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Learning About Pilonidal Disease

Abscessed pilonidal cyst at top of crease between buttocks, with detail of cyst cut open and drained, and detail of cyst removed.

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 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 can you prevent infection?

You may be able to reduce the risk of infection by keeping the area clean and dry. Your doctor will tell you how to clean the area and if you should keep the area free from hair. Also, try to avoid sitting on hard surfaces for long periods of time.

How is pilonidal disease 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.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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