Anytime you get a new lump under your skin, you need to evaluate it and decide if you need medical attention. Whether you live with hidradenitis suppurativa (HS) or not, new bumps can be a cause for concern.

If you think you have an abscess or a cyst, here’s what you need to know. It’s important to get a professional opinion about your lump or bump, too, because only a healthcare provider will be able to tell you exactly what is going on and what kind of treatment you need.

1. An Abscess Contains Pus, a Cyst May Contain Many Things

An abscess is a buildup of pus anywhere in your body. When your immune system is fighting something, like a bacterial infection, white blood cells rush to that area. This can cause that area to become inflamed and eventually form a pocket where white blood cells, dead tissue, fluid, and more can collect. There are different types of abscesses, but they’re all pockets of pus in your body.

A cyst, on the other hand, is a pocket filled mostly by fluid, though it can also have parts inside that are partly or completely solid. Like abscesses, cysts can be located almost anywhere on your body.

2. Abscesses Are Usually Caused by Infection, Cysts Have Other Causes

An abscess is almost always caused by an infection. The bacteria Staphylococcus is usually the culprit. Your body’s response to this bacteria causes the flood of white blood cells to the area, the inflammation, and the ensuing abscess.

On the other hand, there are many different common types of cysts, and most of them seem to appear without a known cause. If your doctor does determine the cause, it’s usually a blocked duct, an injury where something impacted the area, a parasite, or damaged or abnormal cells.

Hidradenitis suppurativa can cause both cysts and abscesses. If you aren’t diagnosed with the condition but you have unusual lumps or bumps in your armpits, thighs, or groin, you may want to ask your doctor to evaluate you for the condition so you don’t miss any early symptoms.

3. Cysts Can Become Abscesses, Abscesses Don’t Become Cysts

Sometimes, a cyst can become infected and turn into an abscess. If this happens, it usually means that bacteria have gotten inside the cyst and the immune system is trying to fight them. Since the cyst is already a pocket, the pus has somewhere to be stored and it can become an abscess.

On the other hand, there are no known cases of an abscess becoming a cyst.

4. Abscesses Are Treated by Draining, Cysts May Require Removal

In order to get rid of an abscess caused by an infection, your doctor may need to remove the pus that’s inside it so it can heal. Sometimes abscesses close to the skin will drain and heal on their own. Most of the time, though, your doctor will have to perform a procedure to drain your abscess as part of your abscess treatment. They’ll numb the area and then remove what is inside. They may leave the abscess open so it can continue to drain. Your doctor might also give you an oral antibiotic to prevent further infection. Note that the treatment of HS abscesses is different.

There’s some disagreement among healthcare professionals as to whether cysts need to be treated. Some argue that the risk of complications is too high if you leave a cyst alone. Others say that some cysts don’t need to be treated if they aren’t causing any issues. The best option is to have a doctor look at your cyst and help you decide what to do. They may decide to remove your cyst surgically to avoid any chance of complications.

5. Abscesses Require More Urgent Treatment Than Cysts

Depending on what type of abscess you have, you may need to get it drained before it bursts. Abscesses burst when pus builds up inside them beyond what they can hold. Besides being quite painful, a burst abscess can spread infection to other areas of your body. In the case of dental abscesses, this can be life-threatening. If you think you have an abscess, you may be able to try and treat it at home for a couple of weeks. However, if you still have the abscess after that much time has passed, you’ll need to see a doctor for help.

While cysts require evaluation by a healthcare provider, as mentioned above, they usually aren’t so urgent. As long as the area isn’t sore, red or otherwise discolored, you don’t need urgent or emergency care.

6. Abscesses Are More Likely To Hurt Than Cysts

Not all abscesses are painful, but pain is one of the most common symptoms people have when they experience them. This is particularly true when the abscess is located deeper in your tissues.

Cysts may or may not hurt, depending on where the cyst is located, how large it is, and what kind of cyst it is. If it doesn’t hurt, it may just seem to be an odd bump under your skin that suddenly appeared one day.

Talk to a Doctor

The best thing you can do for any lumps or bumps you find under your skin is to talk to a doctor. If your lump is painful, tender, causing skin discoloration, looks yellow or white inside, or is accompanied by a fever and chills, try to see a doctor right away, because these are symptoms of an abscess.

If you have recurring lumps and bumps, or cysts and abscesses, and they’re all in places where skin touches other skin, talk to your doctor about hidradenitis suppurativa. Sometimes, people end up living with this inflammatory skin condition for years without getting the proper diagnosis. This can lead to complications like extreme pain, scar tissue that builds up and hinders some of your movements, or the inability to sit or walk comfortably.

You may need to ask to see a dermatologist to get an accurate diagnosis of hidradenitis suppurativa. These skin doctors are trained to identify the condition and differentiate your symptoms from other skin conditions. If a dermatologist finds that you have HS, they will discuss treatment options that can help improve your symptoms.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa, more than 46,000 people with HS and their loved ones come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

Have you had abscesses or cysts that were later diagnosed as hidradenitis suppurativa? How long did it take you to get diagnosed? Share your experience in the comments below, or start a conversation by posting on your Activities page.