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Pilonidal disease

Pilonidal disease is a chronic skin infection that develops in the crease between the buttocks.

If you have pilonidal disease, you will have one or more cysts, between your buttocks, that may become swollen or infected. A pilonidal cyst looks like a small dimple and it may have hair sticking out from it.

What causes pilonidal disease?

You may develop pilonidal cysts from:

  • a hair follicle that is irritated from things such as exercise, tight clothing or heavy sweating
  • hair growth or a loose hair that is trapped and pokes into the skin, causing irritation
  • changing hormones.

Some people are born with pilonidal cysts.

Pilonidal disease symptoms

Unless a cyst becomes infected, you may have no symptoms.

If your pilonidal cyst is infected and becomes an abscess, you may notice:

  • redness or swelling
  • pus or blood coming from the abscess
  • pain when you walk or sit
  • an unpleasant smell
  • fever symptoms.

Pilonidal diagnosis and treatment

Your doctor will diagnose pilonidal cysts and disease from a physical examination of your buttocks. The doctor may need to drain the cysts and prescribe antibiotics if you have a severe infection.

If the cyst gets infected again or doesn’t heal after being drained, you may need surgery to have it removed. Depending on the treatment, it may take 4 to 10 weeks to heal.

You may help heal the infection and prevent it from happening again by:

  • keeping your buttock cleft clean and dry
  • using a mild soap and making sure all soap is removed after cleaning
  • shaving the area regularly or using a hair-removal product
  • soaking in a warm tub (sitz bath) a few times a day
  • taking pain relief medication
  • avoiding sitting for long periods.

Last reviewed: June 2015

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