How do you know if an abscess is not healing? Warning Signs and Next Steps

October 1, 2025 •

4 min read

Approximately 1.7 million emergency department visits for skin and soft tissue infections, including abscesses, occur annually in the United States. If you have an abscess, knowing how do you know if an abscess is not healing? is crucial for preventing complications and ensuring a full recovery.

Quick Summary

An abscess is not healing if pain, swelling, and redness worsen instead of improving, especially if accompanied by fever, chills, or red streaks. Continued or foul-smelling pus drainage, along with a persistent feeling of being unwell, are also clear indicators that medical intervention is needed.

Key Points

Check for Worsening Symptoms: A non-healing abscess is indicated by increasing pain, swelling, or redness that spreads outward, rather than improving over time.
Monitor Drainage: Persistent, thick, foul-smelling pus is a sign of an active infection, unlike the clearing or stopping of discharge seen in healing.
Watch for Systemic Signs: A fever, chills, or feeling unwell are serious indicators that the infection may be spreading throughout the body.
Recognize Spreading Red Streaks: Red lines extending away from the abscess are a critical sign of a spreading lymphatic infection and require immediate medical attention.
Never Self-Treat Aggressively: Do not squeeze or try to drain an abscess yourself, as this can worsen the infection and push bacteria deeper into the tissue.

Differentiating Normal Healing from a Stalled Infection

Proper wound healing follows a predictable timeline, with symptoms like pain, redness, and swelling gradually improving over days or weeks. An abscess that is not healing properly, however, will show a reversal or stagnation of this process, with symptoms worsening or failing to resolve. Recognizing this distinction is the first and most crucial step towards preventing serious complications.

Critical Signs an Abscess is Not Healing

Monitoring the abscess for these specific signs can help you determine if the healing process is stalled or if the infection is worsening:

Increasing or Persistent Pain: While some initial tenderness is normal, increasing or throbbing pain that doesn't improve is a major red flag. If pain returns after an initial period of relief, the infection may be reestablishing itself.
Worsening Swelling and Redness: Normal healing involves swelling and redness decreasing over time. If the redness spreads outwards, forming a larger red halo or distinct red streaks, it's a sign the infection is spreading through the lymphatic system, a condition called lymphangitis.
Discharge that Changes or Persists: A healing abscess may drain some clear or pinkish fluid. If the drainage continues to be thick, yellow, or greenish pus with a foul odor, the infection is still active and unresolved.
Systemic Symptoms: A fever, chills, or a general feeling of being unwell (malaise) indicate that the infection is affecting your entire body, not just the localized area. This can be a sign of a spreading infection, or even sepsis in severe cases.
Formation of New Pockets or Bumps: The appearance of new, pimple-like bumps or tender areas near the original abscess can signal that the infection is spreading to adjacent tissue.

Abscess Healing Timeline: What to Expect

Once an abscess is treated, either by draining naturally or with medical intervention, the healing process typically begins fairly quickly. The timeline can vary based on the size and location of the abscess, as well as the individual's overall health.

Initial Treatment Phase: Within the first few days, you should notice a reduction in pain and pressure as the pus drains. Swelling and redness should begin to subside.
Tissue Regeneration Phase: Over the next couple of weeks, new tissue will start to form, often appearing pink or red. This is a normal part of the healing process.
Remodeling Phase: The final phase can last for weeks or even months as the new tissue strengthens and any scarring matures.

If your abscess isn't following this general trend, or if symptoms return after an initial period of improvement, it's important to seek medical advice. For further reading on wound care, you can visit the MedlinePlus wounds and injuries resource.

Healing Abscess vs. Non-Healing Abscess: A Comparison


Feature	Healing Abscess	Non-Healing Abscess
Pain	Decreases over time and becomes more manageable.	Increases or persists, often with a throbbing sensation.
Swelling & Redness	Gradually reduces, with the skin returning to normal color.	Spreads outward or worsens, potentially with red streaks.
Drainage	Reduces and stops, becoming clearer or pinkish.	Continues with thick, yellow, or green pus and a foul smell.
Systemic Symptoms	Fever and chills, if present, disappear within a few days.	Fever, chills, and fatigue persist or appear.
Appearance	Starts to close, with new tissue forming.	Enlarges, reopens, or develops new pustules.

When to Seek Immediate Medical Help

While many abscesses resolve with proper care, some require urgent medical attention to prevent serious, systemic complications like sepsis. You should seek immediate help if you experience any of the following:

A high fever (102°F or higher) or chills, especially if accompanied by increased pain or swelling.
Red streaks radiating away from the abscess, a sign that the infection is spreading.
An abscess on your face, near your spine, or in the groin or rectal area.
Difficulty swallowing or breathing, which could indicate a severe infection, particularly with a dental abscess.
A very large or deep abscess that is not responding to at-home care.
You have a weakened immune system, diabetes, or other chronic conditions.

Preventing Future Abscesses

While not all abscesses are preventable, practicing good hygiene and wound care can significantly reduce your risk. Keep any cuts or scrapes clean and covered to prevent bacteria from entering. Wash your hands frequently, and avoid squeezing or popping any bumps or boils, as this can push the infection deeper. For those with recurring issues, a medical professional can help identify underlying causes and create a management plan.

Conclusion

Knowing the difference between a healing abscess and one that is not is vital for protecting your health. By carefully monitoring your symptoms for worsening pain, spreading redness, or foul discharge, and by being aware of systemic signs like fever, you can take prompt action. When in doubt, it is always best to consult a healthcare provider to ensure the infection is properly and completely resolved.

Frequently Asked Questions

The first signs of a healing abscess include a noticeable reduction in pain and pressure, a decrease in swelling, and a lessening of redness in the affected area. Any discharge should also become less thick and eventually stop.

The healing timeline varies depending on the abscess's size and treatment method. Most treated abscesses show significant improvement within a few days and heal completely within one to two weeks with proper care.

While some minor abscesses might resolve on their own, medical drainage is often necessary, especially for larger or deeper abscesses. Ignoring a persistent abscess can lead to complications, so proper medical assessment is always recommended.

Yes, it is normal for an external abscess to form a scab as the wound closes and new tissue is rebuilt. However, if the scab is soggy or the area beneath it becomes more painful, it could be a sign of a lingering infection.

You should go to the hospital if you experience a high fever (102°F+), red streaks spreading from the wound, difficulty breathing, a severe increase in pain, or if you have a compromised immune system.

An untreated abscess can continue to grow, spread the infection to other tissues, and potentially lead to life-threatening complications like sepsis (blood poisoning) or endocarditis. The infection can also cause long-term tissue damage.

During the rebuilding stage of healing, the abscess wound will often look pink or red as new blood vessels and tissue form. The skin may also be slightly raised as it repairs itself.