Methamphetamine, a powerful central nervous system stimulant, affects the body in numerous ways, including noticeable changes to the skin. Concerns about skin lesions, often described as “boils,” “bumps,” or “meth sores,” are common among users and their loved ones. These visible skin issues are not caused by the drug directly creating pus-filled lesions. Instead, they are complex side effects arising from the drug’s physiological impact, coupled with psychological and behavioral changes. Understanding the true causes of these skin problems is the first step toward effective management and healing.
How Methamphetamine Affects Skin Physiology
Methamphetamine directly influences the body’s circulation by acting as a powerful vasoconstrictor. This causes blood vessels, especially those near the skin’s surface, to narrow, dramatically reducing blood flow. This limits the delivery of oxygen and essential nutrients to the skin tissue. When the skin is starved of these resources, its natural ability to heal is severely compromised, causing minor injuries to take much longer to repair.
Chronic methamphetamine use also leads to immune system suppression. The drug negatively impacts the function of immune cells responsible for fighting off pathogens. This weakened response, combined with poor hygiene and nutritional deficits common during use, makes the skin vulnerable to breakdown and infection. The combination of poor circulation and a compromised immune system ensures that any break in the skin barrier quickly becomes a persistent problem.
Formication and Self-Inflicted Skin Damage
The primary cause of the characteristic open sores is a psychological phenomenon known as formication. This is a type of tactile hallucination where the user experiences the intense sensation of insects, often called “meth mites,” crawling on or beneath the skin. This feeling is a direct neurobiological effect of the drug on the central nervous system, creating a delusion of infestation.
Driven by this overwhelming sensation, individuals compulsively scratch, pick, and dig at their skin to remove the imaginary parasites. The resulting wounds are self-inflicted excoriations—picked-open spots that resemble scabs or small, raw ulcers. These lesions are mistakenly identified as drug-caused boils or bumps. This obsessive behavior prevents the wounds from healing, leading to multiple sores across the face, arms, and other accessible areas of the body.
The Risk of Secondary Infections and Abscesses
The open, self-inflicted wounds created by skin picking are highly susceptible to becoming true secondary infections, often transitioning into what looks like a boil or abscess. The compromised skin barrier, combined with poor hygiene and a weakened immune system, provides a perfect entry point for environmental bacteria. Common skin bacteria, such as Staphylococcus aureus (Staph) and Streptococcus, can colonize these wounds, leading to serious skin and soft tissue infections (SSTI).
A significant concern is the presence of Methicillin-resistant Staphylococcus aureus (MRSA), a prevalent and dangerous pathogen. When bacteria enter the wound, the immune response attempts to wall off the infection, resulting in a painful, pus-filled lump known as an abscess. If the infection spreads through the deeper layers of the skin, it can lead to cellulitis, characterized by spreading redness, warmth, and swelling that requires immediate medical treatment. Left untreated, these secondary infections can enter the bloodstream and cause sepsis, a life-threatening systemic infection.
Minimizing Skin Damage and Seeking Treatment
For active wounds, basic harm reduction and wound care principles help minimize damage and prevent severe infection. Keep any open sores clean and covered to reduce bacterial entry and prevent further picking. Gently rinsing the wounds with clean water and applying a non-irritating, oil-based ointment, such as petroleum jelly, encourages healing.
Any signs of a deep infection, such as fever, increasing pain, spreading redness, or pus, require immediate professional medical attention. These infections often require prescription antibiotics, and a large abscess may need surgical drainage by a healthcare provider. While managing the immediate physical damage is necessary, the most effective way to prevent the recurrence of these skin issues is by addressing the underlying substance use disorder.