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Pilonidal Disease

Posted on Feb 27, 2015 at

Pilonidal disease is a cyst that forms at the tailbone as a result of an ingrown or infected hair(s). About 0.7% of the population (roughly 1 million people) is afflicted with pilonidal disease. Dr. Tahernia is an expert in surgical treatment of pilonidal disease.

The symptoms of pilonidal disease include: tailbone pain, tailbone swelling and inflammation, redness in tailbone area, drainage and fever. If there is an infection and it worsens, sinus tracts (channels or cavities) may form beneath the skin and surgical intervention is usually necessary. Infections associated with pilonidal disease can respond to antibiotics however surgical treatment will often be necessary.

Given the potential chronicity of this condition, one needs a comprehensive evaluation and surgical approach to afford the highest possible chance for cure.

Indications for Surgical Treatment 

The decision to operate on those with pilonidal disease depends on the state of the affected area. If there is an acute infection, the first step will be to address the infection with antibiotics as well as a first stage drainage. As the infection clears, a more definitive treatment will be pursued. In order to properly treat the pilonidal disease a wide excision may be necessary to remove the disease bearing tissue followed by reconstruction using plastic surgery reconstructive techniques.

Surgical Techniques

  • Simple incision and drainage
  • Marsupialization- incision and drainage with wound edges sewn to the sides with healing occurring over time
  • Wide excision of disease and leaving wound open
  • Wide excision of disease and closing wounds (see illustrations below)
    • Primary closure
    • Flap closure (local and distant tissues)
    • Rhomboid Flap Closure
Pilonidal-DIsease

Risk Factors

There are a few known predispositions to pilonidal disease, including but not limited to:

  • Family History
  • Fetal developmental problems (Spina Bifida Occulta)
  • Amount of hair in the tailbone area
  • Increased friction and pressure on tailbone (such as improper sitting or being over-weight)
  • Trauma to tailbone (such as a fall)
  • High (tailbone) impact activities (such as horseback riding)
  • Tendency toward congested hair follicles (hidradenitis supperativa, acne, boils, sebaceous cysts)
  • Tendency toward other dermatologic conditions (eczema, etc)

Cure

Wide excision with reconstruction of the affected areas affords the highest chance of cure. A very high percentage of patients enjoy a lifetime cure following surgical treatment.

 

Frequently Asked Questions

What is Pilonidal Disease?

Pilonidal disease is a cyst that forms at the tailbone as a result of an ingrown or infected hair(s).

What are the symptoms associated with pilonidal disease?

The symptoms of pilonidal disease include: tailbone pain, tailbone swelling and inflammation, redness in tailbone area, drainage and fever.

Is surgery covered by insurance?

Surgery is covered by most PPO insurance plans.

What are the complications associated with surgery?

Infection, wound healing delays, and recurrence of the disease are the most common post-operative complications.

How is pilonidal disease prevented?

Proper hygiene of the sacrococcygeal region is very important. Shaving the tailbone area or permanent hair removal can reduce the risk of pilonidal disease. In addition patients should avoid prolonged sitting in one position as an additional measure to lessen chance of primary or recurrent disease.

Questions or want to talk to Dr. Tahernia?

Give us a call: (310) 614-9701
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