Q: I have a sore spot that comes and goes where my buttocks meet. What could this be?
A: This is most likely a pilonidal cyst, a chronic infection of the skin that’s caused by a reaction to hairs embedded in the skin. It is more common in men, those who are obese or have thick, stiff body hair, and frequently occurs between puberty and age 40. Symptoms vary from a small dimple to a large, painful mass. Often the area will drain fluid. With infection, the area becomes red, tender and may drain pus. After the abscess resolves, either by itself or with medical assistance, many patients develop a pilonidal sinus, a cavity below the skin surface that connects to the surface with one or more small openings or tracts, like a tunnel. Most patients need a small operation to eliminate them. After healing, the skin in the buttocks crease must be kept clean and free of hair. The good news is that, after age 30, the hair shaft thins, becomes softer and the buttock cleft becomes less deep.
— Dr. Shauna Lorenzo-Rivero, University Surgical Associates; member, Chattanooga-Hamilton County Medical Society
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