Does a recurrent perianal abscess occur in the same location?

Written by Yu Xu Chao
Colorectal Surgery
Updated on March 01, 2025
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The recurrence of a perianal abscess may not necessarily be in the same location, but it is possible. If the internal opening was not completely cleared during the first perianal abscess surgery, this could lead to reinfection of the anal glands and subsequently a recurrence of the perianal abscess.

In such cases, it is advisable to visit a hospital early for a perianal MRI to determine the position of the internal opening and the extent of the infected tissue. Then, a one-time radical surgery for the perianal abscess can be performed. After the surgery, it is crucial to consistently use medications like red oil gauze, anal wash, and golden ointment for dressing changes, to promote wound healing and avoid pseudo-healing.

Additionally, if a perianal abscess was completely cured once, poor diet, lack of sleep, or frequent alcohol consumption could potentially cause abscesses in other perianal areas later. This situation is quite common, so it is important for patients to maintain a light diet.

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Written by Chen Tian Jing
Colorectal Surgery
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How to treat recurrent perianal abscess?

If a perianal abscess has already been treated surgically, it is necessary to develop good dietary and bowel habits postoperatively to reduce the likelihood of recurrence. However, recurrence may still occur due to poor diet and bowel habits of the patient. If there is pain or discomfort at the site of the local wound of the perianal abscess, it is advisable to go to the hospital as soon as possible for an anal examination and perianal ultrasound to confirm if it has recurred. If it is confirmed to have recurred, early surgical treatment is necessary to prevent further expansion of the local infection focus or aggravation of the infection, which would increase the difficulty of treatment later.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.

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Written by Li Jiao Yan
Neonatology
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Can a perianal abscess in children heal by itself?

Although they are all perianal abscesses, each child's condition is different. The size of the perianal abscesses varies; some are as small as a grain of rice and may heal on their own, but there are also larger ones the size of a walnut, or even cause the entire buttock area to become swollen and red. Such cases require hospitalization, especially for younger children who also exhibit systemic symptoms like fever. They generally require hospital treatment. Meanwhile, it is recommended that parents take good care of the baby's perianal area, maintain a healthy diet and bowel habits, avoid diarrhea and constipation, ensure cleanliness around the anal area, and use soft, non-irritating wet wipes when cleaning the area to avoid friction injuries that could lead to infections, as the skin of small infants is very delicate.

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Written by Li Jiao Yan
Neonatology
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Causes of perianal abscess formation in babies

In pediatric outpatient surgery, perianal abscesses are not uncommon, and many parents visit the hospital daily for this issue. They wait, register, and change dressings. Once the wound heals, it often recurs after a while, leading to repeated incisions and drainage, persisting for several months. Eventually, the doctors say a fistula has formed and surgery is required. What exactly causes such troublesome perianal abscesses? The cause of perianal abscesses is not completely clear, but many affected children have been found to have deeper anal crypts than normal, so it's speculated that it may be related to this abnormality. In children under two years old, perianal abscesses mostly occur in boys. Some studies suggest that testosterone levels are higher in boys aged 1-3 months, coinciding with a peak period for perianal abscess incidences, leading to speculation that it may be related to the child’s hormone levels. In children over two years old, there is less gender bias in the incidence of perianal abscesses, and some cases are secondary to Crohn’s disease.

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Written by Chen Tian Jing
Colorectal Surgery
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Will surgery still be performed if a perianal abscess has ruptured?

After a perianal abscess ruptures on its own, a fistula-in-ano has formed, which cannot be completely cured by conservative medication. The main treatment method is still surgery, so further surgical treatment is required after the rupture of the perianal abscess. The surgical approach for a perianal abscess or fistula mainly involves an incision and seton technique, preserving the function of the local sphincter as much as possible while thoroughly removing the infection foci to allow the growth of fresh granulation tissue. Post-operation care requires attention to dressing changes, especially during the early stages of the wound when there may be secretions. It is crucial to thoroughly remove these secretions and apply appropriate hemorrhoids ointment or growth-promoting agents to facilitate the healing and growth of the local mucosa.