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Skin irritated above abscess/cyst

Entchen

Chief Dandelion Picker
Hi: I am awaiting results of a recent MRI; we are not sure whether I have a fistula or a pilonidal sinus. Either way, the "hole" has not been too uncomfortable -- some swelling, lots of drainage, that's mainly it. This morning, however, I discovered that the skin about 1 inch above the "hole" (dead centre in the perianal region, toward the tailbone) is very irritated. Specifically, it is red and looks like there are a series of shallow cuts in the skin. Do you think the area is simply irritated from the nearby drainage, or that maybe something else is now happening as a result of the abscess/sinus? Do you think I'm safe to try a little cortisone on the irritated area?

Thanks for the input! I'll be talking about it with my GI when he calls with the MRI results but am curious *now!*
 
Oh, I so know where you're coming from with this! I have the exact same issue. I was diagnosed with a pilonidal sinus at 17, went through 4 unsuccessful surgeries between 17 and 26, and was diagnosed with Crohn's on my 28th birthday. After the Crohn's diagnosis, the doctors started thinking that what they thought was a pilonidal sinus was a fistula all along! I've had setons put in and replaced over the past 3 years, but it's never really healed and my surgeon seems to think it's one of those things I'll just have to live with.

Anyway, the skin around the hole does tend to get irritated from time to time. The drainage seems to increase when my Crohn's is more active, and can be almost dormant when I'm in remission. I try to keep a gauze pad over the area (depending on location, you may or may not be able to do this) to help absorb any moisture from the drainage. Some days if it's not really draining I leave the pad off just to let some air get to the area. Also, if any drainage is going into your "crack," you can use diaper cream to help soothe the skin. I know it sounds funny, but it really helps! Just get the unscented kind.

I hope you get some answers from the MRI and you find something that works for you....I know these fistulae/pilonial sinuses can literally be a pain in the butt!

Beth
 

Entchen

Chief Dandelion Picker
Beth, your note was *so* informative and gave just the info that I was looking for. Thank you!

I'll get right on the diaper cream and gauze pads.

I was surprised because the irritation isn't directly at the site of the opening, but it is in an area where the moisture would, ahem, gather. And there has been much more drainage this week than usual.

Huge weight off my shoulders knowing this could well be simple irritation and not another abscess popping up.

:hug:
 
I know on all of my cortisone creme it has warnings that read; "external only". I read a lot about cortisone creme and it can cause a lot of issues if it gets in to your blood stream. They warned me not to put it on open sores.
Sounds like it is really sore. Hope the diaper creme works and that its not another abscess.
 

Entchen

Chief Dandelion Picker
That's good to know about the cortisone! My concern was that I'd read it can thin the skin (not good when your skin is already splitting?) but your reason is an even better one to avoid it here.

Yes, it is very sore, but I've already tried the diaper cream and it has soothed things already. Calmoseptine this morning did not help, but the diaper cream is.

Thanks for the well wishes. :)
 
I know this was a long time ago, but I'd try contacting Dr Sternberg in California. He sits on the CCFA board and is a pilonidal specialist.
 
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