Tag: Pilonidal Disease

An experienced pediatric surgeon, Dr. Brian Gilchrist completed pediatric surgery residency training at numerous institutions and hospitals, including the University of Tennessee. Dr. Brian Gilchrist works to provide less painful, minimally-invasive surgical interventions for treating various diseases, including pilonidal disease. Since 2009, he has performed over 250 minimally-invasive procedures for pilonidal disease with no instance of complication or disease recurrence.

Pilonidal disease is a chronic skin infection that affects the crease of the buttocks – anywhere around the area on top of the tailbone to the anus. Often, the disease occurs between the onset of puberty and age 40. It is three to four times more prevalent among males than females.

Symptoms may include a small dimple or large painful mass in the affected area; pain that worsens when a patient sits; and fluid (clear, cloudy, or containing blood) draining from the site. If the area is infected, it may become red and tender, drainage fluid may have a funky order, and patients may also exhibit common symptoms of infectious disease (such as nausea and fever).

In almost all cases, the condition starts with an acute abscess episode when the area becomes tender and swollen. Pus may also drain from it. The abscess may go away naturally over time or with medical care. Once the abscess is gone, the patient may develop a pilonidal sinus. A pilonidal sinus is a cavity or empty space below the skin in the affected area that connects to the skin surface through one or more openings. In the majority of the cases, this needs to be corrected with surgery.

Experienced pediatric surgeon Brian Gilchrist, MD, completed a fellowship in pediatric and transplantation surgery at St. Jude Children’s Research Hospital and Harvard Medical School, respectively. With upwards of 30 years of medical experience, Dr. Brian Gilchrist is familiar with a range of congenital diseases, including pilonidal disease.

Pilonidal disease refers to a chronic skin infection that occurs at the crease of the buttocks near the tailbone, or coccyx. It results in at least one cyst that becomes infected or inflamed, creating the appearance of a small dimple in the area. Sometimes hair grows out of this dimple, but this isn’t always the case.

As the infection worsens, it creates a large, painful mass just above the buttocks and can result in the area becoming red and tender and leaking bloody or cloudy fluid. Patients may also present with a fever or feelings of nausea as their body responds to the infection.

To treat the cyst that forms, physicians will either remove it surgically or open and drain it. If a patient experiences a returning infected pilonidal cyst, surgery is the standard treatment option. Once the cyst is removed or drained, a pilonidal sinus will typically form in the area. This cavity below the surface of the skin will either resolve on its own or necessitate surgical removal.

Following treatment of the cyst, patients must keep the surgical site clean and dry as the skin heals. They must also remove hair from the buttocks crease via a hair removal agent or razor. Doing so reduces the risk of developing another cyst.