Bartholin’s Abscess: Causes, Diagnosis, and Treatments (2023)

A Bartholin’s abscess can occur when one of the Bartholin’s glands, located on either side of the vaginal opening, develop an infection. When the gland is blocked, a cyst will usually form. If the cyst becomes infected, it can lead to a Bartholin’s abscess.

A Bartholin’s abscess can be more than an inch in diameter. It usually causes significant pain. While most people with a Bartholin’s abscess completely recover, in some cases the cyst will return and become infected again.

Women of childbearing age are the most affected population. Nearly 2 percent of women will experience a Bartholin’s abscess in their lifetime.

There are two Bartholin’s glands, each about the size of a pea. The glands sit on either side of the opening of the vagina. They provide lubrication to the vaginal mucosa.

Doctors believe that bacteria, such as E. coli, and sexually transmitted diseases (STDs), such as chlamydia or gonorrhea, may cause the infections that can lead to a Bartholin’s abscess. If bacteria get into the gland, swelling, infection, and an obstruction may occur.

When fluid builds up in the gland, pressure increases on the area. It may take years for fluid to build up enough to form a cyst, but an abscess can form quickly after.

If the infection and swelling advance, the gland may abscess, which breaks open the skin. A Bartholin’s abscess tends to be very painful. It usually only occurs on one side of the vagina at a time.

A Bartholin’s abscess usually causes a lump to form under the skin on one side of the vagina. A Bartholin’s abscess will often cause pain during any activity that puts pressure on the area, such as walking, sitting down, or having sexual intercourse.

A fever may also accompany the abscess. The area of the abscess will likely be red, swollen, and warm to the touch.

To determine if you have a Bartholin’s abscess, your doctor will perform a physical exam. They will check for any lumps within the vagina that could indicate an abscess. They may also take a sample from the area to check for any STDs. STDs will need to be treated along with the abscess.

If you’re over the age of 40 or have already gone through menopause, your doctor may want to perform a biopsy on any masses found in the vagina to rule out other potential conditions. In rare cases, a Bartholin’s abscess can indicate cancer.

In its early stages, a Bartholin’s abscess can sometimes be treated at home using a sitz bath. A sitz bath is a warm, shallow bath you can give yourself in your bathtub or with a sitz bath kit. Soaking may not cure the abscess, but it can help ease your pain and discomfort.

To treat a Bartholin’s cyst, which can lead to an abscess, the Mayo Clinic recommends soaking in three or four sitz baths a day, for at least 10 to 15 minutes each.

It may take many days of sitz baths to treat an abscess because the opening of the Bartholin’s gland is very small, and it may close before drainage is complete.

Other home treatments for cyst care may help the abscess drain and heal on its own. Using a mix of tea tree and castor oil as a topical ointment on the abscess may promote drainage. Tea tree oil is known for its antibacterial properties, which may help clear an infection. Castor oil is thought to promote blood circulation in the affected area, which can reduce inflammation.

You can apply the tea tree and castor oil with a piece of gauze. Adding a hot compress on top of the gauze may make this remedy even more effective.

If you think you may have a Bartholin’s abscess, see your doctor. You can try sitz baths and cyst care at home, but the condition is unlikely to go away without medical treatment.

Typically, the abscess needs to be drained through surgery. In most cases, you can have this procedure at your doctor’s office under local anesthesia. General anesthesia in a hospital is also an option. Talk to your doctor about the best choice for you.

During the surgery, your doctor will make an incision in the abscess and place a catheter inside to drain the fluid. The catheter may remain in place for several weeks. Once the abscess heals, your doctor will remove the catheter or allow it to fall out on its own.

Since the abscess is likely the result of an infection, your doctor may prescribe antibiotics. However, antibiotics may not be necessary if the abscess drains properly.

It’s common for Bartholin’s abscesses to recur. If, after your treatment, the Bartholin’s abscess comes back repeatedly, your doctor may suggest a procedure called marsupialization.

Marsupialization is a surgery that’s similar to the other drainage procedure. But instead of allowing the incision to close, your doctor will stitch the incision open to allow for maximum drainage. They may use a catheter or pack the abscess with a special type of gauze that they will then remove the next day. Local anesthesia is an option during a marsupialization. The procedure can also be performed under general anesthesia. Your doctor will treat any infection present with antibiotics before the surgery.

If these treatments don’t stop the Bartholin’s abscess from recurring, your doctor may recommend having your Bartholin’s glands removed. This surgery is rare and requires general anesthesia in a hospital setting.

There’s no definitive way to prevent a Bartholin’s abscess. But practices such as safe sex, condom use, and good hygiene will help keep bacteria out of the area, which can help prevent infection. It’s also important to find out if you have an STD, and seek necessary treatment.

Maintaining a healthy urinary tract may also help prevent Bartholin’s cysts and abscesses from developing. Drink plenty of fluids throughout the day, and avoid waiting a long time to urinate. Cranberry supplements may help support good urinary tract health.

If a Bartholin’s abscess worsens and goes untreated, the infection could spread to other organs in your body. The infection may enter your bloodstream, a condition called septicemia. This condition is dangerous because the infection can be carried throughout your whole body.

If you have a fever over 103ºF, it’s important to seek medical attention. You should also seek medical help if the abscess ruptures abruptly, or if the pain doesn’t subside.

If you think you may have a Bartholin’s abscess, see your doctor. It’s especially important to seek medical care if you have a fever or if the pain starts interfering with your daily activities.

Once the abscess has drained, recovery time is minimal. Most women feel better within 24 hours after a Bartholin’s abscess has drained.

If your abscess needs surgical removal, your recovery time will vary depending on the details of your procedure. Expect to spend the first few days after the surgery reclining as much as possible. Be sure to rest and follow your doctor’s instructions. It’s important to let any incisions heal completely, and to take any antibiotics your doctor prescribes.

You should have no lasting effects from the abscess once it’s successfully treated, aside from possible skin scarring related to the treatment procedure.


Bartholin’s Abscess: Causes, Diagnosis, and Treatments? ›

When bacteria spreads to a cyst in one of the Bartholin's glands, it can cause a buildup of pus and lead to an abscess. In most cases, drainage is necessary. The Bartholin's glands are two small, pea-shaped glands located on each side of the vaginal opening that secrete fluid to lubricate the vagina.

What is the main cause of Bartholin abscess? ›

Experts believe that the cause of a Bartholin's cyst is a backup of fluid. Fluid may accumulate when the opening of the gland (duct) becomes obstructed, perhaps caused by infection or injury. A Bartholin's cyst can become infected, forming an abscess.

How do you diagnose a Bartholin abscess? ›

To determine if you have a Bartholin's abscess, your doctor will perform a physical exam. They will check for any lumps within the vagina that could indicate an abscess. They may also take a sample from the area to check for any STDs. STDs will need to be treated along with the abscess.

What is the best treatment for Bartholin abscess? ›

If the cyst becomes infected and an abscess (a painful collection of pus) develops, you may be prescribed antibiotics to clear the infection. Once the infection has been treated, a GP may still recommend having the cyst drained, particularly if the abscess is large.

What can be mistaken with Bartholin abscess? ›

Rare vulvar leiomyomas are often mistaken for Bartholin's cysts.

Is Bartholin abscess STD? ›

A Bartholin cyst is not a sexually transmitted infection (STIs). One of the causes of a Bartholin cyst is STIs, but the cyst itself is not considered an STI. If you feel a painful lump in your vaginal area, contact your healthcare provider so they can examine you for infection.

Can poor hygiene cause Bartholin cyst? ›

There is no sure way to prevent a Bartholin's gland cyst from forming. Good hygiene may play a role in prevention. However, sometimes the cysts appear no matter how good your personal hygiene. If you think you have one, tell your doctor right away.

What can be mistaken for Bartholin cyst? ›

Rare vulvar leiomyomas are often mistaken for Bartholin's cysts.

How long does a Bartholin abscess last? ›

Bartholin gland abscesses typically develop over two to four days and usually burst and drain after four to five days.

How can you tell the difference between a Bartholin cyst and an abscess? ›

A Bartholin's duct cyst may show no symptoms and require no treatment. If the cyst has grown large enough to cause discomfort, it may require drainage. An abscess is infected and must be drained. If the surrounding skin has become swollen, red, and tender, it's a sign of spreading infection (cellulitis).

How do you get rid of a Bartholin abscess without surgery? ›

Daily soaking in warm water, several times a day, may be adequate to resolve an infected Bartholin's cyst or abscess. After a surgical procedure to treat an infected cyst or abscess, soaking in warm water is particularly important.

What happens if a Bartholin abscess bursts? ›

If a Bartholin abscess bursts, it may resolve on its own in a few days without treatment.

Will a Bartholin abscess go away with antibiotics? ›

Bartholin's cyst or abscess affect up to 3 in 100 women and can be treated with antibiotics or with a small procedure/operation to drain the collection.

Are Bartholin cysts hard or soft? ›

It's a soft, painless lump that doesn't usually cause problems. See your GP if you develop a lump there – to get a diagnosis and rule out more serious conditions.

Is a Bartholin abscess hard? ›

Examination. The patient's gait may be wide-legged if the cyst is large; it may be uncomfortable for her to sit. There is usually a unilateral labial mass; it may be soft and fluctuant and non-tender (cyst) or tense and hard with surrounding erythema (abscess).

Can a Bartholin abscess make you sick? ›

Symptoms of an infected Bartholin's cyst include: Fever and chills. Pain that gets worse and makes it hard to walk, sit, or move around. Swelling in the area.

What is the most common cause of a Bartholin cyst? ›

They are mainly caused by obstruction of the gland's duct, which can be associated with infections (e.g., STIs) or trauma. Usually, Bartholin gland cysts are asymptomatic or associated with mild symptoms, like swelling and tenderness of lower vulvar vestibule, which worsens when infected.

How does a woman get a Bartholin cyst? ›

The Bartholin's glands secrete fluid that acts as a lubricant during sex. The fluid travels down tiny tubes called ducts into the vagina. If the ducts become blocked, they can fill with fluid and expand to form a cyst.

How do you unclog a Bartholin gland? ›

Treatment options your doctor may recommend include:
  1. Sitz baths. Soaking in a tub filled with a few inches of warm water (sitz bath) several times a day for three or four days may help a small, infected cyst to rupture and drain on its own.
  2. Surgical drainage. ...
  3. Antibiotics. ...
  4. Marsupialization.

What is the most common bacteria in Bartholin abscess? ›

Kessous et al has described the most common microbial pathogens associated with Bartholin abscesses. Escherichia coli was the most common (43.6%), followed by Staphylococcus aureus (6.4%), group B streptococci (4.8%), and Enterococcus spp. (4.8%).

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