Anal Gland Infection

Anal gland infection represents a significant progression beyond simple impaction, occurring when bacteria colonize and proliferate within the stagnant secretions of blocked or poorly emptying anal sacs. This infectious process transforms what might have been a manageable impaction into a more painful and potentially serious condition requiring antibiotic therapy and sometimes additional interventions. The anal glands, positioned on either side of the anus, normally contain secretions that empty during defecation, but when this natural process fails, the accumulated material provides an ideal environment for bacterial growth. Anal gland infections cause substantial discomfort for affected dogs and can progress to abscess formation if not treated appropriately and promptly.

The development of anal gland infection typically follows a predictable pathway beginning with impaction or inadequate gland emptying that allows bacteria normally present in the anal region to enter and multiply within the gland. As the bacterial population grows, the immune system responds with inflammation, causing the characteristic swelling, pain, and heat associated with infection. The infected gland contents become purulent, transforming from the normal oily brownish secretion to a material that may appear yellow, green, gray, or bloody. Without treatment, the pressure from accumulated pus and inflammatory products can eventually cause the gland to rupture through the overlying skin, creating an open draining wound.

The impact of anal gland infection on affected dogs extends beyond the physical discomfort to affect overall wellbeing and daily function. Dogs with infected anal glands typically display obvious pain, often yelping or snapping when the area is touched or when attempting to defecate. The intense discomfort may cause changes in behavior, appetite, and activity levels as the dog attempts to avoid anything that exacerbates the pain. Systemic signs including fever, lethargy, and reduced appetite may develop as the body mounts an immune response to the infection. The quality of life impact makes prompt recognition and treatment essential for resolving the infection before complications develop.

Fortunately, anal gland infections respond well to appropriate treatment when identified before abscess formation or rupture occurs. Treatment typically involves expressing the infected material from the glands, administering systemic antibiotics to combat the bacterial infection, and providing pain management during recovery. Most dogs show significant improvement within a few days of starting treatment, with complete resolution over one to two weeks. However, underlying factors predisposing to impaction must be addressed to prevent recurrence, as dogs that develop infection once face elevated risk for future episodes if the root causes remain unmanaged.

The primary cause of anal gland infection is bacterial invasion and proliferation within anal sacs that have become impacted or are emptying inadequately. Under normal circumstances, the anal glands empty regularly during defecation, preventing the accumulation of secretions that could serve as a growth medium for bacteria. When impaction occurs, the stagnant material within the glands provides nutrients and an appropriate environment for bacterial multiplication. The bacteria responsible are typically those normally residing on perianal skin or in fecal material, including Escherichia coli, Streptococcus, Staphylococcus, and various anaerobic organisms. Once established, the bacterial population grows rapidly within the warm, nutrient-rich environment of the impacted gland.

Genetic and anatomical factors that predispose dogs to anal gland impaction indirectly contribute to infection risk by creating the conditions necessary for bacterial overgrowth. Dogs with anatomically small or poorly positioned anal gland ducts experience inadequate natural emptying, allowing secretions to accumulate and become colonized by bacteria. Breeds with known predisposition to impaction correspondingly face higher rates of infection as a complication of their underlying anatomical issues. Some dogs may have inherited variations in immune function or secretion composition that affect their ability to resist bacterial colonization of the glands, though specific genetic markers for infection susceptibility have not been identified.

Environmental and lifestyle factors contribute to infection development through their effects on impaction risk and bacterial exposure. Poor hygiene in the dog's environment increases bacterial load around the perianal region, elevating the risk that bacteria will enter glands that are not emptying properly. Dogs with chronic soft stools due to dietary factors or gastrointestinal disease face higher impaction rates and consequently higher infection risk. Obesity both predisposes to impaction through fatty tissue accumulation around the glands and may affect immune function, potentially reducing the dog's ability to contain bacterial growth. Environmental stress or conditions that compromise immune function can allow infections to establish more readily in glands that might otherwise have resisted colonization.

Underlying health conditions significantly influence the likelihood of anal gland impaction progressing to infection. Dogs with allergic skin disease experience chronic inflammation that affects anal gland tissue, potentially compromising local immune defenses and allowing bacterial overgrowth. Hypothyroidism and other metabolic disorders may alter secretion composition or immune function in ways that favor infection. Immunosuppressive conditions or medications reduce the body's ability to control bacterial populations, increasing infection risk throughout the body including the anal glands. Chronic skin infections elsewhere on the body indicate an overall tendency toward bacterial overgrowth that may extend to the anal region. Diabetes mellitus predisposes to infections generally and may increase anal gland infection risk.

