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Pilonidal disease

2-minute read

Pilonidal disease is a chronic skin infection that develops in the crease between the buttocks, near your tailbone.

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. It usually occurs in young people between the ages of 15 and 24 years, and is more common in males.

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.

Illustration of a pilonidal cyst.
A pilonidal cyst is a fluid filled sac that develops at the top of the crease between the buttocks. It may have a hair sticking out from it and can become infected and painful.

Pilonidal disease symptoms

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

If your pilonidal cyst is infected and becomes an abscess, it can be very painful. You may also notice:

  • redness or swelling
  • pus or blood coming from the abscess
  • 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 type of surgery required, 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
  • taking pain relief medication
  • avoiding sitting for long periods

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Last reviewed: April 2019

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