Pilonidal Disease

What is Pilonidal Disease?

This is a common condition which typically afflicts patients between the ages of 15-45, with men being affected 2-4 times more often than women. Theories to its causes have varied over the years, but the most agreed-upon concept has at its basis the gluteal cleft. As the skin stretches over the cleft with sitting and standing small breaks occur which allow sharp hairs to embed under the skin. The hairs get drawn deeper into the tissue by negative pressure, creating tracts (sinuses or “pits”). These can collect debris and more hair creating a cyst, which can then become infected, creating an abscess. Chronic infection and inflammation can develop, creating persistent drainage and discomfort.

The treatment of pilonidal disease is varied and depends on the severity of presentation. Treatments can include a period of antibiotics, incision and drainage, excision and packing, sinus tract excision (“pit picking”), and rotation flaps (eg the Bascom Cleft Lift). An excellent online resource for patients is the Pilonidal Support Alliance, found here.

Several of our surgeons (Drs. Cowie, Goodwin & Lord) have trained in the Bascom Cleft Lift Procedure with Dr Bascom, and have a lengthy experience in providing this operation to appropriate patients.

We also are the first institution in North America to be able to offer our patients the minimally invasive Endoscopic Pilonidal Sinus Tract Surgery (EPSiT) or as it is otherwise known, Video Assisted Ablation of Pilonidal Sinus (VAAPS).

Pilonidal Surgery for Patients Across Canada

Our surgeons welcome pilonidal disease patients from British Columbia and from every other province and territory in Canada. Here is how to get started:

Patients in British Columbia

Pilonidal surgery for BC residents is covered by MSP. Ask your family doctor or nurse practitioner to send us a referral along with the intake form below, and complete the Pilonidal Patient App before your consultation.

Patients from outside BC — anywhere in Canada

If you live outside British Columbia and are interested in the Bascom cleft lift or minimally invasive pilonidal surgery, you do not need a BC referral — we see out-of-province patients through Clearpoint Health, with surgery performed at an accredited private surgical facility (fees apply). To get started, request an appointment with Dr. Cowie through ClearPoint Health, and complete the Pilonidal Patient App at the same time so your assessment can begin right away. We have helped patients from across Canada get the right operation and get back to their lives.

Pilonidal Disease FAQs

What is a pilonidal cyst?

A pilonidal cyst is a pocket under the skin at the top of the buttock crease that collects hair and debris. It can become infected, causing a painful abscess or ongoing drainage from small openings called pits.

Will a pilonidal cyst heal on its own?

Sometimes an abscess settles with drainage or antibiotics, but the underlying sinus tracts usually persist. Repeated flare-ups, pain, or drainage are good reasons to ask for a surgical assessment.

Which operation is best for pilonidal disease?

There is no single answer for everyone — treatment is matched to your disease. Options range from pit picking and minimally invasive EPSiT/VAAPS to the Bascom cleft lift, which is particularly effective for complex or recurrent disease.

I live outside British Columbia — can I still be treated by your team?

Yes. We regularly operate on patients from across Canada. Request a consultation through ClearPoint Health and complete the Pilonidal Patient App to get started.