The mechanism by which infection establishes and progresses involves a cascade of bacterial invasion and immune response. Bacteria enter the anal gland either through the duct from the anal canal or potentially through microscopic breaks in the gland lining caused by the pressure of impaction. Once inside, they multiply using the accumulated secretions as nutrients. The immune system detects the bacterial invasion and responds with inflammation, sending white blood cells to the area that produce pus as they combat the infection. The inflammatory response causes tissue swelling that further occludes the duct, preventing drainage and allowing pressure to build. Without treatment, this pressure eventually exceeds what the gland wall can withstand, causing rupture through the path of least resistance, typically the overlying skin.

Early warning signs of developing anal gland infection may be subtle initially but typically progress rapidly to more obvious symptoms as the infection establishes. Dogs in the earliest stages may display increased attention to the perianal area, including more frequent licking or attempts to bite at the region around the tail base. A slight increase in scooting behavior or mild reluctance during defecation might be observed but easily attributed to simple impaction rather than infection. Some observant owners notice a change in odor from the anal region, as infected gland contents have a distinctly more foul smell than normal secretions. These early signs provide a narrow window for intervention before the infection progresses to more severe presentation.

The most common symptoms of established anal gland infection include pronounced pain, swelling, and behavioral changes reflecting significant discomfort. Affected dogs typically show obvious pain when the perianal region is examined, touched, or even approached, potentially snapping, yelping, or attempting to move away. Swelling becomes visible on one or both sides of the anus, creating an asymmetric appearance or obvious fullness beneath the skin. The overlying skin may appear reddened, warm to the touch, and possibly thinned or discolored if abscess formation is developing. Scooting behavior may decrease compared to simple impaction because the associated pain makes the dog reluctant to create pressure against the infected gland.

Behavioral changes associated with anal gland infection often extend beyond localized pain responses to affect overall demeanor and daily activities. Dogs may become reluctant to sit or lie in positions that put pressure on the affected area, showing restlessness and frequent position changes. Activity levels typically decrease as the dog conserves energy to fight the infection and avoids movements that cause discomfort. Appetite changes including reduced interest in food commonly accompany infection, particularly if systemic signs develop. Some dogs display increased irritability or aggression, even toward familiar family members, reflecting the distress caused by persistent pain. House-trained dogs may have accidents due to reluctance to posture normally for defecation.

Physical signs visible during examination become increasingly obvious as infection progresses and may prompt urgent veterinary attention. Swelling adjacent to the anus progresses from subtle fullness to obvious distension that may distort the normal perianal anatomy. The skin overlying an infected gland may transition through stages of redness, purple discoloration, thinning, and eventually development of a soft fluctuant area indicating abscess formation beneath the surface. Discharge may be visible at the anal opening or leaking from the swollen area, appearing yellow, green, brown, or blood-tinged unlike the normal brownish oily anal gland secretion. A strong foul odor typically accompanies the discharge from infected glands.

Symptom progression in untreated anal gland infection follows a relatively predictable course toward abscess formation and potential rupture. As infection continues, pain intensifies and the dog's tolerance for any interaction with the affected area diminishes. The swelling increases as pus accumulates and surrounding tissue becomes increasingly inflamed. Body temperature may become elevated as systemic immune response develops. The overlying skin becomes progressively thinner and more discolored until it either ruptures spontaneously or requires surgical drainage. Dogs may strain to defecate but produce little stool due to pain, or may refuse to defecate entirely.

Emergency symptoms requiring immediate veterinary attention indicate either severe infection or complications that demand urgent intervention. Rupture of an infected anal gland through the skin creates an open wound that drains pus and blood, requiring cleaning, drainage, and aggressive antibiotic therapy. High fever, marked lethargy, complete refusal to eat, or signs of dehydration suggest the infection may be causing systemic illness requiring more intensive treatment. Rapid progression of swelling, extensive skin discoloration, or involvement of tissue beyond the immediate anal gland area indicates aggressive infection that may spread without prompt intervention. Any dog showing these signs should receive veterinary evaluation as an emergency rather than waiting for a routine appointment.

