"Pilonidal" comes from two Latin words meaning
"hair-nest". Basically, pilonidal disease is a
severe case of ingrown hair which occurs over the tailbone.
It probably happens there because of the constant pressure
and chafing which occur when sitting and walking. The problem
is also called " Jeep driver's disease "
because so many GIs suffered from it during World War II.
The problem begins when hairs are driven into enlarged
pores between the buttocks; they then break off and accumulate
under the skin, forming a nest of hair, or a "pilonidal
cyst". These cavities can easily become infected, causing
pain and swelling in the area. An abscess
(pus collection) forms in the cyst if the infection is not
treated
Treatment of an abscess requires surgical drainage and
removal of the accumulated hair from the cyst. After healing,
there is often recurrence of the problem; this can be prevented
in many cases by depilating the
area (removing the hair by shaving, electrolysis, waxing,
or hair creams). This should be done for about one inch
on each side of the center line from the anus to the top
of the cleft between the buttocks. If there is no hair present,
the pilonidal problem usually does not recur.
If the problem becomes chronic (keeps recurring), it may
help to surgically remove the skin and underlying tissue
from the area, which contains the enlarged pores and sinus
tracts. This operation is best done if there is no infection
present; that way, the skin can be stitched together after
removing the cyst with less chance of developing an infection
in the incision.
The problem with the operation to remove a pilonidal cyst
is that it does not guarantee that the cyst will not come
back. It is still a good idea to keep the area free of hair
for about one inch on each side of the center line. This
should be done indefinitely (forever).
Both operations, the incision and drainage of the infected
cyst, and the excision of the recurrent cyst, can often
be done as an outpatient, and sometimes under local anesthesia.
After the procedure , it is important to
avoid sitting on the incision until it is healed (usually
two to three weeks). Any activity that is comfortable is
OK. If there are any special wound care instructions, the
surgeon will let you know. There will probably be two to
three office visits after the procedure to make sure all
is going well. You should start depilation as soon as the
wound is healed; this is the best method to make sure it
does not happen again.
