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.
The bacteria that cause abscesses can come from:
- The surface of the skin at the site of injection
- Syringes that are used or dirty
- 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.
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.
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 & Symptoms | What 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.
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
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.
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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
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Leave a Reply
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D says: 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?
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Karen says:
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?
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Shannon says:
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..
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david says:
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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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?
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..
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
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?