Children's Hospital Colorado
Pediatric Surgery

Pilonidal Disease (Cysts)

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What is pilonidal disease?

Pilonidal disease is caused by a pilonidal sinus, which is one or several openings in the skin between the buttocks. This small hole or tunnel often collects fluid or debris, which can cause a cyst or abscess (a sac filled with fluid or pus) to form.

Most pilonidal sinuses become infected when loose hair and debris collect in them. Hair and sweat, as well as friction and pressure, may push hair into the skin when your child is sitting.

Pilonidal cysts usually form over the tailbone. The first sign of a pilonidal cyst may be a painful bump, or abscess when the area becomes infected. Your child may also have pilonidal cysts without symptoms until they are an adolescent or young adult.

What causes pilonidal disease?

No one knows exactly what causes pilonidal disease. One theory is that hair follicles in the midline of the lower back get blocked and cause inflammation and infection. Others suggest that bits of hair from other parts of the body can get caught in a small opening in the skin of the lower back.

No matter the cause, children with pilonidal disease can have multiple, repeated bouts of infection and discomfort. Draining the abscess or removing the abscess or cysts can help, but these procedures may not fully cure the disease.

Who gets pilonidal disease?

The condition is found mainly in teenagers and young adults between 15 and 24 years old. It is more common in males.

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