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Pilonidal Abscess – Treatment, Surgery, Causes, Symptoms

Updated on December 19, 2013

A pilonidal abscess refers to a large boil which occurs next to the tailbone. The meaning of the word ‘pilonidal’ is a ‘nest of hairs.’

A pilonidal abscess develops near the crack of the buttock. It may be noted that a pilonidal abscess is generally present near the tailbone. Men are most likely to get affected by pilonidal abscess, but women can also experience the condition.

Symptoms of Pilonidal Abscess

The signs and symptoms of pilonidal abscess are listed below:

  • Pilonidal abscess is usually infected. Tenderness when walking or sitting is generally the first sign of an infected pilonidal abscess. Such tenderness can result in sporadic pain or chronic pain. It may also be noted that the severity of this pain can change as per the position of the body.
  • The pain associated with a pilonidal abscess typically lasts for a few days. However, if there is an increase in pain, then it is an indication that the abscess is growing. Swelling or inflammation of a pilonidal abscess is most likely to result in the extreme pain.
  • The swelling of a pilonidal abscess is accompanied by the collection of blood and foul-smelling pus in the growth. Such a swollen pilonidal abscess is extremely tender to touch. It may restrict a patient from carrying out the daily functions. At this point, it is essential that affected individual seek medical help to treat the condition.

Causes of Pilonidal Abscess

The exact cause of a pilonidal abscess is yet to be determined. It is understood that a majority of pilonidal abscess cases occur due to puncture of the skin by hair. The hair can get forced down into the skin via activities that create pressure and friction, such as tight apparels, rubbing of skin against skin, long instances of just sitting, bicycling, or similar causes. The body construes the hair as an alien material and forms an abscess around it.

The above reasoning is applicable for the rare examples of pilonidal abscess which affects sections of the body other than next to the tailbone. For instance, dog groomers, barbers, and sheep shearers have experienced the formation of a pilonidal abscess in the skin occurring between the fingers.

It has also been suggested that the normal movement or stretching of the deeper skin layers leads to extension and rupture of a hair follicle. A pilonidal abscess will then form around this burst follicle.

Some of the risk factors which increase the susceptibility to developing a pilonidal abscess are listed below:

  • A sedentary lifestyle
  • Excessive weight
  • Coarse or stiff hair
  • Sports or professions which require prolonged sitting
  • Increased body hair
  • Poor levels of personal hygiene

Treatment of Pilonidal Abscess

An infected pilonidal abscess is typically full of bus and elicits swelling. Hence, it can be treated by draining of the pus. In some cases, the pilonidal abscess will drain without medical help, while a majority required medical treatment.

A doctor, most often a surgeon, will carry out the process of draining a pilonidal abscess. A numbing agent is first applied to the abscess, and then it is pierced. In certain cases, the doctor may need to make an incision for the pus to drain out from the pilonidal abscess. Once the procedure is complete, a pain reliever will be prescribe by the doctor.It is important for patients to go for regular checkups so as to verify whether the abscess has drained properly and whether the healing process is occurring normally.

The doctor may even recommend antibiotics even after a pilonidal abscess has been successfully drained. The medication is given to destroy the bacterial infection. In some cases, a doctor may only suggest the use of antibiotics and not go for incision or piercing. The dosage of antibiotics typically last for about ten days.

Patients who experience recurrent and severe cases of pilonidal abscesses may require treatment via excision. It is a procedure whereby the complete abscess is surgically removed. The surgery is a same-day procedure which can be carried out in a clinic. Patients who undergo excision of a pilonidal abscess are less likely to get affected by the condition in the future. Healing of the surgical wound will take about 4 to 6 weeks. Regular visits to the doctor are required to verify the healing process.

Prevention of Pilonidal Abscess

Infection of pilonidal abscess can be prevented by engaging in correct personal hygiene practices. It is important to take a through shower every day. After the entire body is washed, take time out to separately wash the area affected by a pilonidal abscess once again.

People who are prone to pilonidal abscess should stop the use of conditioners and shampoos that have a lot of oil content. Also avoid the use of hair and body products that have chemicals.

As pilonidal abscess is caused by penetration of hair into the skin, you can use hair removal products to completely remove hair from body parts most prone to the condition.


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