Pilonidal Disease: We Have Outpatient Procedures for This Painful but Rarely Talked About Issue

You may have never heard of it, but pilonidal disease often makes its presence known with significant pain and has the potential for creating serious infections. It is more common in truck drivers and others who sit most of their day, affects three times more men than women, and typically begins when body hair is forced out of its usual growth pattern.

Our physicians are often called upon to treat pilonidal disease and have significant experience and skill in stopping its progression. You may not want to discuss it at your next social gathering, but we’re happy to explain pilonidal disease. As a colorectal surgeon, Dr. Gabriel Akopian provides expert in-office treatments for this rather common condition.

What is pilonidal disease?

Pilonidal disease is a bacterial infection in the crease of your buttocks; the area from the bottom of the spine to your anus. Pilonidal disease may refer to a one-time cyst or a chronic condition with recurring cysts and abscesses. It usually starts when a hair follicle becomes infected causing skin cells and debris to become trapped under the skin. Hair is then pushed or pulled into the the cavity.

The irritation and inflammation caused by the hair can cause a fluid-filled sac (cyst) with membranous walls to form in the surrounding tissue. When left untreated, a pilonidal cyst can fill with bacteria and result in a large area of infection (abscess) under the skin, which can become excruciatingly painful.

The abscess may eventually begin to ooze pus and blood. There’s also the chance of developing a sinus tract, which is a narrow cavity or empty tunnel under the skin through which the abscess can enlarge and spread in any direction. Because surgery is necessary to close these tunnels or sinus tracts, we always prefer to treat pilonidal disease before a sinus tract develops.

Symptoms to watch for

Symptoms typically begin as mild tenderness that’s often most apparent when you’re seated. You may also notice a small pimple-like bump in the area. As the infection worsens, the affected area grows larger and is usually felt as a lump under the skin that becomes increasingly painful. The cyst may eventually develop an opening at the surface that oozes very foul smelling and discolored drainage tinged with blood.

Seek treatment early

We understand that it’s probably not fun to discuss, much less undergo an examination of, your buttocks. However, seeking treatment early can spare you significant pain and decrease your risk of developing a more serious infection.  

We can usually treat pilonidal disease in the office with a procedure called pit excision. The goal for treatment is to clear the infection by removing the entry point for hair and dead cells. Typically, Dr. Akopian makes a small incision in the area of the abscess and excises the hair follicles which lead to the cyst. It’s a relatively quick, painless procedure because we numb the area with an injection of local anesthetic.

If for some reason a cyst is severe, or it recurs or fails to heal, Dr. Akopian may perform a more involved Bascom cleft lift procedure to remedy the problem.

You can expect detailed instructions regarding aftercare of the treatment site, and you’ll return for follow-up visits to monitor healing.

If you’re suffering from a pilonidal cyst, call our office in Pasadena, California, or use the online booking form to schedule an appointment right away.

 

  




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