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Pilonidal disease

3-minute read

What is pilonidal disease

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

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 an ingrown hair that causes irritation
  • changing hormones

It usually occurs in young people between the ages of 15 and 24 years. It is more common in males and people who are overweight, wear tight clothing, have a lot of hair near the crease of the buttocks, or do not bathe or shower often.

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
  • pain
  • pus or blood coming from the abscess
  • an unpleasant smell
  • fever symptoms

Sometimes the abscess goes away by itself, but it can come back again.

How is pilonidal disease diagnosed?

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

How is pilonidal disease treated?

If the cyst gets infected again or does not 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. See your doctor if the scar becomes swollen, red and warm.

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

  • keeping the area clean and dry
  • using an antibacterial soap and making sure all soap is removed after cleaning
  • taking pain relief medication
  • avoiding sitting for long periods

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: April 2021

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