What is pilonidal disease?
Pilonidal disease is a chronic infection of the skin in the region of the buttock crease. The condition results from a reaction to hairs embedded in the skin. It commonly occurs between the buttocks.
This condition is more common in men than in women. It frequently occurs between puberty and age 40. It is also common in obese people and those with thick, stiff body hair. However, anyone can develop this problem.
Patients with pilonidal disease may notice a pilonidal cyst (abscess) that ranges in size from a small dimple to a large, painful mass. This infected cyst can:
After the abscess improves, many patients will develop a pilonidal sinus. The sinus is a cavity below the skin surface. It connects to the surface with one or more small openings or tracts.
Although sinus tracts can sometimes resolve without therapy, many patients need a small operation to treat them. Without it, these sinus tracts can become inflamed and infected.
Acute treatment — Abscess drainage
Pilonidal disease can be challenging to treat and can result in large wounds with delays in healing.
Our fellowship-trained colorectal surgeons offer a range of options. The first is drainage of acute pilonidal abscesses. This can occur during an urgent care appointment. At Houston Colon, the process involves several steps:
Although this procedure in Houston, TX, can offer relief, it alone does not prevent recurrent pilonidal cysts. Additionally, a sinus tract may still form even after drainage.
Surgical treatment for chronic or recurrent disease
When conservative management fails or the disease is chronic, we may recommend pilonidal sinus surgery in Houston, TX.
Houston Colon’s surgeons have received advanced fellowship training in evidence-based surgical methods. This means our team can perform several procedures to treat pilonidal disease.
Excision involves removing the cyst and the surrounding tissue. The wound may be left open (open healing) or closed (closed healing).
- Open healing reduces the likelihood of the problem recurring, but it slows down healing time.
- Closed healing promotes faster healing and can be associated with recurrence.
A modern technique at Houston Colon is called a pilonidal cleft lift, also known as a Bascom flap. It involves removing the infected tissue and reshaping the buttock contour. Doing so reduces the risk of recurrence.
Surgery is considered a last resort due to challenges with wound healing in this area. However, it is often the only lasting solution for recurrent disease. Seeing our board-certified specialists for pilonidal cyst surgery in Houston, TX, can also help improve the likelihood of long-term success.
Prevention and non-surgical management
Sometimes, it’s possible to manage and even prevent recurrent pilonidal cysts.
The specialists at Houston Colon recommend the following practices:
For mild or first-time cases, these measures can manage symptoms and reduce the risk of recurrence.
