Pilonidal disease
Pilonidal disease is a type of skin infection which typically occurs as a cyst between the cheeks of the buttocks and often at the upper end. Symptoms may include pain, swelling, and redness. There may also be drainage of fluid, but rarely a fever.
| Pilonidal disease | |
|---|---|
| Other names | Pilonidal cyst, pilonidal abscess, pilonidal sinus, sacrococcygeal cyst / fistula |
| Acute pilonidal disease (abscess) in the upper gluteal cleft | |
| Specialty | General surgery, colorectal surgery |
| Symptoms | Pain, swelling, redness, drainage of fluid |
| Usual onset | Young adulthood |
| Causes | Ingrown hair in the natal cleft |
| Risk factors | Obesity, family history, greater amounts of hair (hirsutism), not enough exercise |
| Diagnostic method | Based on symptoms and examination |
| Differential diagnosis | Hidradenitis suppurativa, perianal abscess, folliculitis |
| Prevention | Shaving the area |
| Treatment | Incision and drainage, surgical removal |
| Frequency | 3 per 10,000 per year |
Risk factors include obesity, family history, prolonged sitting, greater amounts of hair, and not enough exercise. The underlying mechanism is believed to involve a mechanical process where hair and skin debris get sucked into the subcutaneous tissues through skin openings called pits. Diagnosis is based on symptoms and examination.
If there is infection, treatment is generally by incision and drainage just off the midline. Shaving the area and laser hair removal may prevent recurrence. More extensive surgery may be required if the disease recurs. Antibiotics are usually not needed. Without treatment the condition may remain long term.
About 3 per 10,000 people per year are affected, and it occurs more often in males than females. Young adults are most commonly affected. The term pilonidal means 'nest of hair'. The condition was first described in 1833.