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Pediatric Surgery
Pilonidal Disease (Cysts)
We treat kids like they should be treated: like kids. That’s why we designed our hospital just for them.
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.
What are the signs and symptoms of pilonidal disease?
- Pain or tenderness at the site
- Swelling and redness
- A skin opening that drains pus or blood, which may be foul-smelling
- Hair protruding from the cyst
- Fever (uncommon)
How do we diagnose pilonidal disease?
We usually diagnose pilonidal disease after finding pits (holes) in the cleft or skin between the buttocks.
Acute and chronic pilonidal disease can be diagnosed by additional findings of a tender mass (lump) and one or more sinus openings draining pus or bloody fluid. Laboratory studies and imaging are usually not necessary.
How is pilonidal disease treated?
Your child’s doctor may recommend surgery if your child has had multiple infections or is in a lot of pain. Surgery is an effective way to relieve pilonidal cyst pain and prevent infection from spreading.
During this operation, the surgeon drains the abscesses and removes the sinus tracts or tunnels and cysts. If your child has an infected cyst, the surgeon may leave the incision open to drain the infection after surgery.
Why choose us for treatment of pilonidal disease?
The care team at Children’s Hospital Colorado customizes a treatment plan based on the severity of your child’s pilonidal disease. Our multidisciplinary approach and experience with children help us to focus on treatment to minimize pain, while trying to limit the number of missed school days and activity restrictions.
Helpful resources
The Pilonidal Support Alliance provides a variety of information about pilonidal disease, treatment and support.
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