HealthInfo Aoraki South Canterbury
Pilonidal disease
Mate kÅpukupuku karioi ki te kiri kumu
Pilonidal 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 is not 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:
- having curly or coarse body hair in the area around your buttocks
- a family history of the disease
- being overweight
- poor hygiene
- prolonged sitting or repeated friction to the area causing increased sweating
- certain other skin conditions.
Pilonidal disease can affect men and women but is most common in men. It usually occurs after puberty and is rare after the age of 40.
Diagnosing pilonidal disease
When you only have a pilonidal sinus, you may not notice any symptoms, but you might have a small pit or dimple in your natal cleft. You might notice a clear fluid coming from the sinus.
If you develop a cyst, you may notice a small lump, but this is not 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:
- pain, redness and swelling
- pus, or blood-stained fluid draining from the holes – this may smell bad
- a fever or feel sick and unwell.
If you have any of these symptoms, it's important to see your general practice team and receive treatment.
Treating 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:
- keeping the area clean
- avoiding tight clothing that increases friction or sweating
- keeping your weight in the normal range for your height
- regularly removing hair from the area
- stopping smoking.
If you have troublesome symptoms with a pilonidal cyst without an abscess, your general practice team 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 your general practice team 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 but these are usually outweighed by the benefits. Your surgeon will discuss the likely risks with you.
It's important that you take adequate pain relief while your anal area is healing.
HealthInfo recommends the following pages
- DermNet NZ – Pilonidal disease
Information about this disease, including pictures.
- Patient.info – Pilonidal sinus
Information and treatment options for this disease.
Written by HealthInfo clinical advisers. Last reviewed July 2022.
SourcesReview key: HIPSD-13805
