Royal Prince Alfred Hospital
Royal Prince Alfred Hospital
Department of Colorectal Surgery

Colorectal Surgery

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Pilonidal disease

Pilonidal disease is a condition that affects the natal cleft of the buttocks. This condition tends to affect young patients and occurs when hair burrows into skin to cause a nest of hair to accumulate under skin. This can then become infected causing pain, swelling and discharge.

An acute pilonidal abscess is where there is a collection of pus because of the nest of hair. Treatment of this involves surgical drainage. The nest of hair is also removed at the time of drainage of the pus. The wound is usually left open to allow it to heal by itself over several weeks. Special dressings while the wound heals may be necessary. Antibiotics may also be required.

A chronic pilonidal sinus is where there is a chronic infected cavity associated with the nests of hair. A pilonidal sinus usually discharges pus continuously and may get periods of exacerbation where acute abscesses can form. Treatment is to excise the chronically infected sinus. A flap reconstruction may be required after excision of the sinus.

Reviewed 2017