The diagnostic process for anal gland infection begins with careful history-taking to understand the timeline of symptoms, any previous anal gland problems, and factors that might have predisposed to the current infection. Owners should describe when symptoms were first noticed, how quickly they progressed, and any previous episodes of impaction or infection. Information about recent dietary changes, current medications, and underlying health conditions helps identify contributing factors. Whether any attempts at home management were made, such as warm compresses or over-the-counter products, should be mentioned as this information affects treatment planning and interpretation of current findings.

Physical examination provides the primary diagnostic information for anal gland infection, typically revealing characteristic findings that distinguish infection from simple impaction. Visual inspection of the perianal region reveals swelling, erythema, and potentially skin changes indicating developing abscess. Palpation carefully performed allows assessment of the affected gland's size, consistency, and degree of pain response. Infected glands feel firmer, more swollen, and significantly more painful than simply impacted glands. If expression is attempted, the material obtained appears abnormal, typically being purulent, discolored, and foul-smelling rather than the normal brownish oily secretion. The veterinarian also assesses for signs of rupture, abscess formation, or involvement of surrounding tissue.

Differential diagnosis considerations ensure other conditions potentially causing similar presentations are appropriately evaluated. Perianal fistulas, particularly in German Shepherds and related breeds, cause chronic draining tracts that might be confused with ruptured anal gland abscesses. Perianal tumors can cause swelling and discharge that mimics infection. Perineal hernias create soft swelling adjacent to the anus that must be distinguished from infected anal glands. Foreign body reactions, bite wounds, or other trauma to the perianal region occasionally present similarly. Severe allergic dermatitis affecting the perineum can cause dramatic swelling and discomfort. Careful examination usually distinguishes these conditions from anal gland infection.

Additional diagnostic testing may be recommended depending on the presentation severity and any complicating factors identified. Cytology of expressed material involves microscopic examination of the gland contents, revealing the presence of bacteria, white blood cells indicating active infection, and potentially abnormal cells that might suggest other diagnoses. Bacterial culture and sensitivity testing identifies the specific organisms responsible and determines which antibiotics will be most effective, particularly valuable for severe infections or those failing to respond to initial treatment. Blood work including complete blood count may reveal elevation in white blood cell counts indicating systemic response to infection. Imaging studies are occasionally useful if abscess extent, involvement of surrounding structures, or underlying masses require evaluation.

Immediate treatment for anal gland infection focuses on removing infected material from the glands, initiating antibiotic therapy, and providing pain relief to improve the dog's comfort. Expression of the infected gland contents, while painful, is essential for reducing the bacterial load and relieving pressure. This may require sedation or anesthesia depending on the dog's pain level and temperament. The material expressed is typically thick, purulent, and foul-smelling, and its character helps confirm the diagnosis of infection rather than simple impaction. Thorough expression may require multiple attempts and is often followed by flushing the gland with antiseptic or antibiotic solutions to reduce residual bacterial populations.

Medical management forms the cornerstone of anal gland infection treatment, with systemic antibiotics being essential for resolving the infection. Antibiotic selection is based on the most common organisms causing anal gland infections, typically broad-spectrum agents effective against both gram-positive and gram-negative bacteria as well as anaerobes. Common choices include amoxicillin-clavulanate, cephalosporins, or fluoroquinolones, though selection may be modified based on culture results if obtained. Treatment duration typically extends two to three weeks to ensure complete resolution and prevent recurrence. Pain medication including non-steroidal anti-inflammatory drugs or other analgesics provides comfort during the recovery period. Anti-inflammatory properties of certain medications also help reduce swelling and promote healing.

Surgical intervention becomes necessary when infection has progressed to abscess formation or when medical management proves insufficient. Abscesses require drainage through either spontaneous rupture sites or surgically created openings to allow accumulated pus to escape. The abscess cavity is thoroughly lavaged with antiseptic solutions and may be left open to drain or partially closed with provisions for drainage. In some cases, placement of a drain allows ongoing removal of infected material during healing. Severe or recurrent infections may ultimately necessitate anal sacculectomy, surgical removal of the affected gland, to eliminate the source of chronic problems. This decision is typically reserved for dogs with repeated severe infections despite appropriate management.

