From the Guidelines
Hydrogen peroxide is not recommended for cleaning an abscess, as it can damage healthy tissue and delay healing. The most recent and highest quality study, published in 2018 1, recommends incision and drainage as the primary treatment for complex abscesses, with antibiotic therapy added if systemic signs of infection are present. This approach prioritizes morbidity, mortality, and quality of life as the outcome.
Key Points to Consider
- Incision and drainage by a healthcare professional is the recommended treatment for abscesses, rather than using hydrogen peroxide or attempting home treatment.
- Gentle cleansing with sterile saline solution or mild soap and water is preferred for wound care after drainage.
- Antibiotics may be prescribed if the infection is severe or spreading, with empiric broad-spectrum antibiotic therapy recommended for complex abscesses 1.
- Over-the-counter medications like acetaminophen or ibuprofen can be used for pain management as directed.
Importance of Proper Care
Improper care of an abscess, including the use of hydrogen peroxide, can lead to complications or worsening infection. Therefore, seeking prompt medical attention is crucial for proper diagnosis and treatment. The 2018 consensus conference recommendations 1 emphasize the importance of evidence-based management of skin and soft-tissue infections to improve patient outcomes.
Evidence-Based Recommendations
The 2018 study 1 provides the most recent and highest quality evidence for the management of skin and soft-tissue infections, including abscesses. This study recommends against the use of hydrogen peroxide for cleaning abscesses and instead advocates for incision and drainage, followed by appropriate wound care and antibiotic therapy if necessary. This approach is consistent with the principles of minimizing morbidity, mortality, and improving quality of life.
From the Research
Suitability of Hydrogen Peroxide for Cleaning Abscesses
- Hydrogen peroxide (H2O2) is a topical antiseptic used in wound cleaning, which kills pathogens through oxidation burst and local oxygen production 2.
- It has been reported to influence biological behavior through multiple mechanisms, including alterations of membrane potential, generation of new molecules, and changing intracellular redox balance 2.
- A study found that daily dressing with 7% H2O2 solution promotes faster healing, stimulates granulation, and minimizes infection by oxidative stress 3.
- However, concentrated hydrogen peroxide can cause toxicity via corrosive damage, oxygen gas formation, and lipid peroxidation, leading to local tissue damage and other complications 4.
- Topical application of H2O2 can modulate wound healing, but its effects are dependent on concentration, with low concentrations enhancing angiogenesis and wound closure, while high concentrations retard wound closure 5.
- A community-based study found that people who inject drugs often self-treat abscesses using methods including applying hydrogen peroxide, with most self-treated abscesses healing without further intervention 6.
Concentration and Usage Considerations
- The use of hydrogen peroxide for cleaning abscesses requires careful consideration of concentration, as high concentrations can cause damage and complications 4, 5.
- Low concentrations of H2O2, such as 7%, have been shown to promote wound healing and minimize infection 3.
- The application of H2O2 should be done with caution, taking into account the potential risks and benefits, and under the guidance of medical professionals if possible.
Alternative Treatment Options
- Medical treatment for abscesses is often underutilized, with many individuals opting for self-treatment methods, including the use of hydrogen peroxide 6.
- Barriers to medical treatment, such as long wait times and fear of being identified as a person who injects drugs, highlight the need for expanded community-based access to education and treatment services 6.