The AP Guide to Abscess Prevention

[Gavin Kane]

Oh my god, what the hell is that lump in my ass? Damnit; it is huge, red, swollen and burning to the touch, wtf is this? I hope this has never happened to any of you but if it has, this article is written as a prevention article about abscesses as well as covering procedures if it does happen.

So what is an abscess? An abscess is a localized collection of pus in any part of the body, usually caused by an infection. Abscesses develop when an area of tissue becomes infected and the body is able to prevent the infection and keep if from spreading. During this process ‘pus’ forms, which is an accumulation of fluid, living and dead white blood cells, dead bacteria or other foreign invaders or materials.

Most abscesses are septic (caused by infection) but sterile abscesses can also occur which are not caused by germs but by non-living irritants such as drugs. If an injected drug, especially oil based ones such as anabolic steroids are not fully absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess. Sterile abscesses are likely to turn into hard, solid lumps as they scar, rather than pockets of pus.

Superficial abscesses are readily visible and as stated above, are red, swollen, painful and warm. Abscesses in other areas of the body may not be obvious and may produce only generalized symptoms such as fever and discomfort. A sterile abscess may cause only a painful lump, for example deep gluteus injections. If the abscess is small enough, ½ inch or less, applying warm compresses/hot soaks to the area for about 30 minutes ed can help.

Sometimes though, it will not disperse and you need medical attention. At this point a culture or examination of any drainage from the lesion will help identify what is causing the abscess. The infection can spread to the tissues under the skin and eventually enter the bloodstream, resulting in septicaemia which can be very serious and life threatening. Unlike other infections, antibiotics alone will not cure a well developed abscess. In general an abscess must be cut open and drained by a doctor in order for it to improve.
Once the sore has drained, the doctor will insert some packing into the remaining cavity to minimize any bleeding and keep it open for a day or two. With time the cavity will heal, but you can expect to be out of the gym for weeks. When it does heal, scar tissue will form, therefore, no more injections in that area.

Infection can be a problem with any type of injection, due to the nature of having to transverse though the protective barrier of the skin. It is extremely important to inject under sterile and sanitary conditions to avoid transmitting infectious foreign organisms into the body. The most common infective complication when injecting Anabolic Steroids is an abscess.

Researchers Rich et al. (1999) report of a case of a 26 year old anabolic steroid user who did not use sterile injection techniques and wound up with an injection-related thigh abscess. This individual reported sharing multi-dosage vials with two other weightlifting colleagues who also developed infections. It took approximately 3-4 months and a trip to the emergency room to control the infection and begin healing.

Two cases of thigh abscesses were discovered in male and female professional weight lifters who injected a veterinary preparation of stanozolol contaminated with Mycobacterium smegmatis. Two case reports of staphylococcal gluteal abscesses developed in young bodybuilders 18 and 21 years of age.

Reported infections associated with anabolic-androgenic steroid injection include abscesses attributable to Mycobacterium smegmatis, Staphylococcus, Streptococcus, and Pseudomonas organisms as well as HIV, hepatitis B, and hepatitis C. These infections are primarily related to nonsterile injection technique, shared injection equipment, and are avoidable with appropriate prevention techniques. Education is needed to prevent infectious complications such as abscesses and blood-borne pathogens among anabolic-androgenic steroid injectors.

The Steroid Control Act of 1990 removed the ability of medical doctor’s to prescribe and monitor steroid use in athletes. This has lead to a boom in black market products, most of which are of questionable quality and are often produced under unsterile manufacturing conditions. Most bodybuilders do not have the means or education necessary to recognize counterfeits or have all of their drugs tested in a laboratory for purity. As a result, people are gambling with their health by using steroids they procure from black market sources. Sometimes the product is fairly pure and the user experiences the expected results. Then again, how often do you hear about a bodybuilder doing a cycle and experiencing none of the expected gains? Usually the guy feels too foolish to tell everybody, "Hey everybody, look at what a fool I am. I just spent a ton of money on steroids, bought them from someone I didn’t know personally, and they turned out to be fake! In fact, I have no idea what I just injected into my body over the last several weeks!" This is not the kind of thing an aspiring young bodybuilder brags about.

Sometimes the mysterious oil in the bottle is innocuous; sometimes it contains infectious agents such as rare bacteria and toxic chemicals. There are several reports in the literature of bodybuilders getting abscesses from "atypical bacteria". Atypical bacteria are ubiquitous in the environment, are able to survive for prolonged periods without nutrients, such as in a vial of steroids, and are very capable of causing difficult to treat infections at the site of injection.

