Pilonidal disease

Pilonidal disease is a type of skin infection that typically occurs as a cyst between the cheeks of the buttocks and often at the upper end. Symptoms may include pain, swelling, and redness. There may also be drainage of fluid, but rarely a fever. Risk factors include obesity, family history, prolonged sitting, greater amounts of hair, and not enough exercise. The underlying mechanism is believed to involve a mechanical process where hair and skin debris get sucked into the subcutaneous tissues through skin openings called pits. Diagnosis is based on symptoms and examination. If there is an infection, treatment is generally by incision and drainage just off the midline. Shaving the area and laser hair removal may prevent recurrence. More extensive surgery may be required if the disease recurs. Antibiotics are usually not needed. Without treatment, the condition may remain long-term. About 3 per 10,000 people per year are affected, and it occurs more often in males than females. Young adults are most commonly affected. The term pilonidal means 'nest of hair'. The condition was first described in 1833.