You and Your Scar
Once you are finally healed, you will have a war wound to remember your battle with Pilonidal Disease. The scar will go through many changes over its first year as it remodels and settles, and you will almost certainly go through periods of “Pilonidal Paranoia” as the scar matures.
Many people are alarmed at how ugly their newly healed scar seems to be, but don’t worry, the scar will soften and fade to a point where it is barely noticeable (with the exception of those who’ve had a major flap surgery) within six to eighteen months.
The scar will be very tender for the first 6 months, and it may go through occasional periods of tenderness for several years. Once damaged, skin will never completely regain all the ability to stretch that it had before. Tenderness is an indication of swelling – which tells you that the area has sustained some type of injury. When a below skin injury happens, it is called a closed wound (not to be confused with a closed surgery) a bruise is considered a closed wound, there is damage below the skin but the protective barrier of the skin has not been broken.
Light swelling in a Pilonidal surgery scar merely indicates that fluid has built up under the skin due to minor damage. Significant swelling of the scar, coupled with an angry red discoloration, the area feeling warmer than the surrounding skin, and low-grade fever indicates a possible infection that needs attention right away.
I have found that my scar at 9 years post-op got tender once or twice a year. Almost always in conjunction with my going through a period of not sitting properly; slouching down in my desk chair while I work. My remedy for this is to immediately start sitting straight again and to start swabbing the scar with No Bump RX every other day until the tenderness subsides. I also sometimes take some Ibuprofin (anti-inflammatory properties) and if it’s really sore, I use an ice pack. The primary objective is to get that swelling down.
At 15 years post-op it almost never happens anymore.
|State of Condition||Symptoms||Remedies|
|Normal||light swelling, minor discomfort when you press on the area||Stop whatever activity is placing pressure on your scar, wash with Hibiclens, swab with No Bump, take some Ibuprofin. Possibly ice if the discomfort level is high enough|
|Not normal||significant swelling, red skin, pain on touch, noticeable warmth on touch, low-grade fever||Get in to see your doctor|
Scar Care Topicals
Many people put Vitamin E on the scar to soften it after it has healed, but there is no consensus as to whether this actually works. You can also try a number of scar treatments available at your local drug store, some can be rather pricey and it is entirely up to you if you want to spend the money on a scar that very few people will ever see.
- Mederma Skin Care for Scars $17 on Amazon
- Scarsof Scar Softening Cream $13 on Clavel.com
- Scarguard Scar Care $23 on Amazon
Long Term Scar Care:
I am a devout believer in the power of No Bump RX to keep further Pilonidal problems from developing. No Bump RX (and Tend Skin, a similar product) are designed to reduce inflammation and ingrown hairs. Their primary active ingredient is… aspirin! This stuff works great on pimples too! It can be harsh, so be careful about how often you use it.
Everyone’s skin is different and you will have to experiment to see how yours reacts. I found every other day is ok for me, for about a week. Apply the product using a Q-tip so you can control where it goes. Use once a month after the scar has settled somewhat to head off any inflammation or blocked pores in the cleft. BE CAREFUL about not getting either of these products on the sensitive tissues around the anus or genitals! OUCH!
The main overview page for our Surgery Aftercare section where you’ll learn all about wound care and healing after surgery.
Now that your Pilonidal journey is complete, share your story and any tips you have for those who are newly diagnosed.
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This page last updated: January 5, 2019