Pilonidal Disease

Pilonidal disease is a disease of young people, usually men, which can result in an abscess, draining sinus tracts, and moderate debility for some. It probably results from hair penetration beneath the skin, for reasons that are not totally clear. Therapy should be simple, inflict minimal pain, have a short hospitalization, have a low recurrence rate, require minimal wound care, and allow rapid return to normal activity. No treatment meets all these ideal goals. Therefore, starting with a simple treatment and progressing to other treatments if failure occurs despite meticulous wound care and hair shaving is the logical approach. Table 1 depicts treatments from simple to more complex.