Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
145 Doctors are Online

Pilonidal cysts and their treatment - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Constipation
Answered by

General & Family Physician
Practicing since : 2009
Answered : 674 Questions
User :   I have delicate skin between my buttocks above my my rectum. I sometimes get these small tears in that cleft and try not to wipe hard as to not further irritate. Recently within the last week, I have noticed that I felt another tear and am not sure why this one is not healing as quickly as they normally have. The tear appeared after a bout with hemmrhoids and my menstrual cycle. What is this and what can I do to help expedite the healing process? I sat in a warm epson salt bath tonight and I feel some better ( not as much itching).
User :   Hi
User :   Hello.
User :   Where exactly are these tears noticed?
User :   Is it close to the anus or is it seen at the clefts where two buttocks meet?
User :   Above my rectum almost to the top of my clefts.
User :   Ok
User :   Do you notice any kind of lump or swelling there?
User :   Is there a discharge from it?
User :   No. nothing like that. I have noticed in the past that when I wipe too hard or am experiencing excessive moisture due to hemmrhoids or cycle that I sometimes have this problem. This time there is a slight discharge since it is a larger lesion.
User :   Ok
User :   Is it occurring exactly at the same location every time?
User :   Are you there?
User :   Not really, but close. I have had to use preparation H this past weekend because of the swelling and I thought that I allowed that to go too long before treating and I didn't know if it was related or not or if the moisture aggrevated me. The tears are usually above between the clefts but never this irritating. I have some 2% hydrocordisone that I tried tonight once I got out of the bath.
User :   Ok
User :   May I know your age?
User :   Do you have diabetes?
User :   42
User :   Not that I am aware of. My mother was diebetic and recently passed from metasticising breast cancer. Diabetes does run in my family, but every time I have been tested, it has been negative. I normally have really good numbers when my blood work is done. I am about 50 pounds overweight though.
User :   Ok
User :   Let me brief you.
User :   ok
User :   ok
User :   Based on your description and the location of the lesion, its unlikely that it is related to hemorrhoids.
User :   I do have hypothyroidism though.
User :   The symptoms are suggestive of pilonidal cyst.
User :   What is that?
User :   This is not a serious condition, however, this can be recurrent and chronic in nature.
User :   What do I do to help reduce or eliminate the problem?
User :   Pilonidal cyst is a lump/swelling that arises at the areas of excessive moisture and probably due to presence of hairs.
User :   They are commonly located at the buttock clefts, thanks to the moistures with or without presence of hairs.
User :   They cause problems if they get infected.
User :   What type of problems?
User :   Infection rates are higher, if one tries to manipulate them.
User :   Let me suggest you the measures that you can follow
User :   So, the bath I took tonight in epson salt and the 2% hydrocordisone may have caused more prpoblems?
User :   ?
User :   Saline water baths are fine, however, I would not recommend you to use the steroid creams further.
User :   Ok
User :   Saline water sit baths will help in controlling the inflammation and reduce the discomfort.
User :   What can I do to help the healing process and to prevent?
User :   The other measures that you will need are
User :   1. Remove if there are excessive hairs around the affected region.
User :   You can get some depilatory creams and remove the hairs.
User :   Do I have to see a doctor in the office for the creams or can those be obtained from the pharmacy over the counter?
User :   2. Use antibiotic creams such as silverex/Polysporin Creams can be used instead of steroid applicantsto prevent infections
User :   Do I need oral antibiotics?
User :   3. Use other measures to control the moisture. Simple talcum powder should help in this.
User :   4. Oral antibiotics will be needed if the lesions is getting bigger or if you notice pus discharge/or develop symptoms of fever.
User :   As mentioned earlier, this can be a recurring condition,
User :   Why is this?
User :   The recurrence is common due to excessive sweating, presence of hair and moisture.
User :   Regular depilation of hairs, use of talcum powders will prevent the pilonidal cysts.
User :   You should also avoid sitting for a long time at a single place.
User :   This condition most often can be treated by conservative measures as explained to you.
User :   Oh, ok. I am not a very hairy person. I teach school so I do stand quite a bit until I get home. I have the moisture due to the medication I use at times from the hemmrhoids and once a month during cycle time.
