Pilonidal Care Program

The word “pilonidal” means “hair nest.”  Pilonidal disease is a chronic infection of the skin in the butt crease region. The condition occurs from a reaction to hairs rooted in the skin causing a “nest.” Pilonidal disease is common and can happen to anyone. It most often happens to teenagers. Boys are three to four times more likely to have pilonidal disease than girls are. 

Some things that can increase the chance of getting pilonidal disease include:

  • Having lots of body hair, especially really thick or coarse hair
  • Being overweight
  • Sitting for long periods of time
  • Excessive sweating
  • Family history of pilonidal disease
  • Hormone imbalances
  • Smoking

A person can still get pilonidal disease even if they do not have any of the above things.

Pilonidal disease can happens when hair follicles in the buttock crease become plugged up. The plugged follicles may rupture into the deeper skin, creating a pit in the skin. If infection and irritation under the skin continue a tract, or “pilonidal sinus”, may form. Many people will have more than one tract. Factors that increase the risk of the follicles to become blocked and rupture include:
  • tight clothing
  • sitting for a long time
  • activities hitting the butt area like horseback riding or bicycling

Once a pilonidal sinus is present hair may move into the tract and establish a nest of hair under the skin, called a pilonidal cyst.  The hair may become infected and become a pilonidal abscess.

Learn more about Boston Children's Hospital Pilonidal Care Program.