Phenol Treatment for Pilonidal Cysts
Allen Kamrava, MD, MBA, FACS, FASCRS· Board-certified in Colon & Rectal Surgery and General Surgery· Published · Reviewed
- Setting
- In office
- Anesthesia
- Local anesthetic
If you have Pilonidal Cysts and are looking for a procedure with advantages such as minimal invasiveness, no anesthesia, no downtime, and minimal scar tissue formation, then Phenol Treatment is a great choice of treatment for you. What’s better, is that the procedure is performed right in the physician’s office.
Dr. Kamrava’s years of experience in colorectal conditions have given him knowledge regarding the advanced techniques in treating such conditions.
What is Phenol Treatment for Pilonidal Cysts?
Crystallized phenol liquifies when placed in the pilonidal sinus. It irritates the inner wall of the pilonidal sinus cavity, forcing a reaction that leads to the sinus scarring and closure of the cavity. This procedure has important advantages as it does not require you to undergo anesthesia in an operating room.Q: When is it used?
A: Liquid or crystallized phenol injections have been used for the treatment of mild to moderate pilonidal cysts and for patients seeking minimally invasive treatment options.Q: How successful is it?
A: A one-time application has a 64.5% cure rate, and the rate of success approaches 95% with two or more applications.Q: Is it painful?
A: Most patients report a mild burning sensation that subsides within a day, and requires no pain medications.Q: How many treatments does it typically take?
A: The average number of treatments at different times is 2-3, though some patients will require more. Some patients only require 1 treatment.Q: What is the treatment like?
A: Treatment will be in Dr. Kamrava’s medical office. The pit is widened with a sterile clamp, and the hair and debris that are in the cavity are cleared out. Dr. Kamrava will then place phenol crystals into the wound which will liquify and irritate the surrounding tissue, initiating the healing cycle.Q: What is the recovery time?
A: Most patients are back at work the same day or the day after.Q: Complications to consider?
A: The most frequent adverse event is irritation to the surrounding skin by the phenol liquid that drains out. Typically irritation is well managed with the simple application of antibiotic ointments.How it's done
- 1Numbing — the area is numbed with local anesthetic in the office. No operating room, no general anesthesia.
- 2Cleaning — the sinus opening is gently widened and the hair and debris inside are cleared out.
- 3Phenol — crystallized phenol is placed into the tract. It liquefies and irritates the lining, prompting the tract to scar closed from the inside.
- 4Home — you leave the same day with a small dressing.
- 5Repeat if needed — one to four applications is typical before the sinus fully closes.
What to expect
Same day
Home shortly after the application — the visit itself is brief.
First days
A mild burning or irritated feeling at the site is common, along with some drainage. The surrounding skin can be irritated by phenol draining out; a simple protective ointment usually settles it.
Following weeks
The tract scars closed from the inside. One application is sometimes enough — in a published series, a single treatment cured about 2 in 3 patients (64.5%); with two or more applications, success rose to 95% (about 19 in 20).
Follow-up
A visit to confirm the sinus has closed.
Sources
- Johnson EK, Vogel JD, Cowan ML, Feingold DL. The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease. Diseases of the Colon & Rectum. 2019;62(2):146–157.
- Girgin M, Kanat BH. The results of a one-time crystallized phenol application for pilonidal sinus disease. Indian Journal of Surgery. 2014;76(1):17–20.
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