A word of caution is all I offer. There are proper ways of administering injectable drugs that reduce the risk of infection. There are also life saving precautions that must be taken by bodybuilders using steroids such as not sharing needles and not sharing multi-dose vials. If you are willing to put in the effort and pay the price to get illegal injectable steroids, at least take the time to educate yourself about the proper way to administer them as well as the risks involved with their use.

Precautions to take when injecting anabolic steroids:

1) Inject under strict sanitary conditions, this means not in your dirty ass bathroom you haven’t clean in a year or near your dirty laundry and sweat socks.

2) Use correct injection technique, inject intramuscularly, aspirate the syringe and use large main, muscle groups only.

3) Avoid sharing or reusing needles. Sharing is for junkies, don’t do it. As for reusing, needles are cheap and readily available right here on our board so don’t do it. Use one needle for withdraw and then remove, put on a new needle and inject.

4) Make sure your skin is clean. Inject right after a shower or use an alcohol swab/wipe to clean the area as well as the top of all multi-injection vials.

5) Check your source for legit products. Some UG gear is made in horrible locations that are not sanitary, do some research to make sure what you are putting in your body is legit and well manufactured.

References
Evans, NA. Local complications of self administered anabolic steroid injections. Br J sports Med. 1997 Dec; 31(4) 349-350
Al-Ismail K et al. Gluteal mass in a bodybuilder; radiological depiction of a complication of steroid use. Eur Radiol. 2002 Jun; 12(6); 1366-9
Plaus WJ, Hermann G. The surgical management of superficial infections caused by atypical myobacteria. Surgery. 1991; 110: 99-105
Maropis C, Yesalis CE. Intramuscular abscess; another anabolic steroid danger. They Physician and Sports Medicine. 1994; 22:105-110
TheDoctor. MuscleTalk.co.uk. Injections and Infections. 2005. article.asp
Rich et al. Med. Sci. Sports Exerc. 31(2) 207-209, 1999

[desolation]

Interesting that this article is up now as I have just been scouring the net for some info on this. I tried the Stealth Injectables last Saturday-250mg test e and 200 eq in the right thigh. Everything went smooth with almost no pain but as the day went on my entire thigh started swelling especially around the knee. Went to sleep and woke up and the swelling was down so I thought there would be no problems. Well, after 8 hours at work my knee was huge, slightly red and fairly hot. It seems as though the the gear moved down from mid thigh to my knee and just settled there. There is no swelling or pain at the injection site. This morning the swelling is down again but my knee area is still large and solid to the touch as if the gear is just solidifying there. The area is red also but I have no symptoms of the flu and feel fine otherwise. Wondering if I should go to the doc's today and tell them my body isnt accepting a b12 shot?

[Gavin Kane]

Do you have any anti-biotics on hand? Are you running a fever? Is the area red and hot to the touch?

[desolation]

The area was red and hot yesterday and it is slighltly warm and mabye a tad pinker than the other leg today. I didint have any antibiotics but i slammed lots of garlic, oregano oil, graprfruit seed extract, etc. It is very painfull to walk and the more I stand the more my knee swells but besides that I feel fine. The swelling subsides overnight, probably from the leg being up, then the swelling increases throughout the day untill it looks like I have a large lump hanging where my knee should be. Actually, the majority of it seems to be right above my knee and it is solid and very painfull to the touch.

[Gavin Kane]

First thing I would do is try to drain it with a 21 or 22g pin. See if you can withdraw any puss. If so you are going to have to see the doc for antibiotics or it will not heal. Your body is possibly fighting an infection and waiting it out is only going to make it worse.

[desolation]

I think the infection is gone as this morning there is no heat or discoloration whatsoever. So I just have to wonder about the hard lump above the knee, I think it may dissolve after awhile otherwise ill try and aspirate something from it. I think my leg didint like 2 ccs at once, also my hand was shaking like fuck when I injected so that wasnt good. Many thanks for you help-

[Jarconis]

to bump this, sometimes guys do not go deep enough on the inject, and this will cause abcess like symptoms until the oil dissapates, but still, I would try to locate a z-pak. Better safe then sorry.

[Grunt76]

Instead of having antibiotics on hand in case something like this happens, you can also dose some colloidal silver, which acts as an immune system all on its own. The guys who use the stuff are NEVER sick and of course they would fight an infection like this much much better. At least probably prevent any septicemia, and of course any PCT or contest prep flu or anysuch.

Here's my article on it: Becoming infection-proof. Impossible?