Pilonidal P.I.T.A?

January 26, 2008 8:06 PM

Recurring pilonidal cyst?

I know there are a lot of posts on pilonidal cysts; I've read many of them in hopes of finding an answer to my situation. Alas, another question posted.

I had a pilonidal cyst taken care of this past summer. I was lucky enough to not require anything more than the outpatient treatment of lancing and draining, but it was still something that set me back 300 bucks, a couple days of work, and was definitely one of my more painful experiences, despite the local anesthetic. I recovered with the aide of some Percocet, an overnight of wound packing (and removal which nearly had me on the floor out cold) and cleared my follow up doc exams, with him only having to reopen the wound once to drain build up.

It is now almost February. I'm a recent grad living paycheck to paycheck as a freelance artist in Brooklyn and lacking insurance (graduation = bye bye Mom & Dad's benefits). My cyst has come back twice, though both times considerably smaller than the first incident, and considerably less painful and disabling. The first return it popped on its own; I was actually unaware of it for the most part until it did so. This second time I did the deed. Good sign - little to no puss. Bad sign - it keeps coming back.

It's as if the area won't fill in with new and healthy tissue, like it's a reservoir that decides to act up every once and a while. It doesn't hurt nearly as bad as the very first time I developed the cyst, but it's still uncomfortable and has definitely fulfilled the "there's a 60% chance this will return" line that I got at the doctor's office.

I know it needs to heal from the inside out, but what else can I do? How do I keep it open, and what can I use to help my bum heal? I've started using Bactine everytime I use the restroom again (I did it the 2nd time I developed the cyst), and it seems to aide healing, but clearly the cyst has come back.

How do you make this thing heal for good? Or does this just become one of those lifelong things you learn to deal with? I've read things from people who've had the major surgery and still have issues, so that doesn't necessarily seem to be the answer either.

Any ideas fellow MeFites?

Take care and thanks for any info!

posted by PaintMeRed9 to health & fitness (5 comments total)

Have you already found the Pilonidal Support Alliance? Their "Living with it" section seems pretty thorough, and has some items you haven't mentioned in your post.
posted by amtho at 8:51 PM on January 26, 2008

Thanks!
posted by PaintMeRed9 at 8:58 AM on January 27, 2008

When I had the surgery, my wife repacked my wound twice a day until it healed (about a month). This was not a pleasant experience, and I have no idea what I would have done if I lived alone - this is not something you could do yourself. However, because the doc cut away all the infected tissue during the surgery, and it healed from the inside out because of the packing, I haven't had it come back.

Is there anybody around you that would be willing to repack you on a daily basis? Even if you don't get the surgery and just get it lanced the next time, you should still pack it until it completely heals, if possible.

Talk to your doctor.
posted by jpdoane at 9:49 PM on January 27, 2008

Both instances since the lancing have been smaller and manageable (almost like dealing with, disgustingly so, a large pimple) just annoying at this point. I've taken care of it each time time, and now it's starting to close up again. Maybe the whole lancing process just isn't effective long term because all it really does is drain the infection and not really remove any infected tissue and so it lies dormant and flares up whenever it feels like it. Thankfully it only seems to happen once every few months, though clearly ideally would be never again.

The Pilonidal Support Alliance link (above) has been really helpful and I'm following some of the steps they outline to see if they'll make a difference.
posted by PaintMeRed9 at 9:10 AM on January 28, 2008

How do you make this thing heal for good?

As someone who also had the same problem, I would recommend the more major surgery. My cyst was excised, and thus far — several years later — it has not come back. Please feel free to shoot me an e-mail if I can be of any help.
posted by WCityMike at 6:57 PM on January 28, 2008