Causes, symptoms and treatment of Pilonidal disease - Houston Colon – Division of Colon and Rectal Surgery

Causes, symptoms and treatment of Pilonidal disease

December 12, 2010

Pilonidal disease is an infection of the skin above the crease between buttocks. It starts as a cyst here that looks like a small dimple, and has hair protruding from the pit. Pilonidal disease can get so painful that pus or blood may drain from the pit, and one finds it difficult sitting and walking.


It was first thought that pilonidal cysts was congenital, and existed at birth. However experts now say that it can form in two other ways:

The cyst may form when a hair follicle gets irritated because of exercise affecting the buttocks area like cycling or horseback riding, tight clothing, heat and extensive sweating. Once the hair follicle gets blocked and infected, it swells and ruptures into surrounding tissues to form an abscess.

A loose hair of people with coarse or stiff hair may get trapped in the buttocks crease. It pokes into the skin, especially where there is a stretched or irritated hair follicle. This is where a cyst forms around the hair, and an infection sets in.


There are no specific symptoms for pilonidal disease. Once the cyst gets infected, there is redness and swelling at the top of the buttocks crease along with draining of blood and cloudy fluid. Sometimes, even walking and sitting gets difficult because of the pain here.

Diagnosis and treatment

Your doctor will do a visual examination by gently feeling the area around the buttocks crease to check for warmth, redness and swelling. Nothing else is generally required.

Treatment will include keeping the area around the buttocks clean using antibacterial soap, and taking antibiotics to control the infection. You could also try using an alcohol swab twice or thrice a day if the area gets irritated, to help manage the infection. Even draining of the cyst and surgery may be resorted to open or remove the cyst.
For more information about Pilonidal Disease and surgery contact the Houston Colorectal Surgical Associates today.