Supportive care measures complement antibiotics and surgical intervention to promote healing and patient comfort. Warm compresses applied to the affected area several times daily help reduce swelling, promote drainage, and provide soothing relief. Keeping the perianal region clean prevents accumulation of discharge that could irritate surrounding skin or serve as a source for recontamination. Elizabethan collars prevent the dog from licking or biting at the healing area, which could introduce additional bacteria or disrupt the healing process. Dietary modifications to produce firmer stools reduce pressure on healing tissues during defecation. Short-term activity restriction may be recommended, particularly following surgical drainage or abscess rupture.

Alternative and complementary treatments may support recovery alongside conventional therapy but should not replace appropriate antibiotic treatment for infection. Hydrotherapy or warm water soaks can provide comfort and promote healing of external wounds from abscess rupture. Probiotics may help maintain healthy gastrointestinal bacteria during antibiotic therapy and support overall immune function. Omega fatty acid supplementation supports skin and tissue health during healing. Some holistic practitioners recommend specific herbal preparations for supporting immune function, though evidence for their effectiveness in treating anal gland infection specifically is limited. Any complementary approaches should be discussed with the treating veterinarian to ensure they do not interfere with prescribed treatments.

Treatment decision factors guide the veterinary team's approach based on individual patient circumstances and infection severity. Mild infections caught early may resolve with oral antibiotics alone, while severe cases require more aggressive intervention including drainage procedures. The dog's overall health status affects treatment choices, particularly regarding anesthesia risk for surgical procedures. Previous response to antibiotics, if infection has occurred before, influences medication selection. Owner compliance capacity affects whether treatments requiring multiple daily administrations or procedures are practical. Cost considerations may influence choices between management options. Presence of underlying conditions predisposing to infection must be addressed as part of the treatment plan to reduce recurrence risk.

Recovery from anal gland infection typically spans two to three weeks when appropriate treatment is initiated promptly, with most dogs showing significant improvement within the first few days of antibiotic therapy. Initial improvement is usually evident within forty-eight to seventy-two hours, with decreased swelling, reduced pain response, and improved demeanor. The dog's appetite and activity levels typically return toward normal as pain resolves and systemic infection response subsides. Complete resolution requires continuing antibiotics for the full prescribed course even after symptoms appear resolved, as stopping early risks recurrence or development of antibiotic-resistant bacteria. Recovery from abscessed or ruptured glands takes longer, typically three to four weeks, as external wounds must heal in addition to internal infection resolution.

Post-treatment care requirements focus on medication administration, wound monitoring, and supporting the healing process. Owners must administer antibiotics consistently as prescribed, typically twice daily for two to three weeks, completing the entire course regardless of apparent improvement. Pain medications are given as directed during the initial recovery period when discomfort remains present. For dogs with abscess drainage or rupture, wound care including gentle cleaning, application of prescribed topical medications, and monitoring for signs of healing problems becomes part of daily care. Follow-up veterinary appointments allow assessment of healing progress and determination of when treatment can be concluded.

Prognosis for anal gland infection is generally very good with appropriate treatment, though the long-term outlook depends on managing factors that predisposed to the infection. Most dogs recover fully without lasting effects from a single infection episode. However, without addressing underlying issues such as chronic impaction, dietary factors, obesity, or allergies, recurrence remains likely. Dogs experiencing their first infection have better prognosis than those with repeated episodes, as chronic infection can cause scarring and permanent changes to the gland that complicate future management. Cases requiring surgical drainage or that progressed to rupture before treatment have slightly longer recovery periods but still carry excellent prognosis for complete resolution.

Long-term outlook and expectations following anal gland infection recovery include both the positive expectation of complete resolution and the ongoing need for preventive management. Once healed, dogs return to normal function and comfort, able to participate fully in all normal activities. However, the occurrence of infection indicates susceptibility that warrants ongoing attention. Establishing preventive protocols including regular gland checks, possible scheduled expressions, dietary optimization, and weight management significantly reduces recurrence risk. Dogs requiring anal sacculectomy for recurrent severe infection have excellent long-term prognosis, with permanent resolution of the anal gland problem following appropriate healing from surgery. Regular veterinary follow-up ensures early detection if problems begin to recur.

