Very mild, should I still be concerned?

luckynmild

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Back story: I first got a cyst I think 5 years ago now? It was very mildly uncomfortable but then it popped and/or drained and it was all over within a week. It seemed like a one off weird thing but when it happened a second time, I looked up my symptoms and was fairly sure it was a pilondial cyst. It has now happened three times with a fourth I'm trying to slow/stop right now.

The first three times? They were years apart. This time? Its been a few months at best and I'm worried as I'm working an office job full time from home. I'd get a standing desk, but my knee would probably give out.

I haven't tried tea tree oil, I usually just make sure I wash well and put some coconut oil while its healing (don't want to clog my pores and make it worse by using it too often).

Thing is I haven't seen a doctor about it because it doesn't impact my life until I notice one/i think about it too much. If my case is this mild, should I see a doctor about it or be very concerned about it? The discomfort is so mild all it does is remind me to sit up straight or roll onto my side to sleep, which I prefer anyways. Never popped it myself, never had a bad pop or anything. Just an incredibly small amount of pus drains out and then it heals and is gone again.

I am incredibly lucky to have it be so mild but I am very nervous about what I should do now or if i should be that concerned at all as my default state is panic and I was a fool who read about worst case scenarios haha.
 
That's a great question. I have heard it said that there could be deep tracts that form if left untreated. I do not know this for a fact and I can tell you my surgeon let me know that surgical intervention was up to me entirely.
 
Not to be alarming but if I were you I would get it taken care of as soon as possible. You can look into more minor procedures such as Pit Picking/Epsit/Silac (all the same thing), or Cleft Lift, which is a more major one but said to be the holy grail (not in my case though).

3 years ago, in the summer during Covid, I noticed a small red pimple looking thing near the top of the midline, just below the tailbone. I thought nothing of it, it wasn't uncomfortable, it didn't hurt, nothing. I told myself that if it didn't go away in a few months I'd pop it. I never did. For a few more months until the summer of '21, it was completely fine then just out of no where it started to feel stiff and became very painful until it drained itself a few days later.

I knew what it was at this point but I didn't take its seriousness to heart at this point as I figured I would just have better hygiene, use tea tree, etc... As you can assume because I'm on this site, that didn't work and it progressively got worse and worse until I finally got the cleft lift procedure from a somewhat unqualified doctor in the summer of '22. Almost a year later, it finally fully healed (due to some complications) but it did not last long as there is now another pilonidal which is draining.

For me, the negative effect it has had on my life has more or less not been in terms of physicality, but rather mentally. Its a burden to deal with every day and a burden to have to orient my life around it, between how I dress and doctors I need to speak to.

Take my words as advice, as I wish I was smart enough to have done more research 3 years ago and go see a doctor as soon as you are able.
 
@diseasedone That's good to know! I did read about possible deep tracts too which is why I was wondering if anyone had any information about this off hand.

@iskanythingreal that sounds like a horrible experience and I hope that it all gets resolved well soon. As yours initially lasted longer, I wonder if that has an impact as well. I will say that if the biggest toll is mentally dealing with this, for me it is already incredibly minor. Yes I notice it and think about it, but I have several other issues with my body that do or can rule my day so this isn't even top 5 priorities in that way.

I really just don't want any major physical issues down the line as I have enough of those but I don't want something invasive if it is safe to leave alone as, again, it has barely any impact on me or my life.
 
Back story: I first got a cyst I think 5 years ago now? It was very mildly uncomfortable but then it popped and/or drained and it was all over within a week. It seemed like a one off weird thing but when it happened a second time, I looked up my symptoms and was fairly sure it was a pilondial cyst. It has now happened three times with a fourth I'm trying to slow/stop right now.

The first three times? They were years apart. This time? Its been a few months at best and I'm worried as I'm working an office job full time from home. I'd get a standing desk, but my knee would probably give out.

I haven't tried tea tree oil, I usually just make sure I wash well and put some coconut oil while its healing (don't want to clog my pores and make it worse by using it too often).

Thing is I haven't seen a doctor about it because it doesn't impact my life until I notice one/i think about it too much. If my case is this mild, should I see a doctor about it or be very concerned about it? The discomfort is so mild all it does is remind me to sit up straight or roll onto my side to sleep, which I prefer anyways. Never popped it myself, never had a bad pop or anything. Just an incredibly small amount of pus drains out and then it heals and is gone again.

I am incredibly lucky to have it be so mild but I am very nervous about what I should do now or if i should be that concerned at all as my default state is panic and I was a fool who read about worst case scenarios haha.
My son uses a coccyx pillow since he’s studying IT, $10-20 on amazon
My son who is 19 has a virtual consultation tomorrow with one of 3-4 colorectal surgeons specializing in pilonidal disease and offering SILAC, we’re consulting with one in California . I believe there’s one in NY and one in Wisconsin too. I’ve been following the case studies and trials since 2019 re: SiLaC, and just this month they are starting to offer it. He has had 2 cleft flap repairs that were unsuccessful and only created more pain and chronic problems. We are on our 5th treatment of laser hair removal which has completely eliminated all but a stray hair or two. Wound care Dr was debreding cavity/tract for about 6mo every 2-4wks and mild and temporary improvement was noted but continued to recur and flare. We have used Vashe to irritgate every 48hrs and I keep the top opened so it will prevent abscess. He uses a peri bottle 1-2x daily with hibiclens surgical scrub mixed with hot h20 to keep the surface of the wound and area surrounding as close to sterilize as possible and he’s only had one infection in 2yrs and that was due to no proper hygiene or wound care performed for 3-4 days after 3-16hr shifts at work which is labor intensive. Please let us know here if anyone is considering or has recently had the SILAC treatment, especially with chronic recurrent pilonidal disease. I will keep everyone updated after our virtual visit to determine if he’s even a candidate. Prayers to everyone out there dealing with this
 
@diseasedone That's good to know! I did read about possible deep tracts too which is why I was wondering if anyone had any information about this off hand.

