Recurrent pilo - 5 years after open excision - need advice


New Member
I had a flare up last Saturday(18Nov17) and there is inflammation right under the scar tissue of my previous open wound excision which is to the left of my cleft and also inflammation right on the coccyx region. The pain and inflammation increased till Tuesday when I met a surgeon who suggested that I lance it and go on antibiotics. I chose to try the conservative part of taking the antibiotics first. Since then the inflammation and pain is slowly reducing and I can now easily sit, stand and sleep without any issues. It never looked red and I never had a fever. Here is what I have been doing the following regimen since Monday

1. Shower twice a day and apply Hibiclens on the inflammation and one visible pit to avoid further infection
2. Use the handheld shower to spray hot water on the pilo to make the cyst surface and drain.
3. Drying the area with the handheld dryer after shower.
4. I am meeting Dr Isho who does cleft lift in San Diego the coming Tuesday to get his opinion

What do you guys think? Am I doing the right thing by not getting it lanced and waiting for it to drain on its own? Any thing I can add to my regimen to make it drain?

BTW I do understand that the pit/sinuses/abscess is not going away without a surgery, but my wife and sister both seem to have had it several years ago and they have got away without a sugery.

Brief history
In 2011, I had 5 to 6 flare ups in as many months that drained on its own, so I got an open excision procedure done in July 2011. I was never given antibiotics. The open wound closed up wonderfully. In Dec 2012, I was put on a foam roller by my physio to treat an unrelated back ache and my scar tissue swelled a little bit, was painful to touch but everything resolved in about a week. No issues for 5 years till the current one.


New Member
I met Dr Isho today and he concluded that I still do not have an abscess and that I should just keep the area clean by scrubbing with normal soap and water daily to keep my pit open. He would recommend surgery only if this thing keeps flaring up