FAQs: Pilonidal DiseaseShomaf Nakhjo, DO Advanced Minimally Invasive Surgery

What Is Pilonidal Disease?

Pilonidal disease is a chronic condition that causes infection in a pocket beneath the skin, typically occurring in the natal cleft (the lower center of the back above the buttocks). This condition is caused when hair, debris, moisture, and pus collect, creating a small pit that tunnels its way into multiple branches beneath the skin. While antibiotics and abscess draining can provide temporary relief, surgery is the only definitive treatment that can cure the disease.

What are conventional treatments for Pilonidal Disease?

Acute phase treatment of the disease involves the use of antibiotics, and if necessary, abscess drainage. However, for long-term treatment, surgery is required.

Traditionally, it has been believed that pilonidal disease is a congenital condition that results from trapped hair and debris deep within the skin. However, most procedures performed by non-specialists are still based on this theory and often leave the wound open, which requires daily dressing changes for 1-3 months and can be disruptive and painful to everyday life. In addition, recurrence rates are high, up to 35-40%.

Is there a long-term, permanent treatment for Pilonidal Disease?

The Cleft Lift Procedure is considered the best surgical option for preventing recurring pain and infection from pilonidal disease. This procedure involves removing pitted or scarred midline skin from one side of the cleft, shifting fat and skin on the opposite side of the natal cleft, and drawing the deeper tissues together to re-contour the cleft. The resulting wound is off to the side of the midline, exposed to air, and can heal well, resulting in minimal discomfort for patients. Complications are rare, and the most common one is a separation of the wound edges where tension is high, which usually resolves in 2-3 weeks. Recurrence can happen in 1-5% of cases.

Learn More about Pilonidal Disease

If you want to learn more about pilonidal disease, treatments, and the cleft lift procedure, schedule a consultation at our office with Dr. Nakhjo today.