Pilonidal disease is an infection or inflammation of the skin above the buttock crease. It is more common in young people, particularly men who are obese or have thick hair. Prolonged sitting and poor hygiene can also contribute to the condition. Treatment involves draining the infected area and removing hair, or more complex surgery for chronic cases. Proper wound care and hair removal can prevent recurrence.
Pilonidal disease is a condition in which the skin just above the buttock crease becomes infected or inflamed. The disease often begins with an abscess in the natal cleft that is tender, swollen, and may drain fluid. After the abscess goes away, either on its own or with treatment, a pilonidal sinus or cavity under the skin will develop.
Pilonidal disease tends to occur in young people, most often between the ages of 18 and 40. Men are more likely to be affected than women, and people who are obese or have stiff, thick hair are also more vulnerable. A lifestyle or job that requires prolonged periods of sitting also contributes to the likelihood of developing pilonidal disease. Excessive sweating and poor hygiene can cause a pilonidal cyst to become infected and lead to pilonidal disease.
A pilonidal cyst, often the first sign of pilonidal disease, can range from a large, painful abscess to a small pimple. If the area is infected, it will drain fluid that smells bad, and the area will be red and tender. The infection could also cause fever or nausea. The pilonidal sinus tracts that develop can also become infected and cause swelling, pain, and drainage.
A hair that becomes embedded in the skin causes a pilonidal cyst, which can develop into pilonidal disease. Pressure on the buttock area from activities such as bicycling or long periods of sitting can cause the hairs to dig into the skin and become cystic. Stretching deep layers of skin can rupture a hair follicle, and hair growing from that follicle can also cause a pilonidal cyst.
An infected pilonidal cyst is typically treated with a simple procedure in which a doctor drains the infected area and removes hair and other foreign material. To treat pilonidal sinuses or chronic pilonidal disease, more complex surgery is required. In this procedure, a doctor opens the sinuses or abscesses and cleans them out, then leaves them open to heal from within. Leaving the wound open to heal reduces the risk of an infection recurring after the wound has healed.
If a surgical wound is not treated properly, a recurring infection is much more likely to cause the pilonidal disease to return. If the wound is left open, frequent dressing changes will be necessary to keep it clean and to allow fluid to drain. After the wound has healed, the hair around the upper buttock area may need to be removed to prevent further infection.
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