Primary prevention of anal gland infection centers on preventing the impaction that typically precedes infectious complications. Maintaining healthy stool consistency through appropriate diet ensures natural gland expression during defecation, reducing the accumulation of material that could become colonized by bacteria. High-fiber diets or fiber supplementation with pumpkin, psyllium, or commercial fiber additives promotes firm stool formation. Adequate hydration supports healthy digestive function and appropriate stool consistency. Weight management prevents obesity-related impaction risk while also supporting overall immune function. Regular exercise promotes healthy bowel movements and maintains the muscle tone that supports natural gland expression.

Responsible breeding practices contribute to reducing anal gland problems within predisposed populations over time. Breeders aware that anal gland issues run in their lines can factor this into breeding decisions, selecting against dogs with chronic severe problems when possible. While specific genetic tests for anal gland anatomy or function are not currently available, documenting family history of anal gland issues helps breeders make informed decisions. Prospective puppy buyers should inquire about anal gland health history in breeding lines, particularly when considering breeds known for high prevalence. Over generations, selection away from severely affected individuals can reduce problem prevalence within breeding populations.

Nutritional management specifically targeting anal gland health helps prevent the impaction that leads to infection. Identifying and eliminating food sensitivities that cause chronic loose stools removes a major predisposing factor. Appropriate protein and fiber balance promotes optimal stool consistency. Avoiding sudden dietary changes that might cause temporary digestive upset prevents episodes of soft stool that allow glands to become impacted. Omega fatty acid supplementation supports skin health throughout the body including the anal gland tissues, potentially improving secretion quality and reducing inflammation. Probiotics maintain healthy gut bacteria populations that support consistent stool formation.

Regular preventive care represents the most direct method for preventing impaction from progressing to infection. Routine anal gland checks during veterinary visits or grooming appointments allow early detection of fullness before impaction becomes severe. Dogs identified as prone to impaction benefit from scheduled preventive expression at intervals appropriate for their individual needs, preventing the prolonged accumulation that allows bacterial overgrowth. Maintaining cleanliness of the perianal region reduces bacterial load in the area, decreasing the likelihood that bacteria will colonize glands that are not emptying well. Prompt attention to any signs of developing impaction prevents progression to the point where infection can establish.

Early intervention when impaction is suspected prevents the prolonged gland distension that creates conditions for infection. Owners familiar with their dog's patterns can recognize early signs of fullness and seek expression before significant accumulation occurs. Learning what normal versus abnormal anal gland behavior looks like for their specific dog helps owners identify problems promptly. Establishing communication with the veterinary team about the dog's anal gland history ensures appropriate scheduling of preventive visits. Treating underlying conditions including allergies, hypothyroidism, or gastrointestinal disorders that contribute to impaction addresses root causes rather than just managing symptoms. For dogs with recurrent problems despite appropriate prevention, discussing surgical options before severe infection occurs may be appropriate.

Daily management for dogs that have experienced anal gland infection involves ongoing attention to prevention strategies and early recognition of potential recurrence. Establishing consistent feeding schedules with measured portions of appropriate high-fiber diet maintains healthy stool consistency. Observing defecation and stool quality helps identify changes that might predispose to impaction. Monitoring behavior for early signs of anal gland discomfort including mild scooting, increased perianal licking, or reluctance to sit comfortably allows prompt intervention. Daily routines should include opportunities for adequate exercise that promotes healthy digestive function and bowel movements.

Home environment considerations focus on hygiene and monitoring rather than significant modifications. Keeping the dog's sleeping areas clean reduces bacterial load in contact with the perianal region. Maintaining cleanliness of outdoor elimination areas where practical removes potential sources of contamination. Indoor surfaces where the dog spends time should be easy to clean in case scooting or discharge occurs. Having supplies available for gentle perianal cleaning if needed between grooming appointments supports ongoing hygiene. Easy observation of the dog's elimination behavior and any discharge from the anal area allows early problem detection.

Maintaining quality of life for dogs with history of anal gland infection requires balancing preventive management with normal enjoyable activities. Dogs with well-managed anal gland issues should not experience significant lifestyle limitations once any active infection has fully resolved. All normal activities including exercise, play, swimming, and social interaction can resume following appropriate healing. The focus shifts to prevention rather than restriction, with dietary management and regular expression schedules becoming routine parts of care. Mental stimulation and enrichment remain important, and owners should not allow concern about anal gland problems to limit appropriate activities and social experiences.

