Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A pilonidal cyst can be diagnosed by your health-care professional based on your symptoms and the findings on your physical exam. No blood work or imaging studies are usually necessary to make the initial diagnosis.
What is the treatment for a pilonidal cyst?
For those individuals who have a dimple or sinus tract without symptoms and
that has not become infected, no immediate treatment is necessary. However, if
there are any signs or symptoms of an infected pilonidal cyst (pilonidal
abscess), then incision and drainage is necessary. Generally speaking, this
procedure can usually be performed in a physician's office or in an emergency
department with local anesthesia.
Using sterile technique and after placing the patient in the prone
(facedown) position, numb the infected area with an injection of local
anesthetic.
Using a scalpel, make a longitudinal incision into the skin off the
midline, drain the pus, and remove hair and any other debris from the wound.
The wound is packed with ribbon wound packing in order to allow continued
drainage and then dressed and allowed it to heal.
Antibiotics are not necessary unless your physician feels that you have a
spreading skin infection (cellulitis). Pain medication will often be prescribed.
You will then need to follow up with your health-care professional in a timely
manner to ensure proper wound healing and to monitor for any potential
complications. The ribbon wound packing may be removed by your health-care
professional if there is no continued purulent drainage. Otherwise, treatment at
home will consist of pain control, wound care, and cleansing of the wound using
warm shower water or Sitz baths once the packing has been removed. The skin
wound will eventually close and heal on its own, and keeping the area clean and
free of any hair will help prevent the recurrence of pilonidal disease. If you
encounter any signs or symptoms of continued infection, or if the wound fails to
heal, prompt follow-up should be arranged with your health-care professional. In
the majority of cases, the wound heals completely in approximately one month.
For
those individuals with recurrent, complicated, or chronic pilonidal disease, more
invasive surgery may be necessary in an operating room. Several different
surgical techniques may be used, and your surgeon will discuss the various
options with you. In general, the major difference in surgical techniques
involves either leaving the surgical wound open after surgery and allowing it to
heal (requiring a longer healing time but having a lower recurrence rate) versus
closing the surgical wound after debridement during the surgery itself (with a
shorter healing time but higher recurrence rate). Another surgical technique
involves suturing the skin edges of the wound and allowing the open wound to
slowly heal (marsupialization). Healing time and recovery vary based on the
surgical technique used and may range from several weeks to several months.
Finally, the treatment of pilonidal disease using a series of phenol injections
is another alternative to surgery alone, although this option is more commonly
used in Europe than in the United States. Follow-up with your surgeon should be
arranged after your procedure, and meticulous wound care and hygiene are
necessary to ensure proper wound healing and to prevent recurrence.
A boil is a skin abscess, a collection of
pus localized deep in the skin. There are several different types of boils. Among them are the following: furuncle or
carbuncle, Cystic acne, Hidradenitis suppurativa, and Pilonidal cyst.
Cellulitis is an acute spreading bacterial infection below the surface of the skin characterized by redness, warmth, inflammation, and pain. The most common cause of cellulitis is the bacteria Staph (Staphylococcus aureus).
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
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