What are the Treatment Options for Pilonidal Disease?

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Pilonidal cysts usually develop above the crease of the buttocks forming a sac that is often filled with fluids. There may be hair growing out of the cyst and if it is infected then it can cause a lot of pain. And this infection can lead to pilonidal diseasea chronic skin infection. In case you are suffering from the condition, you are more than likely to have at least one or more cysts that might have been infected or swollen. 

Causes of pilonidal disease

So far, the main cause of pilonidal is still unknown. Various conditions can lead to the development of the disease. An ingrown hair can cause pilonidal sinus at the cleft of the buttocks. However, so long the condition remains as a cyst, it is not a problem at all unless there is an infection. The following are some of the reasons that cause the development of pilonidal cysts:

  • Irritation of the hair follicle due to heavy sweating,  exercise, or tight clothing 

  • Irritation due to ingrown hair or hair growth

  • Hormonal changes

  • Being overweight

  • Excessive hair growth near the buttock’s crease

  • Poor hygiene

Young people between the age group of 13 to 26 years commonly suffer from this condition. 

Risk Factors

As compared to females, males are found to be more prone to this condition. However, if you are aware of the things that can likely cause the condition then it can help you in decreasing your risk of pilonidal disease:

  • Presence of hair that is curly or coarse

  • Excessive hair growth surrounding the sinus

  • Family members with a history of this condition

  • Deep crack in the cleft of the buttock

  • Sitting for a longer duration

  • Injury of the affected area

  • Obesity

Symptoms of Pilonidal Disease

It is quite likely for you to not notice the symptoms of pilonidal sinus as without an infection it does not show any infection. However, the chances of the infection recurring are quite high. And if there is an infection then there will be the development of an abscess and show the following symptoms:

  • Swelling or redness

  • Pain

  • Foul smell

  • Fever

  • Blood or pus draining from the sinus

  • Lump near the tailbone

The abscess may, however, go away on its own, but there is still the chance of recurrence. Nevertheless, the symptoms will develop quickly and if left treated it might get worse. Also, the condition will cause discomfort while sitting or lying down.

Diagnosis of pilonidal disease

As far as the diagnosis is concerned, the doctor will perform a physical examination. If the infection is severe then antibiotics and draining of the cyst may be necessary. 


After the drainage procedure, if the infection of the cyst recurs, then the need to remove it surgically might arise. The time for recovery may vary according to the type of surgery. Some procedures will heal you in 4 weeks while some may take 10 weeks to heal. Get in touch with your doctor if the scar appears red, swollen, and warm. The following are some of the treatments available for pilonidal disease:


If the symptoms of the condition appear rapidly then the doctors may prescribe antibiotics to control the infection. Treatment with antibiotics is useful if the infection is mild or early. However, in case the infection prolongs then surgery may be the only option o remove it.

Incision and drainage along with antibiotics

Incision and drainage is a short procedure that is usually done once you are on antibiotics. You can visit any urgent care or hospital for this procedure. Also, right after the procedure, you can go home. You must change the dressing daily and maintain good hygiene to avoid further infection. 

Minimally invasive surgery

This procedure involves the removal of the pilonidal pits and the sinus tracts and proper cleaning of the area. Also known as Gip’s procedure, the process involves the doctor identifying the depth of the sinus tracts. After locating the tracts, the doctor will remove the infected tissue and leave the wound open. To collect the drainage, a small gauge dressing will be placed in the area. In addition, the doctor will recommend cleaning the area regularly with mild, warm soapy water. 

Excision and Reconstruction 

If the condition is severe, then excision and reconstruction may be the only way to treat it. This procedure is sometimes referred to as the Cleft procedure. It involves the removal of the skin of the infected area. Then the surgeon closes the wound with other tissue ensuring the coverage of the area. This may cause the cleft of the buttock to appear off-center. Usually, a plastic surgeon performs this procedure. 

Despite the treatment, there is a 25 to 50 percent chance of recurrences of the disease. Therefore, it is important to maintain good personal hygiene to reduce the risk. Also, after the procedure, it is necessary to clean the wound regularly and remove any hair growing near the wound. The following are some of the tips that can help in healing the wound to prevent further recurrences:

  • Keep the area clean

  • Remove hair growing in the area

  • Use antibacterial soap

  • Pain relief medication

  • Avoid sitting for long periods.



Written by Pilonidal Expert

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