Pilonidal Disease
Pilonidal disease is a chronic infection of the skin in the region of the buttock crease. The condition results from a reaction to hairs embedded in the skin, commonly occurring in the cleft between the buttocks. The condition is not contagious and is more common in men than women, most frequently between puberty and age 40.
Symptoms may include:
- Pain that often worsens when sitting
- A pilonidal cyst that is red and tender, ranging in size from a small dimple to a large mass
- An abscess with draining pus or blood, which may be foul-smelling
- Nausea, fever, and extreme tiredness (fatigue)
There are several common patterns of this disease. Nearly all patients experience an episode of an acute abscess, during which the area is swollen, tender, and may drain pus. After the abscess resolves—either on its own or with medical treatment—many patients develop a pilonidal sinus.
A pilonidal sinus is a cavity beneath the skin that connects to the surface through one or more small openings or tracts. While some sinus tracts may resolve without treatment, most patients require a minor procedure to eliminate them.
A small number of patients develop recurrent infections and inflammation of these sinus tracts. Chronic disease can cause repeated episodes of swelling, pain, and drainage. Surgery is almost always required to resolve this condition.
Depending on the severity of symptoms, a number of treatment methods are available. Our expert team can advise you in the best options, including:
- Draining the cyst This procedure can happen right in your provider’s office. A small incision (cut) will be made to open and drain fluid from your infected cyst.
- Injections Injections (phenol, an acidic chemical compound) can treat and prevent mild and moderate pilonidal cysts.
- Antibiotics Antibiotics can treat skin inflammation. However, antibiotics can’t heal pilonidal cysts on their own.
- Laser therapy Laser therapy can remove hair which otherwise might become ingrown and cause more pilonidal cysts to come back.
- Surgery to remove the cyst Complex or recurrent disease must be treated surgically. Procedures may vary from unroofing the sinus to excising the cyst and possible closure utilizing different types of flaps. If the wound is left open, it will require dressing care and take longer to heal. Your surgeon will discuss your surgical options with you.
It is important that the skin in the buttock crease area be kept clean and free from hair. This can be accomplished with shaving or laser treatment.
While awaiting treatment, pain can be managed by using a warm compress on the affected area. An inflatable seat or mattress can provide comfort.