Ongoing monitoring and veterinary care play essential roles in preventing recurrence and catching problems early if they develop. Keeping records of expression frequency, any symptoms noted, dietary changes, and response to management adjustments helps optimize prevention strategies over time. Regular wellness examinations should include anal gland assessment even when no symptoms are present. Any changes in symptom patterns, increased frequency of problems, or signs suggesting infection may be developing warrant prompt veterinary evaluation. Open communication with the veterinary team about what is working and what challenges persist allows collaborative adjustment of the management plan.

Caregiver support resources help owners managing dogs with chronic anal gland issues maintain appropriate perspective and avoid frustration. Understanding that while inconvenient, anal gland problems are very manageable with proper attention provides reassurance. Connecting with other owners of affected dogs through breed groups or online communities offers practical tips and emotional support. Financial planning for ongoing preventive care costs including regular expression visits helps incorporate this expense into normal pet care budgeting. Learning to perform expression at home after proper training can increase flexibility and reduce costs for some owners. Discussing surgical options with the veterinarian for dogs with severe recurrent problems ensures all management possibilities are considered.

Small and toy breed dogs face elevated risk for anal gland infection due to their high predisposition to the impaction that typically precedes infectious complications. Breeds including Chihuahuas, Toy and Miniature Poodles, Bichon Frises, Shih Tzus, Cocker Spaniels, and Lhasa Apsos commonly experience impaction and consequently higher rates of secondary infection. The anatomical factors that predispose these breeds to impaction, including smaller duct diameter and gland positioning, create conditions that allow bacterial colonization when natural emptying fails. Owners of small breed dogs should be aware of this risk and establish proactive monitoring and prevention protocols. Regular grooming appointments should include anal gland assessment and expression as needed.

Certain medium and large breed dogs also face increased anal gland infection risk, though overall prevalence is lower than in small breeds. Bulldogs, both English and French, experience higher rates of anal gland problems related to their body conformation and tendency toward allergic skin disease. Basset Hounds face elevated risk associated with their predisposition to obesity and skin conditions. German Shepherds, while more prone to perianal fistulas than simple impaction, may experience anal gland problems as part of their overall tendency toward perianal disease. Dogs with chronic allergies of any breed face increased risk as inflammation affects anal gland tissue and secretion quality.

Screening and prevention recommendations should be tailored to breed risk and individual history. Owners of high-risk breeds should establish baseline anal gland assessment early in the dog's life and maintain regular monitoring throughout. Scheduled preventive expression at intervals appropriate for the individual dog prevents the prolonged impaction that allows infection to develop. Dietary optimization focusing on fiber content and appropriate nutrition should be a priority from puppyhood. Maintaining healthy weight reduces multiple risk factors simultaneously. Breed clubs and breed-specific health organizations may provide resources regarding anal gland health and other breed-relevant health concerns.

Several conditions commonly co-occur with anal gland infection or share underlying risk factors that predispose dogs to both. Allergic skin disease frequently accompanies anal gland problems because inflammation affects the perianal region and anal gland tissues, compromising local defenses and altering secretion consistency. Dogs with chronic allergies often experience recurring anal gland issues requiring ongoing management. Obesity commonly coexists with anal gland problems, as the metabolic and mechanical factors involved predispose to impaction that leads to infection. Chronic gastrointestinal conditions causing persistent soft stools prevent natural gland emptying and increase infection risk.

Conditions presenting with similar symptoms require differentiation to ensure appropriate treatment. Simple anal gland impaction presents similarly but without the pain, swelling, and systemic signs characteristic of infection. Perianal fistulas cause chronic draining tracts that might be confused with ruptured anal gland abscesses, particularly in German Shepherds. Perianal tumors can cause swelling and discharge mimicking infection. Perineal hernias create soft swelling near the anus requiring different treatment. Bite wounds or other trauma to the perianal region may present with localized infection that resembles anal gland involvement. Thorough veterinary examination distinguishes these conditions.

Potential complications of anal gland infection represent progression of the infectious process and emphasize the importance of prompt treatment. Abscess formation occurs when infection progresses, creating a walled-off pocket of pus that causes intense pain and requires drainage. Rupture of the abscess through the skin creates an open wound requiring wound care in addition to antibiotic therapy. Cellulitis, spreading infection through surrounding tissues, can occur if infection extends beyond the gland itself. Systemic infection or sepsis, while uncommon, represents the most serious potential complication if infection spreads into the bloodstream. Chronic recurring infection can cause scarring and permanent gland changes that ultimately require surgical removal.