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HealthInfo Canterbury

Pilonidal disease

Pilonidal sinus diseasePilonidal disease is a condition that occurs at the base of your spine in the gap between the top of your buttocks (your natal cleft).

It happens when hairs burrow into your skin, causing a small nest of hairs that has an opening to the surface of your skin.

Causes of pilonidal disease

We aren't sure why pilonidal disease happens, but it may be due to having a small dimple in the area, or damaged hair follicles that poke into your skin.

Once the hairs become stuck in your skin they irritate it, causing inflammation. A cavity can develop in this area called a pilonidal sinus.

This can form a lump (pilonidal cyst) that isn't painful or red. If this cyst gets infected it becomes a pilonidal abscess.

There are certain situations that make it more likely to happen. These include:

Pilonidal disease can affect men and women but is most common in men. Usually it occurs after puberty and is rare after the age of 40.

Diagnosing pilonidal disease

When you only have a pilonidal sinus present you may not notice any symptoms, but you might have a small pit or dimple in your natal cleft. You may notice a clear fluid coming from the sinus.

If you develop a cyst, you may notice a small lump, but this isn't usually painful. If you've had the disease for a while it may feel as if there is more than one lump. If you spend a long time sitting, the area may become sore.

If you develop an abscess in the area you may get:

If you have any of these symptoms, it's important to see a GP and receive treatment.

Treatment for pilonidal disease

If you have pilonidal disease without any symptoms you may not need treatment. But it's important to reduce the chance of the condition getting worse.

You can help prevent it getting worse by:

If you have troublesome symptoms with a pilonidal cyst without an abscess, your GP can refer you to the General Surgery Outpatients Department to see if you would benefit from surgical treatment. There are several types of surgery and your surgeon will give the details and pros and cons of each.

If you develop an abscess with pain, swelling, discharge or fever you need to see a GP as soon as possible. You'll be referred to a surgeon at the hospital straight away, who will treat the abscess by draining the area. You may be given antibiotics if you're unwell, or have other risk factors such as heart valve disease, or reduced immunity.

Risks of general surgery

Having surgery involves some risks, however these are usually outweighed by the benefits. Your surgeon will discuss the likely risks with you.

It's important that you are taking adequate pain relief to manage this while the anal area is healing.

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Written by HealthInfo clinical advisers. Endorsed by General Surgeons Canterbury DHB. Page updated December 2018.

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Review key: HIPSD-13805