38 male Psoriasis, running, exercising after surgery, Koebner effect, closed incision.
Those were my main searches while recovering and worrying, although didn’t find much help. Since everyone’s situation is different, I wanted to share some thoughts for those possibly searching the same topics. There are so many horror stories on here, and I truly feel for anyone going through a rough recovery, but hopefully the majority of recoveries are short and uncomplicated.
Even though I was in pain for a few weeks, it wasn’t the end of the world and now I’m free of pain and my weeping cyst. I’m 7 weeks post-op now and been feeling great for 3 weeks and want to share a few experiences for those who might be looking for answers. If you suffer from psoriasis in your cleft/cheeks area, get it cleared up before you have surgery. I have psoriasis and have a steroid ointment that will clear up my psoriasis in a few days, but I typically just live with the psoriasis since the ointment application is a daily nuisance.
Neither my doctor nor surgeon said anything about my obvious psoriasis in the area pre-surgery. I even explained to them how I have psoriasis and that’s why the area was so red. A week after having a closed incision surgery I felt great and told my wife I felt like I could start running again (half joking with my stitches still in).
About day 8 I was in so much pain I wanted to start taking pain killers for the first time after the surgery. I could barely sleep. Apparently trauma to psoriasis prone areas can develop the “Koebner effect” where the skin forms puss filled lesions and sores. My stitches were covered in painful crusty sores and I was in constant pain (like an 8 out of 10). I called my Dermatologist’s after hours line and asked her about putting the psoriasis steroid on my stitches/incision and she recommended doing so. Thankfully it cleared up the koebner issue. It was 3-4 days of hell, and I regretted having the surgery every hour of those days. Just be cautious of you have psoriasis to keep it in check and you’ll be fine.
I spoke to a physician friend recently who said most surgeons won’t touch an area if you have skin issues until it’s cleared up. So maybe I was just unlucky. Next, running and exercising post closed incision. I run 3-5 miles about 3 times a week. When my surgeon told me after the procedure that I couldn’t run for 6 weeks I was devastated. I was also freaked out that I might rip my stitches and be stuck with an open wound which heals much slower.
I broke the rules and did gentle push-ups and pull-ups starting the day after surgery. I was very careful and listened to my body. All was fine. I had my stitches removed on day 12. On day 20 I broke the rules again and went for a very slow 2 mile treadmill jog and listened to my body again. All was fine and I was so relieved to get my legs going again. I ran every other day slowly and checked my incision often. I slowly built up speed from there and by week 5 I was running full speed again. I’m still not totally out of the woods from an accidental fall or something that could injure the healing scar, but am completely back to where I was running pre-surgery 7 weeks ago.
I started going to my wifes aesthetician to get the hair removed in that area. I found out that electrolysis sucks, but it’s better than the pilonidal cyst recurring! Which I read can have a ~30% recurrence rate. Apparently electrolysis is the best way to avoid a recurrence.
Last item, I had my cyst drained 2x in a 3 year period when it was huge and inflamed. I waited for it to heal and shrink before having my surgery. It was then small, the size of a grape, and allowed me to have the faster healing closed incision surgery. That process worked for me. I hope those experiences can help anyone in a similar situation.
Good luck! Greg