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Tactics for Dealing With Pilonidal Cysts

Dear Dr. Roach: The article about the boy suffering after surgery for three years from a pilonidal cyst really hit home. My son developed a pilonidal cyst in June 2012 and also had a very bad infection from it. The surgeon refused to operate while he was infected. The cyst was just gross — so much blood and other yuck.

Finally, the surgeon gave up and operated at the end of September since we couldn’t get rid of the infection.

He had to cut out a lot of tissue in order to not cut across anything infected. For a month, he was healing great. Then two more holes appeared. We were heartbroken — my 17-year-old son, having what probably seemed like everyone looking at his private area, unable to heal and unable to cycle or swim.

The reason I’m writing is to please ask you to pass on what finally helped him heal: laser hair removal! The surgeon told us that every “problem” patient he had sent for hair removal had finally healed, and it truly has been a blessing. By the time he had his second laser session (two months), it was obvious that the wounds were closing up. We were there today for the fourth session, and they are closed up! Removing the hair made all the difference in the world!

Now we hope our son will be able to get back to his chosen sport — cycling! Please pass this on! — M.S.

Answer: Thank you for passing on this helpful information. I have received a great deal of mail about this topic, so let me explain a little bit more about pilonidal cysts.

“Pilonidal” means “nest of hair,” and a cyst is just a fluid-filled sac. They are most commonly found at the base of the spine, just above or within the cleft of the buttocks.

Prolonged sitting and sweating seem to predispose some to getting this condition.

Hair is commonly a problem with pilonidal cysts, with hair and debris often found by the surgeon at the time of removal. They can become infected, and many times, this is how they are discovered. One reader, a nurse, found crystals inside a pilonidal cyst and had success with Regranex, a medication used to help heal diabetic ulcers. Another reader recommended a surgeon who performed a surgery called a “cleft lift” procedure, which reduces risk of recurrence.

The Pilonidal Support Alliance offers a wealth of information and support. You can find it on the Web at www.pilonidal.org.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, Fla. 32853-6475.