User :   Occasionally you may need oral antibiotics, if the local measures doesn't cure the symptoms.
User :   On few occasions, when nothing is helping, then surgical incision of the cyst is the treatment then.
User :   Let me summarize the things that I have said.
User :   How do I know that I am or am not a candidate for a surgical solution?
User :   1. Use talcum powders and control the moisture
User :   2. Continue with the saline water sit baths
User :   3. Use local antibiotic creams(topical silverex creams or polysporin creams to be applied at the affected region
User :   4. Avoid handling the lesions with bare fingers.
User :   5. Avoid sitting constantly for a long time
User :   6. If the symptoms are not controlled with topical creams or if find any of these symptoms- increase in the size of lesions, presence of pus discharge, aggravating pain or discomfort, fever, then you will need oral antibiotics.
User :   If you develop these symptoms, consult a doctor who will prescribe you with the oral antibiotics.
User :   7. If the conservative measures(as suggested above) are not helping,
User :   then you will need surgical procedure.
User :   Have you followed what I have suggested?
User :   Do you have any other query?
User :   It seems you have moved out of the chat window. Please log in back if you have medical queries
User :   I ran out of time.
Doctor :   Dr XXXXXXXX here
User :   I understand the steps that you are outlining. I just wanted to make sure that if I needed to get oral medication that I did that ASAP.
Doctor :   I think You need to visit a general surgeon or a proctologist for a physical examination
Doctor :   We cannot acurately diagose Your condition without physicaly examining You nor can we offer You any medications
User :   Is this to determine if I need surgery?
Doctor :   Yes
Doctor :   Also he may be able to suggest certain investigationa and a line of treatment
User :   I do understand.
Doctor :   I think You should avoid straining
Doctor :   When passing stool
Doctor :   Avoid constipation
User :   Should I still go ahead and get the oral meds or just use the topical first and see what happens? Also, should I be taking the salt baths more than once a day?
Doctor :   You can do thin by taking a mild laxatibve at noght probably some isapghol powder disolved in water
Doctor :   keep the area clean and dry to avoid infection and do visit a proctologist or general surgeon without fail
User :   Do I find that powder in the pharmacy or health food store?
User :   May I ask a different question since I have a little time remaining?
Doctor :   I think You should see a proctologist
Doctor :   yes
Doctor :   yes
Doctor :   Ok do see a general surgeon without fail for physical examination .do not attempt to treat Yourself
User :   I will locate one locally. I have recently relocated and my general practicioner is about 50 miles away. I will go online tonight to try to locate one to contact tomorrow to set up an appointment.
Doctor :   Ok where zare You located/
User :   I have been diagnosed with hypothyroidism since October 2003. I seem to have been having difficulty with weight ever since. I never had weight issues before that and it has been quite taxing to find something to help me with reducing my weight. I am in
Doctor :   Ok
User :   I have tried naturalpathy to regulate my temperature as well as try to jump start my thyroid. I changed from taking synthroid to taking armour thyroid. I tried taking T3 with the synthroid and it seems to be very difficult to get regulated and leveled out with my weight and energy level. I am not a bit eater and never have been.
Doctor :   Ok
Doctor :   People with thyroid problems are prone to weight or weight loss
User :   I also need to find a good endocrinologist in the area because my general practicioner was the one who prescribed my thyroid meds.
Doctor :   Ok
Doctor :   I am not familiar with the doctors in your area
Doctor :   so i am afraid that I cannot help you out
User :   So, is there nothing that can be done or prescribed to help me drop some of the weight? I have attended boot camp for women, gone to bariatrics (with some success that didn't last once I stopped with the foods), and tried a variety of other methods. I would like to know if iodine or iodide is something that I should be using to help my meds absorb better?
Doctor :   I think Your endocrinologist will be able to help You best in this regard
User :   Not a problem about the doctors. I will ask a few people on this end and research on line.
Doctor :   Hope You have understood
User :   Thanks.
Doctor :   Is there anything else I can help You with?
User :   No, thank you for your help. Good night.
Doctor :   Bye for now
Question is related to
Diseases and Conditions
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor