published Thursday, August 28th, 2014

Ask a doctor: Treating a chronic buttock crease skin infection

Dr. Shauna Lorenzo-Rivero

Q: There is a bump where my buttocks cheeks meet; it's occasionally is sore and drains. What is this, and how is it treated?

A: A pilonidal cyst is a chronic infection of the skin of the buttock crease. It is caused by a reaction to hair and is more common in men between puberty and age 40, obesity and those with thick body hair. Symptoms vary from a small dimple to a large painful mass which may drain fluid. Nearly all patients have an abscess or boil. After the abscess resolves, a small channel may develop. Most patients need an operation to eliminate this or it will continue to flare. To prevent flares, the skin in this area must be kept free of hair by using a razor or a hair removal cream every two weeks. Treatment depends on severity. An abscess is managed with drainage, which can be performed in the doctor's office with local anesthesia. A chronic channel usually requires an operation, and there are several types available to resolve the problem.

— Dr. Shauna Lorenzo-Rivero; member, Chattanooga-Hamilton County Medical Society

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