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Pilonidal Disease

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Pilonidal disease is a chronic infection of the skin in the buttock crease, or natal cleft, that runs from just below the sacrum to the perineum. People with this condition have one or more cysts that get inflamed and infected. 


Symptoms of Pilonidal disease range from a small dimple to a large painful mass. Often the area will drain fluid that may be clear, cloudy or bloody. If infection is present, the area becomes red, tender, and the drainage will have a foul odor.

Other symptoms of infection at the site are

  • Fever
  • Malaise
  • Nausea
  • Pain when walking or sitting

Causes and Risk Factors

Pilonidal disease is a congenital condition present at birth. There are no known causes, however, there are known risk factors including:

  • Family history of Pilonidal Disease
  • Fetal development problems such as spina bifida
  • Shape, size and scaliness of the person's hair
  • Amount of hair in the natal cleft and buttocks
  • Size of the pores in the skin over the tailbone
  • High degree of friction and pressure on the tailbone often due to bad posture
  • Traumatic injury to the tailbone
  • Participation in high tailbone-impact activities such as horseback riding
  • Depth of the natal cleft
  • Shape of the natal cleft
  • Tendency towards blocked hair follicles for example acne, boils, or sebaceous cysts
  • Tendency towards other skin problems such as eczema

Diagnostic Tests

Your doctor will start with a medical history, do a physical examination, and perform other tests to diagnose pilonidal disease. Your doctor will want to know if you have any of the risk factors that can lead to pilonidal disease.

Telling your doctor about how often and how severe your symptoms are will help in creating a successful treatment plan.

Treatment and Procedures

Pilonidal disease typically goes through a general pattern. Treatment depends on the disease state and severity.Pilonidal disease does not need treatment if it is not causing symptoms.

If a cyst forms and becomes infected, your doctor may recommend:

  • Antibiotics.
  • Opening and draining the cyst
  • Surgery to remove the cyst or repair sinus tracts left after an abscess is drained

Your health is our greatest concern. Please contact the Center for Colon & Rectal Surgery at 407.303.2615for a private consultation today.