Pilonidal Abscess: Causes, Symptoms, Treatments and Prevention

Been diagnosed or wondering about this strange-sounding infection? Well this page will give you a brief guide on all you need to know about a pilonidal abscess.

Pilonidal is a medical term that means “a hair-containing cyst of the skin in the lower spine”. The term originates from the Latin word, “pilus” meaning hair, and “nidus” meaning nest.

Since there are hairs in this part of our lower spine aka the “tail bone”, the hair can grow inwardly, and the pores of the skin can get blocked. If this happens, a pilonidal abscess can form, ie an abscess between the top of the buttocks, backside, bottom or bum (whichever term you prefer!). The problem is more common in men.

 

Pilonidal Abscess Causes

There are several causes of pilonidal abscess:

• Direct trauma or pressure to the lower spine – such as in the case of prolonged sitting (travelling) and long term bed-rest (for people in coma or complete bed rest). Obesity can also cause direct damage to the lower spine due to the heavy weight.
• A break to the skin – a crack, wound or any small opening to the lower spine can cause harmful organisms to enter the skin. This can infect the wound and eventually cause pilonidal abscess.
• Suppressed immune system – a weakened immune system may be caused by disease, medications and treatments, such as chemotherapy and radiation therapy. If the immune system is down, the protection is also low, and this can cause infections to form.
• Foreign object – when a foreign object like sand or dirt enter an opening of the skin in the lower back, this can cause infection and the person can acquire pilonidal abscess.

• Poor hygiene and environmental factors –If the environment is crowded (like in refugee huts, evacuation centers and slums), the risk for acquiring pilonidal abscess is higher. Poor hygiene also plays a huge role in formation of the problem. Poor self care can block pores and accumulate dirt, making oneself at a higher risk for the occurrence of infection.

 

So, the risk factors for acquiring pilonidal abscess are the following:

• Frequent travellers (e.g. long-distance drivers), comatose patients, people on complete bed rest and certain occupations. People who are sitting or at bed rest for a long time have a higher risk for acquiring the problem than those who are moving or active. The pressure is greater in the lower spine due to the weight and gravity. The blood flow does not circulate well at this part of the body.
• Family history contributes to the acquiring of pilonidal abscess. The anatomy of our parents plays a role in our genetic makeup. The anatomy of pores in the skin can be inherited, and a large pore is a risk factor for the development of abscesses. Loose hair can penetrate the skin including dirt, sand and microorganisms.

 

How Can You Spot the Problem?

The signs and symptoms of pilonidal abscess vary from one person to the other. Common signs include:

• Lump in the lower spine – this is protruding and varies in size.
• The lump is painful, red and swollen. It may also be warm to touch. It may appear yellowish due to the pus present inside.
• A pus may drain out of the infected area.
• Due to inflammation brought about by the infection, fever may be present.

 

Pilonidal Abscess Treatment

Treatment of pilonidal abscess can be pharmacological, i.e. the use of medicines to fight infection and reduce the pain. The drugs used may include:

• Oral antibiotics – may come in the form of tablet or capsule to fight infection and normalize bodily functions.
• Topical antibiotics – an antibiotic cream or ointment applied externally to skin area affected.
• Injectable antibiotic – an antibiotic that comes in ampule or vial container, injected intramuscularly by the physician or health care provider to fight infection.
• Antipyretic medicines – to normalize body temperature and to reduce inflammation and pain.
  

  Pilonidal Abscess treatment often includes antibiotics

 

Pilonidal Abscess Surgery

Pilonidal abscess treatment may also include surgical methods such as incision and drainage. Surgery is reserved for more severe infections. This is often done as an outpatient basis, meaning that after the procedure, you may go home and rest. There are also some cases that require admission to the hospital.

Usually, incision and drainage is done with local anesthesia (injection of a numbing medicine to the surgical site and its surrounding muscles). In this procedure, the patient is awake through the entire procedure.

There are also some cases where a general anesthesia may be done (wherein an oxygen mask is placed in the facial area covering the mouth and nose, putting the patient to sleep).  A general anesthesia may be preferred by the doctor when the infection is deep. Another thing to consider in ordering general anesthesia is the age of the patient. Kids may be uncooperative and they are also difficult to keep still through the entire procedure. In addition, pain tolerance will also be considered.

 

Pilonidal Abscess Home Treatment

There are also treatments for pilonidal abscess that we can do at home for speedy recovery:

• Proper wound care – the process of proper wound care relies on a faster recovery. Wash hands before touching the items for wound care. Put on gloves and cleanse the wound and apply medications in a sterile manner.
• Warm baths – cleanses the whole body and the warm water reduces pain in the area.

Drinking medicines on schedule is a must and so is the follow-up check up to your doctor. The doctor will be able to assess any progress in your abscess. During the follow-up check up, medications may be adjusted such as the dosage and frequency.

 

Finally, a word on prevention:

Pilonidal Abscess Prevention

Pilonidal abscess, just like any other diseases may be prevented by the following measures:

• Proper hygiene – bathe daily and change clothes regularly. Hair in the buttocks may be trimmed or shaved to prevent the loose hair from penetrating the skin.
• Healthy diet and lifestyle – low in fat and salt. Prepare a healthy diet making the food pyramid your daily guide to food selection. Exercises like sports and other activities are not only fun, but also healthy. In addition, exercise promotes good blood circulation all throughout the body.

 

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