A perianal abscess is a painful collection of pus near the anus, usually caused by an infected anal gland. It typically appears as a swollen, red, intensely tender lump, sometimes with fever. An abscess rarely resolves with antibiotics alone — the standard treatment is prompt drainage. The board-certified colorectal surgeons at Surgery Group LA, Dr. Yosef Nasseri and Dr. Moshe Barnajian, treat perianal abscesses at Cedars-Sinai in Los Angeles and manage the anal fistulas that can follow them. Call (310) 861-7493 — prompt treatment matters.
Treatment is incision and drainage — a small opening is made over the abscess so the infection can drain, giving rapid pain relief. Small abscesses can sometimes be drained in the office under local anesthesia; deeper or larger ones are drained in the operating room. Antibiotics may be added in certain situations, such as surrounding skin infection or immune compromise, but they are not a substitute for drainage. Because some patients later develop an anal fistula — a small tunnel between the anal canal and the skin — follow-up with a colorectal surgeon after drainage is important.
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Dr. Yosef Nasseri and Dr. Moshe Barnajian are board-certified colorectal surgeons at Cedars-Sinai who treat the full spectrum of anorectal conditions — abscesses, fistulas, fissures, and hemorrhoids — with expertise in sphincter-preserving techniques when an abscess progresses to a fistula.
Seek prompt medical care for severe anal pain with swelling, fever or chills, spreading redness, or difficulty urinating. An untreated abscess can enlarge, spread infection into deeper tissue, and cause serious illness — particularly in patients with diabetes or a weakened immune system.
Rarely. Once pus has collected, antibiotics cannot reliably clear it — the abscess needs to be drained. Delaying drainage usually means more pain and a larger abscess. Antibiotics are sometimes added after drainage in specific situations, but they are not a substitute for it.
The infection usually starts in a small anal gland. After drainage, the tract between that gland and the skin sometimes fails to close, leaving a tunnel that drains persistently — an anal fistula. If you notice ongoing drainage or a recurring abscess in the same spot, see a colorectal surgeon; fistulas need surgical treatment and do not heal on their own.
Relief is usually rapid once the abscess is drained. The small wound is typically left open to heal from the inside out over a few weeks, with sitz baths and simple wound care. Most patients return to normal activities within days; your surgeon will schedule follow-up to make sure the area heals fully and no fistula has formed.
Surgery Group LA's colorectal surgeons see patients at 8635 W 3rd St, Suite 880W, Los Angeles, CA 90048, with procedures performed at Cedars-Sinai Medical Center and its affiliated facilities. Call (310) 861-7493 — for severe pain with fever, seek emergency care.
Beverly Hills patients trust Surgery Group LA for expert, compassionate surgical care just minutes from home. Call (310) 861-7493 or request an appointment online, and our team will match you with the right board-certified specialist and verify your insurance before your visit.
