an abscess is a different beast.How long have they abstained for,it could be that they’re majorly unlucky in that the last hit they had caused the abscess..

      Reply
      • david says:
        December 4, 2021 at 10:24 pm

        hi, i’m an addict who’s never shot, but i popped what i thought to be pimple on face , and it has grown hard around open wound portion, which drains out pus once it is opened up by using warm washcloth as a compress. what should i do next? please help

  • D says:
    December 2, 2021 at 8:39 am

    I have two lumps one on my wrist and the other on my hand but neither are red or hot. They were painful at first but now they’re just there. Are they abscesses?

    Reply
  • D says:
    December 2, 2021 at 8:39 am

    I have two lumps one on my wrist and the other on my hand but neither are red or hot. They were painful at first but now they’re just there. Are they abscesses?

    Reply
  • Karen says:
    October 3, 2021 at 9:56 pm

    Can a previous Heroin addict suddenly have a heroin abscess that’s requiring an I&D with antibiotics or is this a current use? It started about 2 weeks ago and After today it got really bad and she had to go to the emergency room. Trying to get real answers here on if this can occur in remission or is it current?

    Reply
    • Shannon says:
      November 8, 2021 at 6:08 am

      You only get an abscess if you’ve done something to cause it..bacteria won’t just appear under the skin confined in that one spot..if the person is run down from the way abstinence hits you for six when you first start abstaining then i would expect them to be prone to things like spots and sores until their immune system bounces back,but an abscess is a different beast.How long have they abstained for,it could be that they’re majorly unlucky in that the last hit they had caused the abscess..

      Reply
      • david says:
        December 4, 2021 at 10:24 pm

        hi, i’m an addict who’s never shot, but i popped what i thought to be pimple on face , and it has grown hard around open wound portion, which drains out pus once it is opened up by using warm washcloth as a compress. what should i do next? please help

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Dr. David Zoeller M.D.

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Dr. Zoeller has been practicing internal medicine for more than 30 years with a special interest in brain and addiction science. He is a Diplomate of the American Board of Pain Medicine and certified in addiction medicine by the American Board of Preventive Medicine. After starting his career as a Chemical Engineer at IBM, Dr. Zoeller graduated from the Louisville School of Medicine. He currently serves as an associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University.

  • Medical executive at JourneyPure, a nationally-recognized drug & alcohol treatment center with locations across the country
  • 30 years as a medical doctor
  • Certified in addiction medicine by the American Board of Preventive Medicine
  • Diplomate of the American Board of Pain Medicine
  • Associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University
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