@iskanythingreal that sounds like a horrible experience and I hope that it all gets resolved well soon. As yours initially lasted longer, I wonder if that has an impact as well. I will say that if the biggest toll is mentally dealing with this, for me it is already incredibly minor. Yes I notice it and think about it, but I have several other issues with my body that do or can rule my day so this isn't even top 5 priorities in that way.

I really just don't want any major physical issues down the line as I have enough of those but I don't want something invasive if it is safe to leave alone as, again, it has barely any impact on me or my life.
You can read my sons story below. His also appeared to be healed a couple months after both surgeries only to find out there were fistulas and new dealer sinuses that the hair started growing into created new areas of abscess
 
Back story: I first got a cyst I think 5 years ago now? It was very mildly uncomfortable but then it popped and/or drained and it was all over within a week. It seemed like a one off weird thing but when it happened a second time, I looked up my symptoms and was fairly sure it was a pilondial cyst. It has now happened three times with a fourth I'm trying to slow/stop right now.

The first three times? They were years apart. This time? Its been a few months at best and I'm worried as I'm working an office job full time from home. I'd get a standing desk, but my knee would probably give out.

I haven't tried tea tree oil, I usually just make sure I wash well and put some coconut oil while its healing (don't want to clog my pores and make it worse by using it too often).

Thing is I haven't seen a doctor about it because it doesn't impact my life until I notice one/i think about it too much. If my case is this mild, should I see a doctor about it or be very concerned about it? The discomfort is so mild all it does is remind me to sit up straight or roll onto my side to sleep, which I prefer anyways. Never popped it myself, never had a bad pop or anything. Just an incredibly small amount of pus drains out and then it heals and is gone again.

I am incredibly lucky to have it be so mild but I am very nervous about what I should do now or if i should be that concerned at all as my default state is panic and I was a fool who read about worst case scenarios haha.
My only advice is, if you do decide to do something about it, DON’T go for an excision (open or closed)—too many horror stories!! I made the mistake of getting a closed excision first, reasoning it was less invasive than the cleft lift. But as far as I can tell, it really is just worse in every way. It wasn’t horribly painful, nor so overdone that I had any issues with a subsequent cleft lift, but it probably would have failed and it was definitely not worth the mental agony of dealing with it repeatedly reopening during healing!

As it sounds your case is mild, I’d probably recommend laser ablation if possible, maybe pit picking if not. There’s nothing wrong with trying a more minor procedure first—in some ways I wish I’d tried traveling to get laser ablation as lots of people seem to have success with it and it seems less extensive. But after a (likely) failed closed excision, the cleft lift with Dr. Immerman also seems to have worked very well for me!! I’m 4 weeks post-op & would def recommend taking the trip to see him if laser ablation/pit picking/etc. aren’t available or don’t work! Healing has been great, pain was minimal and really only kinda bad the 4th day after the numbing stuff he injects wore off, and even then just Tylenol/Motrin did the trick! Surgery was fully paid by insurance (since I’d already had the first excision earlier this year), and travel/food costs were probably around $3,000 for two of us. Which obviously isn’t cheap, but I think it was totally worth it
 
My only advice is, if you do decide to do something about it, DON’T go for an excision (open or closed)—too many horror stories!! I made the mistake of getting a closed excision first, reasoning it was less invasive than the cleft lift. But as far as I can tell, it really is just worse in every way. It wasn’t horribly painful, nor so overdone that I had any issues with a subsequent cleft lift, but it probably would have failed and it was definitely not worth the mental agony of dealing with it repeatedly reopening during healing!

As it sounds your case is mild, I’d probably recommend laser ablation if possible, maybe pit picking if not. There’s nothing wrong with trying a more minor procedure first—in some ways I wish I’d tried traveling to get laser ablation as lots of people seem to have success with it and it seems less extensive. But after a (likely) failed closed excision, the cleft lift with Dr. Immerman also seems to have worked very well for me!! I’m 4 weeks post-op & would def recommend taking the trip to see him if laser ablation/pit picking/etc. aren’t available or don’t work! Healing has been great, pain was minimal and really only kinda bad the 4th day after the numbing stuff he injects wore off, and even then just Tylenol/Motrin did the trick! Surgery was fully paid by insurance (since I’d already had the first excision earlier this year), and travel/food costs were probably around $3,000 for two of us. Which obviously isn’t cheap, but I think it was totally worth it
Do you mind sharing pictures of your cleft lift before and after?
 
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