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Pilonidal Disease

Conditions Basics

What is pilonidal disease?

Pilonidal (say "py-luh-NY-dul") disease is a common skin condition. It usually develops at the top of the crease between the buttocks. It may look like a small hole or dimple called a pit. Loose hair and skin debris trapped there can cause an infection or an abscess. It's also called a pilonidal cyst.

What causes it?

The exact cause isn't known. But it may start when skin above the buttocks is stretched as a person sits or bends. Loose hair and skin debris can get caught in an enlarged skin pore, creating a cyst. If the cyst gets infected, it can form a pocket of pus called an abscess.

What are the symptoms?

You may have no symptoms. But if the cyst gets infected, you may have redness or swelling in the area. You may also have a fever. You may have cloudy fluid or blood draining from the cyst. Some people may find it hard to walk or sit because of the pain.

How is it diagnosed?

A physical exam of the buttocks is usually all doctors need to diagnose pilonidal disease. You probably won't need any other tests unless the area doesn't heal or your doctor thinks there may be another problem.

How is it treated?

  • For a pilonidal cyst that isn't causing symptoms:
    • You don't need medical treatment. But your doctor may talk with you about how to keep the area clean and whether to remove hair from the area.
  • For a pilonidal cyst that's draining, bleeding, or causing pain:
    • Your doctor may treat the cyst with medicines. Or the cyst may be removed using special tools and small cuts in the skin.
  • For a pilonidal cyst in which infection has created an abscess:
    • Your doctor will likely cut open and drain the cyst.
    • If it gets infected again or doesn't heal, your doctor may treat it with medicines. Or the cyst may be removed using special tools and small cuts in the skin.
    • If these treatments fail, then you may need surgery to remove the entire area of the cyst. This requires a larger cut called a wide excision. A skin flap may be used to help with healing.

How can you care for yourself?

While you are being treated for an infected cyst:

  • Keep the area dry and clean.
  • Soak in a warm tub several times a day.
  • Take nonprescription pain medicine if needed.

For cysts that are not causing symptoms or after you have had surgery to remove a cyst:

  • Keep the area dry and clean.
  • Try not to sit on hard surfaces for long periods of time.

Keeping the area free of hair may also help. Talk with your doctor about what they recommend.

Credits

Current as of: August 2, 2022

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
John Pope MD - Pediatrics