PILONIDAL DISEASE

 Basic information

description

Pilonidal disease is an infection in the skin, just above the crease of the buttocks. It starts with a pilonidal cyst (a sac) under the skin. The cyst can become infected and form an abscess (pus-filled area). An opening (sinus) may also develop that goes from the abscess to the outside skin. The disease affects both sexes, but is more common in males, from teenagers to age 40.

FREQUENT SIGNS & SYMPTOMS

• Symptoms may go unnoticed in mild cases.
• Pain, redness, tenderness, and swelling in the area.
• Fever and chills.
• Discharge of pus.
• Sitting or walking may be difficult.

causes

The exact cause is unclear. It was thought for many years that people were born with the cysts. Now the theory is that they are acquired and caused by problems within a hair follicle.

risk increases with

• Obesity.
• Men more than women.
• Family history of pilonidal disease.
• Sedentary lifestyle (lack of exercise).
• Repeated trauma (injury) to the tailbone area.
• Work that requires a lot of sitting.
• Activities, such as biking or motorcycle riding, that can cause sweating and friction to the tailbone area.
• Heavy growth of body hair.
• White persons are affected more often than African American or Asian persons.

PREVENTIVE MEASURES

• Bathe or shower daily to keep the area clean. Warm tub baths seem more effective in preventing infection of the cyst than showers.
• Avoid risk factors where possible.

expected outcomes

Mild cases may need no treatment. In cases of abscess or recurrence of the disease, treatment can help. Healing time may take weeks to months, depending on treatment procedure.

possible complications

• The disease recurs in about 40% of the patients after the initial treatment. It may clear up on its own after age 40.
• Without proper treatment, there may be an increased risk of skin cancer.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam of the cyst. Medical tests may include blood studies and a culture of the discharge from the cyst.
• Treatment may involve self-care, incision and drainage of the cyst, drugs, and surgery. Your health care provider will discuss the options with you.
• Treatment may not be needed for mild disease. Use extra care in keeping that area of the body clean. You may be advised to shave or use a hair remover product to keep the area free of hair. Soaking in a tub of warm water may help if there is discomfort or pain.
• Incision and drainage may be recommended. This involves opening the cyst so that any hair or pus can be removed. The opening is then packed with gauze. Healing may take several weeks. Recurrence may be somewhat more common than with surgery.
• Surgical removal (excision) of the cyst or sinus may be recommended. Several different surgical methods can be used. Healing time will depend on the procedure. You will be advised about follow-up home care.

medications

Antibiotics may be prescribed for infection.

activity

No limits, unless the cyst becomes infected. Then, limit activities until the infection is cured. Use a special doughnut cushion if sitting is uncomfortable.

diet

No special diet. A weight-loss diet may be recommended if overweight is a problem.

 notify our office if

• You or a family member has symptoms of pilonidal disease.
• Symptoms recur after treatment.

Special Notes: