Limited disease
A few small skin pits or tunnels may require a different strategy than a broad scarred area with multiple openings.
PILONIDAL DISEASE · LOS ANGELES
Pilonidal disease is common. Recurrent disease deserves a better plan than repeated flare-ups.
Dr. Michael A. Zadeh treats pilonidal cysts, painful infected pockets (abscesses), small draining tunnels in the skin, and pilonidal disease that keeps returning. Treatment depends on whether the immediate problem is an active infection, an ongoing condition, or recurrence after prior procedures.
UNDERSTANDING PILONIDAL DISEASE
The problem develops in the cleft above the tailbone, but the way it behaves varies from patient to patient.
Pilonidal disease can appear as small skin pits with no symptoms, ongoing drainage, repeated inflammation, or a painful pocket of infection called an abscess. Hair, friction, the depth and shape of the cleft, and local skin conditions can contribute to the problem.
PAINFUL ABSCESS
When there is a painful abscess, the immediate priority is controlling the infection and pressure.
A tense, tender pocket of infection may require drainage. Antibiotics alone do not reliably empty a collection of pus when a true abscess is present.
Treatment intended to prevent future episodes may be discussed after the sudden inflammation has settled, particularly when infections keep returning.
Prompt evaluation is appropriate for rapidly worsening pain, spreading redness, fever, or a suspected abscess.
ONGOING AND RECURRING DISEASE
Repeated drainage is not the same thing as resolving the disease.
Patients with repeated swelling, drainage, small skin openings or tunnels, or prior failed procedures may benefit from a discussion about surgery intended to prevent future episodes rather than treating each episode as an isolated event.
Recurrent disease
Prior incisions, scar tissue, persistent midline openings, and recurrent infection can change the surgical plan.
Shape of the area
The depth and shape of the cleft, location of openings, and amount of affected tissue all matter when choosing an operation.
SURGERY TO PREVENT RECURRENCE
The operation should be tailored to the extent and pattern of disease.
There is no single operation that is right for every patient with pilonidal disease. The choice depends on whether this is the first episode or a returning problem, how much tissue is involved, prior treatments, wound-healing considerations, and the patient’s goals.
The discussion should include the expected wound, time away from work or exercise, the chance of the problem returning, and the tradeoffs of the available approaches.
RECOVERY
Recovery is part of choosing the operation.
Wound care, sitting, driving, exercise, work, hair control, and follow-up vary depending on the procedure. These expectations should be clear before surgery rather than discovered afterward.
PILONIDAL SURGEON IN SHERMAN OAKS
Pilonidal care for patients across Los Angeles and the San Fernando Valley.
Dr. Michael A. Zadeh evaluates painful pilonidal abscesses, ongoing drainage, and pilonidal disease that has returned after prior treatment at Zadeh Surgical in Sherman Oaks. The plan addresses both the immediate problem and, when appropriate, how to reduce future episodes.
Convenient for patients in: Sherman Oaks, Encino, Studio City, Tarzana, Van Nuys, and surrounding Los Angeles communities
FREQUENTLY ASKED QUESTIONS
Common questions about pilonidal disease.
Is a pilonidal cyst the same as an abscess?
Pilonidal disease can exist without an active abscess. An abscess is a painful pocket of infection that usually causes increasing pain, swelling, and tenderness.
Can antibiotics cure a pilonidal abscess?
Antibiotics may be useful in selected situations, but a true abscess often requires drainage because antibiotics do not reliably empty the infected collection.
Why does pilonidal disease come back?
The problem can return because of persistent skin pits or tunnels, the depth and shape of the cleft, hair and friction, wound-healing issues, and the type of prior treatment. Recurrent disease deserves a fresh evaluation rather than assuming the next operation should simply repeat the last one.
PILONIDAL CONSULTATION · SHERMAN OAKS
If the same pilonidal problem keeps coming back, it is worth discussing a long-term plan.
14658 Ventura Blvd, Sherman Oaks, CA 91403 · (818) 789-1111