Once you know you have a Pilonidal Abscess you have two choices: surgery or try to live with it. The decision will be based on the frequency and severity of your flare ups and should be discussed with your doctor. Surgery is not right for everyone and it is up to you to read through the options and make the decision. Each of us has our own level of tolerance for discomfort and our own feelings about the science of medicine.
Surgery has it's risks but so does choosing to live with the abscess. How severe the drawbacks are depends on how active your
abscess is. At the worst case, an untreated Pilonidal Cyst that flares up regularly probably keeps getting bigger over time. Having your immune system constantly battling infection
can wear it down to a point where your immune response is greatly
reduced, leaving you more vulnerable to infections or
sickness.
One thing you can be certain of, the odds of the abscess going away on it's own are not good. There is considerable evidence that if the
abscess is surgically removed shortly after the first flare-up that chances of further problems are minimal. For those who opt to forgo surgery, the
cornerstones of self-care for Pilonidal abscesses are Hygiene, Posture and Hair Removal.
Hygiene -
Clean is the word. Very, very clean. Use antibacterial soap and don't let a day go by without bathing. It is best to also scrub the area with a loofah-type of sponge to exfoliate any hairs
or other debris hanging around. Sometimes it's actually loose hair from your head that lodges in the buttock cleft from rinsing your hair after shampooing - it's wise to always rinse out the cleft as the last thing you do before getting out of the shower.
One thing that may have to change in your life now that you have this condition is your level of comfort with your body. If you are a person who thinks everything "down there" is dirty and shouldn't be touched, you are going to have a hard time with this disease. You and several strangers are going to become intimately acquainted with places that the sun does not shine, so you are going to have to learn that your private parts are not bad or dirty; they are a part of your body. They need to be cleaned and cared for and you're just going to have to get over the "ewwwww" factor.
If you are prone to boils or acne on your backside you might take a
look at your shampoo and conditioner to make sure neither of them
have any oils as ingredients - those oils might be clogging your
pores and encouraging the problem. A great shampoo for those who are
sensitive to pore blockages is Aveda Scalp Benefits.
After washing, swab the midline with a product that helps prevent ingrown hairs.
- No Bump ** is available at Sally Beauty Supply and other retail beauty supply outlets. Look for it in the wax and hair removal section. Cost is about $8 for a 4 oz bottle.
-
Tend Skin** (www.tendskin.com) Should be available at any beauty salon that does electrolysis. The cost is around $15 for 4 oz bottle, you may have to call around to find the best price.
**both of these products can burn the skin so try using only every other day at first until you see how your skin reacts,
use a q-tip to best control the area of application.
There is an FDA approved cream that claims to retard facial hair growth. From what
we've read so far, it showed results in 58% of those tested, 42% experienced no results.
We haven't used this nor do we know anyone who has and you should definitely check with your doctor first!
http://www.vaniqa.com/
Also do a Google search on Vaniqa to read other info besides the manufacturer's hype...
Powder also helps to keep the area dry, especially if you're active or sweat a lot.
Hair Removal -
So much fun, we have whole page about it!
Medications -
Antibiotics - are the usual route to knock back an infection. Be sure to take them for the full course, don't stop when the pain has gone. Don't make the mistake of thinking that you can cure Pilonidal Disease with antibiotics. The antibiotics will kill the immediate infection but it will most likely be back since the
abscess is still there and prone to infection.
Iodex - (Courtesy of message poster Sandra) Is Iodine in a paste form that helps draw out infection. Use it for real bad flare ups - unless the infection is beyond the drawing out stage and you need it lanced. To use during the day just cover with a bandage since it is black in color and will stain your clothes. It works best overnight - apply liberally then cover and use a heating pad. Your pharmacist probably won't stock it and will need to special order. Made by Lee Pharmaceuticals 1444 Santa Anita Ave.so. El Monte, CA 91733. 800 950-5337
Homeopathic Remedies - There have been reports of good results from the homeopathic remedy of Hepar Sulphuris and Silicea, which several people on the message board are trying in hopes of avoiding surgery. Beyond that, Pilonidal Cysts will not be cured by Herb Compotes, Colloidal Silver Concoctions, Tea Tree Oil or any other potion.
Drainage -
Pilonidal abscesses do tend to drain during flare-ups if you have a sinus opening or any weakened section of skin such as a scar from lancing. The amount of drainage will determine what sort of dressing you use. Light drainage can be dressed with gauze and medical tape. Suggestions from the message board for dealing with heavy drainage include using feminine mini pads that will tape right onto your underwear.
Posture -
Be careful how you sit. Pressure from poor sitting positions can aggravate the
abscess. This is especially true of driving since most auto seats put the body into a position where all the weight localizes onto the tailbone area. The name of the game is to keep the pressure OFF your tailbone. No
slouching in your chairs, this is suspected to be a primary cause of
the "stretched" follicles/pores that start Pilonidal
Disease.
Cushions -
A must for anyone trying to live with this disease. It is imperative to keep the pressure off your tailbone. Don't get a "donut" designed for hemorrhoid sufferers. What you need is a coccyx cushion. There are several brands available and they can be found online or at any medical supply store. Prices start at about $20.
Higher quality cushions can be found at
www.tushcush.com
and Gelco
Ergonomic Gel Seat Cushions.
There is an excellent run-down of various cushions over at
coccyx.org:
http://www.coccyx.org/coping/cushions.htm
Also, for those who cannot find relief with the cushions on the market, there is something called seat mapping system that some rehabilitation centers are using to help determine the best type of cushion to use for pressure relief for people with various disabilities. The centers have various samples of cushion materials (air, gel, closed cell, open cell) that could be tried over your chair, car seat or other place and the computer reads out how much pressure is present and exactly where it is over the buttock region. From the readouts they make alterations in the cushion, try another material, or/and change your position to relieve the pressure over the painful or delicate area. These professionals suggest and can customize cushions if necessary to relieve pressure. A prescription is
needed for the evaluation. You can also use it to determine which seat cushion was best
to use on a saddle for horse back riding."
Another custom seating cushion product:
www.rohoinc.com
More info on pressure mapping:
www.pressuremapping.com
This page last updated:
07/10/2007
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