Colorectal surgeon Dr. Mari Madsen from Cedars Sinai Medical Center in Los Angeles, California explains the cause and cures of pilonidal cysts.
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Pilonidal Cyst: Causes and Cures Dr. Travis Stork: And our next eek factor is one that can cause quite a bit of pain, and it isn’t very pretty. I'm talking about pilonidal cyst. And joining us via Polycam to talk about what she calls her own little buddy is Jody from Tarpon Springs, Florida. So, Jody, first things first, how long have you had your “little buddy”. Jody: Since puberty. Dr. Travis Stork: How is it acting up right now? Jody: Currently, it’s sleeping, and I work really hard to keep it that way. Dr. Travis Stork: So, do you do -- ever do anything to baby it? Jody: All the time. The list is long. A few of them are the blue jeans that I wear. I never flop down on any piece of furniture, the car that I buy, auditorium seats, I have to make adjustments for that. Probably, the biggest offender that’s caused me the most grief are the handrails inside of elevators. I now stand my ground in the center. Dr. Travis Stork: That’s a great point. So, here to help us explain the various treatments for pilonidal cyst is Colorectal Surgeon Dr. Mari Madsen from Cedars Sinai Medical Center. Welcome to the show. Dr. Mari Madsen: Thank you. Dr. Travis Stork: Let's explain what a pilonidal cyst is. Dr. Mari Madsen: It’s literally hair that has been -- it’s not actually an ingrown here but it’s hair that has been pushed back into the gluteal cleft, and it gets forced underneath the skin and thus, more and more hair nest underneath the skin. Eventually, it forms a cyst which potentially gets infected. Dr. Travis Stork: As you can see there, sitting in a certain position, leaning up against the railing can cause a significant amount of pain, a lot of different options and some, not as pleasant as others. Dr. Mari Madsen: Certainly, most of the time when people come to a position for the first time with this issue, it’s because it’s become infected or abscessed. And so it will become acutely painful. If it’s allowed to grasp for long enough, people will notice puss or blood coming from that area. And oftentimes, it may need to be drained the acute setting, and that would usually be the first round of treatment of someone who are to come in with an abscess. Dr. Travis Stork: And those abscess is you get really big, and speaking of an eek factor, well, just to be honest on the show, draining the pilonidal cyst is right up there with -- Dr. Jim Sears: Its’ up there. Dr. Travis Stork: It would be affected. Dr. Jim Sears: Probably one of the worse things I have to deal with. Dr. Travis Stork: I'm pleasant. It’s something that gathers in there. Dr. Lisa Masterson: Yeah. Dr. Travis Stork: And, the problem is once you have a pilonidal cyst -- we were just talking with Jody who’s had it since puberty, you have that and less you do something more significant, right. Dr. Mari Madsen: There are many authorities who believe that pilonidal disease, after perhaps 10 years or so can oftentimes burn itself out. Of course, there are people like Jody who unfortunately this is a chronic problem that can go on for many, many years. Some of the conservative things that people can do to manage the disease is trying to keep the area free of hair. Hygiene also plays an important role but if it doesn’t improve then oftentimes, surgery becomes an option that people must pursue. Dr. Travis Stork: So take home point, Jody sounds like something you’ve been very cognizant of steps that you need to take in your daily life to keep your “little buddy” sleeping. Jody: Yup. That’s right. Dr. Travis Stork: So, we want to thank you for sharing your story and helping to explain along with Dr. Madsen to everyone what a pilonidal cyst is. We appreciate it. Thank you both.