A Per-cyst-ant Problem

July 6, 2007 1:30 PM

The wonderful world of pilonidal cysts...

A few years ago a pilonidal cyst developed on me. It began to drain, so I had a surgery to close it. This worked for a year, but then it began to drain again, and so another surgery was done. This one seems to have worked, as it's been 2 years and the area looks fine (I have it looked at from time to time).

However, what's driving me nuts is that ever since the beginning, the drainage from the cyst has caused my perineum to itch. Even after the surgeries, when the cyst area was packed and thus couldn't drain, it would itch.

Even now it itches, and I try not to scratch, but it gets unbearable. Sometimes I scratch to the point of bleeding, which I know is stupid, but it gives relief for a little while.

I actually went and saw a dermatologist who said that perhaps that area had become hyper-sensitive during the drainage time and now is "on" all the time. Is there anything I can do? Just use a cream of some sort every day? It doesn't seem like the cyst is draining anymore as I've said, and I'd really like to avoid another surgery if possible. Any ideas?

posted by anonymous to health & fitness (8 answers total)

Dude - I feel your pain. Those things really are a pain in the ass. If I recall, I had a lot more itching before my surgery, when the cyst was growing, and haven't had much since (1.5 yrs)

MY advice is to go back to your doctor and have them check it again to make sure that its not returning. I'm not sure what you mean when you say you had it "closed" For my surgery, they basically cut out all the infected area (not a fun few months afterward). If they just patched up the surface, I'm not sure what that would do for the cyst itself - seems like it would just come back worse later

You really want to stay on top of this and take care of it when it is managable. The surgery is no fun at all, but the longer you leave it, the worse it is. I've talked to guys who have said they have had the surgery four of five times over the years - No thanks if I can help it!

The advice my doctor gave me was to make sure to keep the area really clean and shave it regularly (ingrown hairs are a common cause of occurance/reoccurance).

Also, there appears to be a support site, whete you might find some answers to your specific question
posted by jpdoane at 2:16 PM on July 6, 2007

I, too, dealt with this a few years back. If you can, check with either your physician or your own medical records and tell us what precisely the name of the procedure was. If it was just lanced, for example, or was somehow artificially closed, it could be that you've still got the cyst. If you actually had a complete cut-it-all-out pilonidal cystectomy, then that's not as much of a concern.

As for itching, I wonder if it might be a cleanliness issue, given its proximity to the anus ... skin irritation from detritus in the area following defecation. You might want to take a wet wipe to the perineum following defecation (I think there's some sort of Cottonelle thing for adults) and see if that solves the problem ...
posted by WCityMike at 2:26 PM on July 6, 2007

The Cottonelle thing I was thinking of.
posted by WCityMike at 2:29 PM on July 6, 2007

Some otc hydrocortisone cream (cortaid, etc) should knock the itch out fast. Unless for some reason it is contraindicated for your condition.
posted by vronsky at 4:43 PM on July 6, 2007

'Buttpaste' might be worth trying. With a name like that, it's gotta be good. You can get it at Walmart IIRC.
posted by Heywood Mogroot at 8:09 PM on July 6, 2007

I would very strongly suggest you ask your doctor to prescribe Caipascin ointment, or whatever this preparation is called in the US. It's extracted from chillis and is used on particularly probelmatic scarring where they itch or just regularly drive their owners crazy. Unfortunately not all scarring is neat and wonderful. You can have nerve endings doing funny things. This desensitizes the area over time and I think it could really help you.
I don't know if you're female (you're statistically more likely to be male with this problem) so obviously it can only be applied to the external skin of the perineum. And do wash your hands extra carefully after use ( a good tip a wound care nurse I know tells patients is to apply a little olive oil to the tips of the fingers before you apply the ointment ((same is true of chopping chillies for cooking, just be careful cos it makes the fingers slippy)) then it is easier to wash off anything that might cause problems. Best of luck with it
posted by Wilder at 4:22 AM on July 7, 2007

Probably the only girl to have had this thing, ever. Twice, actually. The recovery is the worst!

Could it be possible that it's the scar tissue that's itching? It might be ultra sensitive since that area can get quite...humid. The itching during the actual recovery and such is normal..and tends to drive one crazy, yup.

Keep it clean and dry - in the summer you can even use breathable women's panty liners, cut and, um, tucked in, if you feel it gets too sweaty (cut it in half, remove the paper from the sticky part, and fold it lenghtwise). And try the ointment, that sounds like a good option.

I'm glad I'm already happily married, I'd never get a date after revealing so much knowledge about this..
posted by Andorinha at 7:07 PM on July 7, 2007

Wow, two butt-cyst questions of one day!

My ex had this problem, I sympathise! You're not the only girl to have ever had this, Andorinha.

She says the itching DOES go away eventually (she had her surgery about 3.5 years ago) but just try and keep it as dry and clean as possible— definitely do not scratch it!

Avoid sweat and body lotion/oily substance in the area as far as possible— you don't want blocked pores. Just keep it clean, and if you notice anything a bit suspicious in that area, get to your doctor fast. Anti-biotics can mean the difference between a "pimple" and an abcess.
posted by indienial at 3:00 AM on July 8, 2007