An abscess is a pocket of infection containing pus, trapped under the skin, surrounded by inflamed tissue. Medical research shows that abscesses usually occur long after the initial piercing—on average from four to twelve months later. 

An abscess can be created when jewelry is removed from an infected piercing, thus eliminating the pathway for pus and matter to leave the body, trapping the infection inside. Occasionally an infection will occur and an abscess will form adjacent to a piercing when jewelry is in place. This is more apt to happen if your jewelry constricts the tissue because the initial size was too small, or because of an unexpected amount of post-piercing swelling.

Identifying an Abscess
•    Tenderness, pain, inflammation, heat, and swelling at the site of a hard localized mass (feels like a marble under the skin). In the case of nipples, the duct system can result in an abscess forming inches away from your piercing.
•    Redness or darkening of skin (if the abscess is closer to the surface, rather than very deep underneath).
•    Worsens over time and may cause nausea, fever, and chills if severe.
•    Infections caused by the bacterium Mycobacterium abscessus have been described as cold abscesses because of the absence of tenderness and inflammation. This means you could have an abscess when a hard mass is present, even if you don’t have any of the other symptoms.

What to Do for an Abscess
•    For milder cases (a localized abscess without systemic symptoms such as fever or nausea), saline soaks or application of warm-to-hot moist compresses might cause spontaneous drainage.
•    Switching to jewelry of a thinner gauge may also help to encourage drainage if the mass is close to an opening of the piercing.
•    Elevating the area and taking over-the-counter analgesics according to package instructions may help to make you more comfortable.

If the abscess does not drain within forty-eight hours as a result of these steps, or if symptoms worsen, a visit to the doctor is urgent. Infection can spread to deeper tissue or the bloodstream if untreated. This is serious!

•    If red streaks emanate from the site, the lump is larger than 1/2 inch across, or a fever is present, you must visit the emergency room right away, as the infection may have spread and become cellulitis (discussed next).
•    An incision and drainage procedure to empty the pus-filled cavity is commonly needed. If the abscess is in close proximity to the piercing, the channel may be lost (cut) in the process.
• Antibiotics alone will not necessarily resolve an abscess. It usually must be cleared out as well. In fact, doctors sometimes drain an abscess without prescribing antibiotics.

Disclaimer: These suggestions are not to be considered a substitute for advice from a medical professional.