Shiva Seethal

Pilonidal Cysts— A Pain in the . . .

Pilonidal cysts and sinuses are conditions that occur from hairs growing downward into the skin and deeper tissues, usually in the region of the lower back and tailbone. Pilonidal cysts occur in 26 out of every 100,000 patients. They are three times more common in males and tend to show up in the late teens and early 20s. The name is derived from the Latin words pilus (“hair”) and nidus (“nests”). Folks who carry more hair in the affected areas are more likely to suffer from this ailment. It was once thought that they were congenital but more recent evidence has cast doubt on that assumption.
Many times, they are a source of pain or discomfort. Specifically, due to their awkward location, sitting for long periods can aggravate the pain. When examined, they appear as swelling or as dimples in the skin. In the uncomplicated form, they can be troublesome, but symptoms can become much worse when they become infected. Abscesses can form at the sites of the cyst and in such circumstances, these require surgical drainage.
Definitive management can be achieved by excising the affected skin and underlying tissue. This is best performed when there is no inflammation or infection. In the presence of infection, it is better to treat and allow to subside before attempting complete excision. In severe cases, multiple procedures are often required. Thankfully, with proper management, many of those affected can “outgrow” the ailment and it is very uncommon in later years when treated earlier.
If this ailment and its symptoms sound familiar, have a discussion with your doctor about treatment options. Sometimes early intervention is best to avoid complicated outcomes. Hope this helps!
This article is sponsored by Heart of Florida Regional Medical Center.
BIO: Dr. Shiva Seetahal is a board-certified general and bariatric surgeon. He has published over 20 scientific articles and book chapters. For questions related to surgical health, you can contact him at, or call his office at (863) 421-7626 to schedule an appointment.

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